Abstract
The purpose of this study was to assess the value of the fast imaging sequence called RARE (rapid acquisition with relaxation enhancement) MR urography (or RMU) In pregnant women with painful ureterohydronephrosis. A total of 17 pregnant women with an acute flank pain were examined with RMU. Results were compared with those of US, X-rays and the evolution of symptoms. The gold standard techniques used to evaluate the results of MR urography were US when it showed the entire dilated urinary tract and the nature of the obstruction (9 cases), limited intravenous urography (IVU) when performed (3 cases) or endoscopic procedure (5 cases). The accuracy of RMU in the detection of urinary tract dilatation and the localization of the level of obstruction was excellent (sensitivity 100% in our series). The determination of the type of obstruction, intrinsic vs extrinsic, was always exact. The RMU technique alone could not specify the exact nature of the obstruction. The RMU technique is able to differentiate a physiological from a pathological ureterohydronephrosis during pregnancy. It could be considered as the procedure of choice when US failed to establish the differential diagnosis.
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References
Swartz HM, Reichling BA (1978) Hazards of radiation exposure for pregnant women. JAMA 239: 1907–1911.
Webb JAW (1990) Ultrasonography in the diagnosis of renal obstruction. Sensitive but not very specific. Br Med J 301: 944–946.
Hennig J, Nauerth A, Friedburg H (1986) RARE imaging: a fast imaging method for clinical MR. Magn Reson Med 3: 823–833.
Henning J, Friedburg H, Strobel B (1986) Rapid nontomographic approach to MR-myelography without contrast agents. J Comput Assist Tomogr 10: 375–378.
Roy C, Saussine C, Jahn C, Vinee Ph, Beaujeux R, Campos M, Gounot D, Chambron J (1994) Evaluation of RARE-MR-urography in the assessment of ureterohydronephrosis. J Comput Assist Tomogr 18: 601–608.
Henning J, Friedburg H (1988) Clinical applications and methodological developments of the RARE technique. Magn Reson Imaging 6: 391–395.
Vinee Ph, Stover B, Sigmund G et al. (1992) MR imaging of pericardial cyst. J Med Reson Imaging 2: 593–596.
Sigmund G, Stover B, Zimmerhackl LB et al. (1991) RARE-MR-urography in the diagnosis of upper urinary tract abnormalities in children. Pediatr Radiol 21: 416–420.
Sigmund G, Stover B, Zimmerhackl LB et al. (1991) Cystic diseases of the kidney in children: MRI, including RARE-MR-urography. Eur Radiol 1: 27–32.
Waltzer WC (1981) The urinary tract in pregnancy. J Urol 125: 271–279.
Peake SL, Rowburgh HB, Le Planglois S (1983) Ultrasonic assessment of hydronephrosis in pregnancy. Radiology 146: 167–170.
Horowitz E, Schmidt JD (1985) Renal calculi in pregnancy. Clin Obstet Gynecol 128: 324–328.
Stothers L, Lee LM (1992) Renal colic in pregnancy. J Urol 148: 1383–1387.
Webb JAW (1990) Ultrasonography in the diagnosis of renal obstruction. Sensitive but not very specific. Br Med J 301: 944–946.
Beers GJ (1988) Biological effects of weak electromagnetic fields from 0 Hz to 200 MHz: a survey of the literature with special emphasis on possible magnetic resonance effect. Magn Reson Imaging 7: 309–331.
Schwartz J, Crooks LE (1982) NMR imaging procedures: no observable mutations or cytotoxicity in mammalian cells. AJR 139: 583–586.
Cronan JJ (1991) Contemporary concepts in imaging urinary tract obstruction. Radiol Clin North Am 29: 527–542.
Erickson LM, Nicholson SF, Lewall DB, Frischke L (1979) Ultrasound evaluation of hydronephrosis pregnancy. J Clin Ultrasound 7: 128–131.
Fried AM (1979) Hydronephrosis of pregnancy: ultrasonographic study and classification of asymptomatic women. Am J Obstet Gynecol 135: 1066–1069.
Hill MC, Rick JI, Mardiat JG, Finder CA (1985) Sonography vs excretory urography in acute flank pain. AJR 144: 1235–1238.
McNeily AE, Goldenberg SL, Allen GJ, Ajzen SA, Cooperberg PL (1991) Sonographic visualization of the ureter in pregnancy. J Urol 146: 298–301.
Platt JF, Rubin JM, Ellis JH (1993) Acute renal obstruction: evaluation with intrarenal duplex Doppler and conventional US. Radiology 186: 685–688.
Burge JJ, Middleton WD, McClennan BL, Hildebolt CF (1991) Ureteral jets in healthy subjects and in patients with unilateral ureteral calculi: comparison with color Doppler US. Radiology 180: 442–473.
Takehara Y, Ichhijo, Tooyama N et al. (1994) Breath-hold MR cholangiopancreatography with a long-echo-train fast spin echo sequence and a surface coil in chronic pancreatitis. Radiology 192: 73–78.
Rothpearl A, Frager D, Subramanian A et al. (1995) MR urography: technique and application. Radiology 194: 125–130.
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Roy, C., Saussine, C., Le Bras, Y. et al. Assessment of painful ureterohydronephrosis during pregnancy by MR urography. Eur. Radiol. 6, 334–338 (1996). https://doi.org/10.1007/BF00180604
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DOI: https://doi.org/10.1007/BF00180604