The objective of this study was to compare Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in evaluation of patients with hydronephrosis on ultrasonography. 49 patients of hydronephrosis on USG w...The objective of this study was to compare Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in evaluation of patients with hydronephrosis on ultrasonography. 49 patients of hydronephrosis on USG were enrolled for the study from Jan. 2011 to Dec. 2012. All patients under went Intravenous Urography (IVU). MRU was done to determine the anatomical details and function of each renal unit. MRU was performed on a 1.5 tesla unit (Magneton Avento;Siemens, Erlangen, Germany). Static T2-weighted Magnetic Resonance Urography (MRU) was performed by using a standard fast spin echo technique. Dynamic study was performed after injecting intravenous diuretic followed by Gadolinium contrast media. Morphological results of MRU were compared with IVU. The anatomical findings were compared with operative findings. Stastical analysis was performed and data expressed as mean ± SD. MRU showed PUJ obstruction in 41 out of 45 patients (91.1%). We concluded that MRU can provide complete diagnostic evaluation of entire urinary tract in a single session and has potential to replace IVP.展开更多
Objective To observe the imaging findings of congenital megaureter in order to enhance the understanding of this disease. Methods Image data of 5 patients with congenital megaureter and 2 misdiagnosed patients were a...Objective To observe the imaging findings of congenital megaureter in order to enhance the understanding of this disease. Methods Image data of 5 patients with congenital megaureter and 2 misdiagnosed patients were analyzed, and image findings of congenital megaureter were summarized. Elscint Prestig 2.0T superconductive magnetic resonance urography （MRLI） with conventional sequence （spin-echo, T 1W1560 ms/16 ms; fast spin-echo, T2WI 9600 ms/96 ms） was performed. Raw data were acquired with fast spin-echo sequence from heavy T2-weighted image （9600 ms/120 ms）. Post-processing method of MRH was the maximum in- tensity projection with three-dimensional reconstruction in the workstation. Intravenous pyelography （IVP） was conducted, in which X-ray films were taken 7 minutes, 15 minutes, and 30 minutes after injecting contrast agent, except that in 2 patients the films were taken delayed at 60 and 90 minutes. X-ray retrograde pyelography was performed on 2 patients, successful in one but failed in the other. Results The dilated ureter showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images in conventional MRI. The mass wall was intact, uniform in thickness, and showing hy- pointensity on Tl-weighted and T2-weighted images. The MRH images showed a retroperitoneal mass appearing as an elongated tubular cystic structure spreading from kidney to bladder. MRLI also revealed dilated calices and renal pelvis, pelviureteric obstruction, and renal duplication. The main signs of congenital megaureter in X-urography was significant dilatation of ureter, or normal renal pelvis with ureter dilatation, hydronephrosis, deformity, and displacement. Conclusions MRH with X-urography could visualize the characteristics of congenital megaureter, including the dilation of renal pelvis and ureter, calculi, urinary tract duplication, and stenosis location. The two techniques can complement each other in disease diagnosis and provide more detailed information for preoperative treatment.展开更多
Background Transitional cell carcinoma of the upper urinary tract （UUT-TCC） accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC ...Background Transitional cell carcinoma of the upper urinary tract （UUT-TCC） accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC to all urothelial tumours may be 26%, which is higher than that in the western world. The early diagnosis of UUT-TCC is difficult and the present study elucidates the diagnostic value of poor or nonvisualization （PNV） in intravenous urography in patients with UUT-TCC and its correlations with pathological findings and clinical characteristics. Methods The data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC who underwent nephroureterectomy in our departments were selected and analyzed retrospectively. Results Of our sample, 144 cases presented with gross haematuria （83.7%） and 12 with microscopic haematuria （7.0%）. Forty-six cases （26.7%） were detectable by cytology. Filling defect identified 36 positive cases of 172 patients （20.9%）, PNV was present in the images of 105 of 172 patients （61.0%）. The detection rate by PNV （61.0%） was significantly different from that by cytology （26.7%） or by filling defect （20.9%） （P=-0.031, P=-0.001, respectively）. Univariate logistic regression analysis for PNV showed that tumour stage, grade and size were significant predictors （P=0.028; P=-0.031; P=-0.006, respectively）. Tumour stage and size were identified as independent risk factors in the multivariate logistic regression model （P=-0.042; P=-0.014）.Conclusions Except for suspected urolithiasis, urinary tuberculosis or congenital abnormalities, UUT-TCC should be considered if PNV exists in intravenous urography especially of old patients. The value of PNV is much more significant than filling defect in intravenous urography in the diagnosis of UUT-TCC. It is supposed that PNV carries more risk of higher stage and larger tumour size in UTT-TCC.展开更多
文摘The objective of this study was to compare Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in evaluation of patients with hydronephrosis on ultrasonography. 49 patients of hydronephrosis on USG were enrolled for the study from Jan. 2011 to Dec. 2012. All patients under went Intravenous Urography (IVU). MRU was done to determine the anatomical details and function of each renal unit. MRU was performed on a 1.5 tesla unit (Magneton Avento;Siemens, Erlangen, Germany). Static T2-weighted Magnetic Resonance Urography (MRU) was performed by using a standard fast spin echo technique. Dynamic study was performed after injecting intravenous diuretic followed by Gadolinium contrast media. Morphological results of MRU were compared with IVU. The anatomical findings were compared with operative findings. Stastical analysis was performed and data expressed as mean ± SD. MRU showed PUJ obstruction in 41 out of 45 patients (91.1%). We concluded that MRU can provide complete diagnostic evaluation of entire urinary tract in a single session and has potential to replace IVP.
文摘Objective To observe the imaging findings of congenital megaureter in order to enhance the understanding of this disease. Methods Image data of 5 patients with congenital megaureter and 2 misdiagnosed patients were analyzed, and image findings of congenital megaureter were summarized. Elscint Prestig 2.0T superconductive magnetic resonance urography （MRLI） with conventional sequence （spin-echo, T 1W1560 ms/16 ms; fast spin-echo, T2WI 9600 ms/96 ms） was performed. Raw data were acquired with fast spin-echo sequence from heavy T2-weighted image （9600 ms/120 ms）. Post-processing method of MRH was the maximum in- tensity projection with three-dimensional reconstruction in the workstation. Intravenous pyelography （IVP） was conducted, in which X-ray films were taken 7 minutes, 15 minutes, and 30 minutes after injecting contrast agent, except that in 2 patients the films were taken delayed at 60 and 90 minutes. X-ray retrograde pyelography was performed on 2 patients, successful in one but failed in the other. Results The dilated ureter showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images in conventional MRI. The mass wall was intact, uniform in thickness, and showing hy- pointensity on Tl-weighted and T2-weighted images. The MRH images showed a retroperitoneal mass appearing as an elongated tubular cystic structure spreading from kidney to bladder. MRLI also revealed dilated calices and renal pelvis, pelviureteric obstruction, and renal duplication. The main signs of congenital megaureter in X-urography was significant dilatation of ureter, or normal renal pelvis with ureter dilatation, hydronephrosis, deformity, and displacement. Conclusions MRH with X-urography could visualize the characteristics of congenital megaureter, including the dilation of renal pelvis and ureter, calculi, urinary tract duplication, and stenosis location. The two techniques can complement each other in disease diagnosis and provide more detailed information for preoperative treatment.
文摘Background Transitional cell carcinoma of the upper urinary tract （UUT-TCC） accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC to all urothelial tumours may be 26%, which is higher than that in the western world. The early diagnosis of UUT-TCC is difficult and the present study elucidates the diagnostic value of poor or nonvisualization （PNV） in intravenous urography in patients with UUT-TCC and its correlations with pathological findings and clinical characteristics. Methods The data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC who underwent nephroureterectomy in our departments were selected and analyzed retrospectively. Results Of our sample, 144 cases presented with gross haematuria （83.7%） and 12 with microscopic haematuria （7.0%）. Forty-six cases （26.7%） were detectable by cytology. Filling defect identified 36 positive cases of 172 patients （20.9%）, PNV was present in the images of 105 of 172 patients （61.0%）. The detection rate by PNV （61.0%） was significantly different from that by cytology （26.7%） or by filling defect （20.9%） （P=-0.031, P=-0.001, respectively）. Univariate logistic regression analysis for PNV showed that tumour stage, grade and size were significant predictors （P=0.028; P=-0.031; P=-0.006, respectively）. Tumour stage and size were identified as independent risk factors in the multivariate logistic regression model （P=-0.042; P=-0.014）.Conclusions Except for suspected urolithiasis, urinary tuberculosis or congenital abnormalities, UUT-TCC should be considered if PNV exists in intravenous urography especially of old patients. The value of PNV is much more significant than filling defect in intravenous urography in the diagnosis of UUT-TCC. It is supposed that PNV carries more risk of higher stage and larger tumour size in UTT-TCC.
