MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging.
Eur Radiol
; 24(1): 19-25, 2014 Jan.
Article
en En
| MEDLINE
| ID: mdl-23884301
ABSTRACT
OBJECTIVES:
To evaluate the performance of diffusion-weighted imaging (DWI) against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1-WI) in children.METHODS:
Thirty-nine consecutive patients (mean age 5.7 years) with suspected acute pyelonephritis underwent magnetic resonance imaging (MRI) including DWI and (the reference standard) Gd-T1-WI. Each study was read in double-blinded fashion by two radiologists. Each kidney was graded as normal or abnormal. Sensitivity and specificity of DWI were computed. Agreement between sequences and interobserver reproducibility were calculated (Cohen κ statistic and the McNemar tests).RESULTS:
Thirty-two kidneys (41 %) had hypo-enhancing areas on Gd-T1-W images. The sensitivity and specificity of DWI were 100 % (32/32) and 93.5 % (43/46). DWI demonstrated excellent agreement (κ = 0.92,) with Gd-T1-W, with no significant difference (P = 0.25) in detection of abnormal lesions. Interobserver reproducibility was excellent with DWI (κ = 0.79).CONCLUSION:
DWI enabled similar detection of abnormal areas to Gd-T1-WI and may provide an injection-free means of evaluation of acute pyelonephritis. KEY POINTS ⢠Diffusion weighted magnetic resonance imaging (DWI) can confirm acute pyelonepritis. ⢠DWI provided comparable results to gadolinium enhanced T1-W MRI in acute pyelonepritis. ⢠Contrast medium injection could be avoided for diagnosing acute pyelonephritis by MRI. ⢠MRI with T2-WI and DWI provide a fast and comprehensive diagnostic tool.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Pielonefritis
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Medios de Contraste
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Gadolinio DTPA
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Imagen de Difusión por Resonancia Magnética
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Riñón
Tipo de estudio:
Diagnostic_studies
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Prognostic_studies
Límite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2014
Tipo del documento:
Article