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1.
Magn Reson Med ; 89(1): 343-355, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36089805

RESUMO

PURPOSE: To assess the potential of DCE MR CEST urography for assessing renal function in mice with unilateral ureter obstruction (UUO) by simultaneous pH and renal uptake/clearance measurements following injection of iopamidol. METHODS: The right ureter of nine mice was obstructed via suture ligation. The animals were imaged at day 1, 2, and 3 post-obstruction on an 11.7T MRI scanner. Ninety-six sets of saturated CEST images at 4.3 and 5.5 ppm were collected. Renal pH values were obtained by calculating the signal ratio for these two frequencies and using a pH calibration curve. Renal time activity curves were measured as a percentage change in the post-injection CEST signal at 4.3 ppm relative to the average pre-injection signal. RESULTS: For the healthy mice, the time activity curves of both kidneys were nearly identical and displayed rapid excretion of contrast. For the UUO mice, the dynamic CEST curves for the obstructed kidneys displayed prolonged time to peak (TTP) values and delayed contrast excretion compared with the contralateral (CL) kidneys. Renal pH maps of the healthy animals showed similar acidic values for both kidneys (pH 6.65 ± 0.04 vs 6.67 ± 0.02), whereas in the obstructed kidneys there was a significant increase in pH values compared with the CL kidneys (pH 6.67 ± 0.08 vs 6.79 ± 0.11 in CL and UUO kidneys, respectively). CONCLUSION: Our findings indicate that DCE-MR-CEST urography can detect changes in renal uptake/excretion and pH homeostasis and distinguish between obstructed and unobstructed kidney as early as 1 day after UUO.


Assuntos
Ureter , Obstrução Ureteral , Animais , Camundongos , Obstrução Ureteral/diagnóstico por imagem , Rim/diagnóstico por imagem , Rim/fisiologia , Imageamento por Ressonância Magnética/métodos , Concentração de Íons de Hidrogênio , Urografia
2.
Urologie ; 61(7): 782-791, 2022 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-35925251

RESUMO

The diagnostics and treatment of pediatric urology patients in the clinical routine can be extremely challenging. In comparison to adult patients, congenital diseases, more time consuming examinations and limited options in addition to the parents' expectations must be taken into account in the diagnostic work up. In this first of two parts we will delve into ultrasound diagnostics as the cornerstone in the diagnostic pathway of children with hydronephrosis ans take a closer look on contrast enhanced ultrasound (CEUS). Conventional voiding cystourethrography still plays a major role in the diagnostic pathway of vesicoureteric reflux and will be treated in this article. Computed tomography should only be considered in pediatric patients in rare cases, always taking radiation into critical account. Magnetic resonance imaging provides an excellent anatomical overview without exposing the child to unnecessary radiation. This article provides an overview on the diagnostic imaging studies in pediatric urology and brings tips for the diagnostic evaluation.


Assuntos
Urografia , Urologia , Adulto , Criança , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Ultrassonografia/métodos
3.
BMC Urol ; 22(1): 97, 2022 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-35787264

RESUMO

BACKGROUND: To assess the inter-observer and intra-observer reliability of the magnetic resonance urography (MRU)-upper urinary tract dilation (UUTD) grading system. METHODS: A total of 40 patients with a diagnosis of NB were enrolled in this study. The images were assembled in an electronic presentation randomly. The presentations were reviewed and graded by 4 junior and 4 senior urologists. One week later, the images were randomized again and reassessed. The inter-observer reliability was estimated by Kendall's coefficient of concordance and intra-class correlation coefficient (ICC), and the intra-observer reliability was estimated by weighted Cohen's kappa. RESULTS: The inter-observer reliability strength was excellent for all urologists, with the ICC value of 0.939 (0.908-0.963) and Kendall's W value of 0.967. The highest agreement was shown in Grade 4 at 92.50%, and the lowest in Grade 2 at 82.14%. All disagreements were within one grade of difference. Moreover, the Intra-observer reliability was excellent, with the weighted kappa value ranging from 0.904 to 0.954. CONCLUSIONS: The inter-observer and intra-observer reliability of this novel MRU-UUTD grading system is confirmed, providing adequate evidence for broader clinical application.


Assuntos
Bexiga Urinaria Neurogênica , Sistema Urinário , Dilatação , Humanos , Espectroscopia de Ressonância Magnética , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Bexiga Urinaria Neurogênica/diagnóstico por imagem , Sistema Urinário/diagnóstico por imagem , Urografia/métodos
4.
Appl Radiat Isot ; 187: 110339, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35785638

RESUMO

Abdominal colic pain or hematuria is suspected to be caused by urinary tract stones. Commonly used X-ray examinations include kidney-ureter-bladder plain radiography (KUB), intravenous urography (IVU), and abdominal computed tomography (CT). In this study, a high-sensitivity thermoluminescent dosimeter (TLD) was embedded in a Rando phantom to directly measure organ dose and evaluate effective dose. During each experiment, 139 TLD measurement points that cover almost all organs (as recommended by the ICRP 103 report) were examined. Red bone-marrow and remainder tissues have a high tissue weighting factor (0.12), and they are widely distributed. In the phantom, 34 TLDs and 31 TLDs were embedded in the red bone-marrow and remainder tissues to improve the accuracy and representativeness of organ doses. The detailed organ dose distributions for KUB, IVU, and abdominal CT are presented. The effective doses for KUB and IVU were 0.22 and 1.51 mSv, respectively, and those for two abdominal CTs were 8.21 and 9.27 mSv. This experiment presents a conversion factor of 0.0177 mSv·mGy-1 cm-1 for the abdominal CT examination, which differs from most of the conversion factors obtained through the Monte Carlo simulation method.


Assuntos
Ureter , Rim/diagnóstico por imagem , Imagens de Fantasmas , Doses de Radiação , Radiografia , Tomografia Computadorizada por Raios X/métodos , Ureter/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem , Urografia/métodos
5.
Contrast Media Mol Imaging ; 2022: 2572681, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35821887

RESUMO

Methods: We grouped the patients who had undergone cervical cancer surgery in a hospital in this article and compared the nanodrug carrier system under CT imaging with traditional laparoscopy. The postoperative physical parameters of surgical patients are collected from cervical cancer patients of different degrees, and the parameters and prognostic health of patients after different operations are compared. Results: The results of the study show that the postoperative patient's body parameters of the nanodrug delivery system under the CT imaging technology used in this article are better than those of the traditional surgery group, and the average intraoperative blood loss is about 20% less than that of the traditional surgery. Postoperative complications occur. The situation is even lower, more than 30% lower than traditional surgery. Conclusion: This shows that the operation of the nanodrug delivery system based on CT imaging technology has broken through some of the limitations of the development of laparoscopic technology and has played an important role in the surgical treatment of cervical cancer.


Assuntos
Laparoscopia , Sistema Urinário , Neoplasias do Colo do Útero , Feminino , Humanos , Laparoscopia/métodos , Tomografia Computadorizada por Raios X/métodos , Urografia/métodos , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/cirurgia
6.
Eur Radiol ; 32(12): 8588-8596, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35763094

RESUMO

OBJECTIVE: To determine the sensitivity of dual-energy (DE) virtual non-contrast computed tomography (vNCT), generated from the excretory phase of a CT urogram, compared to true non-contrast CT (tNCT) for the detection of urinary calculi. METHODS: A search of multiple medical literature databases was performed using predetermined search terms. Inclusion and exclusion criteria were applied, and bias risk was assessed by two independent reviewers using the quality assessment of diagnostic accuracy studies (QUADAS) tool. Collated estimates of sensitivity were generated, and sources of heterogeneity were identified and reviewed. RESULTS: Thirteen studies (1760 patients; 1740 urinary calculi) were included for sensitivity assessment. Pooled sensitivity for urinary calculi on vNCT was 78.1% (95% CI: 70.2 to 85.0%); however, heterogeneity between studies was very high (I2 = 92.0%). Sources of heterogeneity between studies were explored through subgroup analysis by categorising studies according to slice thickness (≥ 2 mm and < 2 mm), use of oral hydration, and use of intravenous furosemide. Pooled sensitivity for detection of urinary calculi on vNCT for studies that used oral hydration and < 2 mm slice thickness was 92.2% (95% CI: 89.5 to 94.5%). Pooled specificity was not performed as true negatives were not reported in most studies. Potential sources of bias were identified in included studies. CONCLUSION: vNCT demonstrated a moderate pooled sensitivity compared to tNCT for the detection of urinary calculi in split bolus CT urogram protocols. However, subgroup analysis suggests higher sensitivity when employing oral hydration and < 2 mm slice thickness or increment. KEY POINTS: • vNCT demonstrated moderate pooled sensitivity for the detection of urinary calculi in split bolus CT urogram protocols. • Subgroup analysis suggested higher sensitivity with oral hydration and < 2 mm slice thickness or increment.


Assuntos
Cálculos Urinários , Urografia , Humanos , Urografia/métodos , Cálculos Urinários/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Furosemida , Sensibilidade e Especificidade
7.
Vet Radiol Ultrasound ; 63(4): E7-E10, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35452146

RESUMO

A 7-year-old male neutered, 6.5 kg, Maltese breed dog was referred with a history of dysuria after undergoing two cystotomies to remove calcium oxalate uroliths. Survey radiographs were inconclusive. Excretory urography allowed visualization of two filling defects in the cranioventral urinary bladder region. Ultrasonography showed urinary bladder sediments, a diffusely thickened wall, and two circumscribed intramural/intraluminal structures with an anechoic interior and a smooth and regular surface. The cystoscopic diagnosis was urinary bladder abscesses and urine cultures were positive for Escherichia coli. Antimicrobial/anti-inflammatory therapy was started with good clinical outcomes and negative culture after 21 days.


Assuntos
Doenças do Cão , Bexiga Urinária , Abscesso/diagnóstico por imagem , Abscesso/cirurgia , Abscesso/veterinária , Animais , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Masculino , Ultrassonografia/veterinária , Bexiga Urinária/diagnóstico por imagem , Urografia/veterinária
8.
J Pediatr Urol ; 18(3): 313.e1-313.e6, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35474163

RESUMO

INTRODUCTION: Retrograde Intrarenal Surgery (RIRS) is one of minimally invasive procedures for pediatric upper urinary stones. However, a RIRS predictive system for children to evaluate postoperative stone free rate (SFR) is still unavailable. OBJECTIVE: The aim of this study is to validate the efficacy and reliability of different RIRS scoring systems for children. STUDY DESIGN: We collected clinical data of 137 pediatric patients treated with RIRS in our center between 2014 and 2021. All the predictors were acquired by preoperative non-contrast CT or CT urography. Receiver Operative Curve (ROC) and Area Under Curve (AUC) were showed to compare the predictive power of different models. RESULTS: A total of 162 RIRS procedures were performed for these 137 pediatric patients. Median surgical duration, irrigation volume and hospitalization were 30 (20, 40) min, 500 (300, 1000) ml and 6 (4, 7) days, respectively. Overall SFR and complication rate was 79.6% (129/162) and 29.2% (40/137), respectively. Significant difference was detected between non-stone free group and stone free group in terms of stone complexity (p < 0.001), cumulative stone sizes [2.3 (2.0, 3.5) cm vs. 1.5 (1.0, 2.0) cm, p < 0.001], RUS groups (p < 0.001), S-ReSC groups (p < 0.001) and RIRS nomogram score [10 (8, 12) vs. 23 (18, 25), p < 0.001]. Among them, RIRS nomogram presented with the maximum AUC values in comparison with the other two systems (RUS: 0.944 vs. 0.874, p = 0.001; S-ReSC: 0.944 vs. 0.808, p < 0.001). DISCUSSION: We reported the largest sample size of pediatric patients treated with RIRS in our center. Similar with previous studies, RIRS is an efficacious and safe option for pediatric patients. RIRS nomogram showed the best predictive outcome due to the inclusion of multiple parameters, but an innovative predictive system based on pediatric clinical data is warranted in the future. CONCLUSION: Among the three scoring systems, RIRS nomogram showed the most optimal predictive power of postoperative SFR for pediatric patients.


Assuntos
Cálculos Renais , Criança , Humanos , Cálculos Renais/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento , Urografia
9.
Urology ; 166: 118-125, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35469811

RESUMO

OBJECTIVE: To evaluate the detection and quantification of urinary stones using virtual unenhanced images (VUE) at different phases and slice thickness in contrast-enhanced dual-energy CT Urography (DECTU) in comparison with true unenhanced images (TUE). METHODS: One hundred and twelve urinary stone patients who required triphasic DECTU were analyzed. Data were reconstructed as the followings: TUE images with 1.25 mm thickness (TUE portal venous phase VUE images with 1.25 and 5-mm thickness (VUE(VP)_1.25 mm and VUE(VP)_5 mm) and excretory phase VUE images with 1.25 and 5-mm thickness (VUE(EP)_1.25mm and VUE(EP)_5mm). The. The stones were divided into large (≥5 mm) and small stones. The detection rate, size and CT value of stones were assessed by 2 radiologists and statistically compared among the above groups. RESULTS: Two hundred and thirty urinary stones (163 large and 67 small stones) were detected on TUE_1.25 mm images. For large stones, the detection rate on VUE(VP)_1.25 mm, VUE(VP)_5 mm, VUE(EP)_1.25 mm and VUE(EP)_5 mm was 100%, 96.9%, 85.9%, and 80.4%; while for small stones, the rate was 77.6%, 37.3%, 46.3%, and 23.9%, respectively. VUE(VP) images significantly improved the stone detection rate compared with VUE(EP) images at both slice thicknesses. In general, VUE images identified stones with smaller sizes and lower Hounsfield units, but thinner slice thickness images reduced the inaccuracy. Inter-reader agreement of the stone detection revealed a k value range from 0.85 to 0.94 for TUE and VUE images. CONCLUSION: Large stones (≥5 mm) can reliably be detected on thin section VUE(VP) images with 33% radiation dose reduction. However, for small stones TUE remains superior. Stone size is underestimated on VUE images.


Assuntos
Imagem Radiográfica a Partir de Emissão de Duplo Fóton , Cálculos Urinários , Meios de Contraste , Humanos , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Tomografia Computadorizada por Raios X/métodos , Cálculos Urinários/diagnóstico por imagem , Urografia/métodos
10.
Khirurgiia (Mosk) ; (4): 69-74, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35477203

RESUMO

OBJECTIVE: To assess the possibility of magnetic resonance imaging in diagnosis of complications of kidney and ureteral injury in different periods of traumatic disease. MATERIAL AND METHODS: There were 139 patients with kidney and ureteral injuries between 2015 and 2019. We clarified the MR-signs of renal complications in different periods of traumatic disease. RESULTS: We analyzed the effectiveness of MRI in identification of renal complications compared to ultrasound, excretory urography, computed tomography, intraoperative and follow-up data. High diagnostic accuracy of MRI for early and late manifestations of traumatic disease was demonstrated.


Assuntos
Traumatismos Abdominais , Rim , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/diagnóstico por imagem , Humanos , Rim/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X , Urografia/métodos
11.
BMC Urol ; 22(1): 60, 2022 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-35413901

RESUMO

BACKGROUND: To evaluate the diagnostic accuracy of computed tomography-urography (CTU) to rule out urinary bladder cancer (UBC) and whether patients thereby could omit cystoscopy. METHODS: All patients evaluated for macroscopic hematuria with CTU with cortico-medullary phase (CMP) and cystoscopy at our institute between 1st November 2016 and 31st December 2019 were included. From this study cohort a study group consisting of all UBC patients and a control group of 113 patients randomly selected from all patients in the study cohort without UBC. Two radiologists blinded to all clinical data reviewed the CTUs independently. CTUs were categorized as positive, negative or indeterminate. Diagnostic accuracy and proportion of potential omittable cystoscopies were calculated for the study cohort by generalizing the results from the study group. RESULTS: The study cohort consisted of 2195 patients, 297 of which were in the study group (UBC group, n = 207 and control group, n = 90). Inter-rater reliability was high (κ 0.84). Evaluation of CTUs showed that 174 patients were assesessed as positive (showing UBC), 46 patients as indeterminate (not showing UBC but with limited quality of CTU), and 77 patients as negative (not showing UBC with good quality of CTU). False negative rate was 0.07 (95%, CI 0.04-0.12), false positive rate was 0.01 (95% CI 0.0-0.07) and negative predictive value was 0.99 (95% CI 0.92-1.0). The area under the curve was 0.93 (95% CI 0.90-0.96). Only 2.9% (3/102) with high-risk tumors and 11% (12/105) with low- or intermediate-risk tumors had a false negative CTU. Cystoscopy could potentially have been omitted in 57% (1260/2195) of all evaluations. CONCLUSIONS: CTU with CMP can exclude UBC with high accuracy. In case of negative CTU, it might be reasonable to omit cystoscopy, but future confirmative studies with possibly refined technique are needed.


Assuntos
Neoplasias da Bexiga Urinária , Cistoscopia/métodos , Citidina Monofosfato , Hematúria/diagnóstico , Humanos , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodos , Neoplasias da Bexiga Urinária/patologia , Urografia/métodos
12.
Radiol Med ; 127(6): 577-588, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35381905

RESUMO

Computed tomography-urography is currently the imaging modality of choice for the assessment of the whole urinary tract, giving the possibility to detect and characterize benign and malignant conditions. In particular, computed tomography-urography takes advantage from an improved visualization of the urinary collecting system due to acquisition of delayed scan obtained after excretion of intravenous contrast medium from the kidneys. Nevertheless, the remaining scans are of great help for identification, characterization, and staging of urological tumors. Considering the high number of diseases, urinary segment potentially involved and patients' features, scanning protocols of computed tomography-urography largely vary from one clinical case to another as well as selection and previous preparation of the patient. According to the supramentioned considerations, radiation exposure is also of particular concern. Italian radiologists were asked to express their opinions about computed tomography-urography performance and about its role in their daily practice through an online survey. This paper collects and summarizes the results.


Assuntos
Radiologia , Sistema Urinário , Meios de Contraste , Humanos , Tomografia Computadorizada por Raios X/métodos , Urografia/métodos
13.
Vet Clin North Am Equine Pract ; 38(1): 123-140, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35282964

RESUMO

This article provides a comprehensive review of imaging techniques used to evaluate the equine urinary tract. This overview includes officially recognized modalities and new applications reported in the most current literature. Technical aspects and indications for use of endoscopy and ultrasonography are highlighted. Normal endoscopic and ultrasonographic appearance of the upper and lower urinary tract is described, with characterization of common abnormalities found in patients with hematuria, stranguria, and renal failure. Visual examples of several pathologic conditions from clinical cases are provided. An outline of the main features, potentials, and limitations of radiography, nuclear scintigraphy, and computed tomography is provided.


Assuntos
Doenças dos Cavalos , Sistema Urinário , Animais , Hematúria/veterinária , Doenças dos Cavalos/diagnóstico por imagem , Cavalos , Ultrassonografia/veterinária , Sistema Urinário/diagnóstico por imagem , Urografia/métodos
14.
Tomography ; 8(2): 644-656, 2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-35314631

RESUMO

This observer study investigates the effect of computerized artificial intelligence (AI)-based decision support system (CDSS-T) on physicians' diagnostic accuracy in assessing bladder cancer treatment response. The performance of 17 observers was evaluated when assessing bladder cancer treatment response without and with CDSS-T using pre- and post-chemotherapy CTU scans in 123 patients having 157 pre- and post-treatment cancer pairs. The impact of cancer case difficulty, observers' clinical experience, institution affiliation, specialty, and the assessment times on the observers' diagnostic performance with and without using CDSS-T were analyzed. It was found that the average performance of the 17 observers was significantly improved (p = 0.002) when aided by the CDSS-T. The cancer case difficulty, institution affiliation, specialty, and the assessment times influenced the observers' performance without CDSS-T. The AI-based decision support system has the potential to improve the diagnostic accuracy in assessing bladder cancer treatment response and result in more consistent performance among all physicians.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Neoplasias da Bexiga Urinária , Inteligência Artificial , Humanos , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/terapia , Urografia
15.
Abdom Radiol (NY) ; 47(6): 2230-2237, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35238963

RESUMO

OBJECTIVE: To compare image quality and radiation dose between single-bolus 2-phase and split-bolus 1-phase CT Urography (CTU) performed immediately after microwave ablation (MWA) of clinically localized T1 (cT1) RCC. METHODS: Forty-two consecutive patients (30 M, mean age 67.5 ± 9.0) with cT1 RCC were treated with MWA from 7/2013 to 12/2013 at two academic quaternary-care institutions. Renal parenchymal enhancement, collecting system opacification and distention and size-specific dose estimate (SSDE) were quantified and image quality subjectively assessed on single-bolus 2-phase versus split-bolus 1-phase CTU. Kruskal-Wallis and Pearson's Chi-squared tests were performed to assess differences in continuous and categorical variables, respectively. Two-sample T test with equal variances was used to determine differences in quantitative and qualitative image data. RESULTS: Median tumor diameter was larger [2.9 cm (IQR 1.7-5.3) vs 3.6 cm (IQR 1.7-5.7), p = 0.01] in the split-bolus cohort. Mean abdominal girth (p = 0.20) was similar. Number of antennas used and unenhanced CTs obtained before and during MWA were similar (p = 0.11-0.32). Renal pelvis opacification (2.5 vs 3.5, p < 0.001) and distention (4 mm vs 8 mm, p < 0.001) were improved and renal enhancement (Right: 127 HU vs 177 HU, p = 0.001; Left: 124 HU vs 185 HU, p < 0.001) was higher for the split-bolus CTU. Image quality was superior for split-bolus CTU (3.2 vs 4.0, p = 0.004). Mean SSDE for the split-bolus CTU was significantly lower [163.9 mGy (SD ± 73.9) vs 36.3 mGy (SD ± 7.7), p < 0.001]. CONCLUSION: Split-bolus CTU immediately after MWA of cT1 RCC offers higher image quality, improved opacification/distention of the collecting system and renal parenchymal enhancement at a lower radiation dose.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Exposição à Radiação , Idoso , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Meios de Contraste , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Masculino , Micro-Ondas/uso terapêutico , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Urografia/métodos
16.
Abdom Radiol (NY) ; 47(5): 1828-1839, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35234996

RESUMO

PURPOSE: To compare the performance of 3D MRU based on a breath-hold gradient- and spin-echo (BH-GRASE) technique with conventional 3D respiratory-triggered FSE (RT-FSE) sequence in patients with urinary tract dilation. METHODS: We prospectively included 90 patients with urinary tract dilation who underwent both 3D BH-GRASE and RT-FSE MRU at 3T. The acquisition time of two MRU sequences was recorded. Three readers blinded to the protocols reviewed the image quality using a five-point scale and assessed the diagnostic performance related to urinary tract dilation. The relative contrast ratio (CR) between the urinary tract and adjacent area was measured quantitatively. RESULTS: Acquisition time was 14.8 s for BH-GRASE MRU and 213.6 ± 52.2 s for RT-FSE MRU. The qualitative image analysis demonstrated significant equivalence between the two MRU protocols. 3D BH-GRASE MRU better depicted bilateral renal calyces than RT-FSE MRU (p < 0.05). The CR values of the urinary tract were lower on BH-GRASE MRU compared with RT-FSE MRU (p < 0.05). There were excellent agreements in the assessment of urinary tract dilation between BH-GRASE and RT-FSE MRU, including the dilated degree, obstructive level, and obstructive imaging features (inter-sequence κ = 0.924-1). CONCLUSION: 3D BH-GRASE MRU significantly decreased the acquisition time and achieved comparable image quality, urinary tract visualization, and diagnostic performance with conventional 3D RT-FSE MRU. Breath-hold 3D MRU with GRASE may provide a feasible evaluation of urinary tract dilation.


Assuntos
Suspensão da Respiração , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Urografia
17.
J Healthc Eng ; 2022: 6294752, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35035850

RESUMO

OBJECTIVE: To explore the application value of the X-ray digital tomographic fusion technique in the diagnosis of urinary system diseases. METHODS: 500 patients with suspected urinary diseases in our hospital were examined by three methods: X-ray digital tomographic fusion imaging (DTS), intravenous pyelography (IVP), and abdominal plain film (KUB), and the image quality before and after tomographic fusion was objectively evaluated. The image quality could be divided into three grades: excellent, good, and poor. RESULTS: The image excellent rate of DTS (88%) was higher than that of IVP (27.5%). The sensitivity of DTS in the diagnosis of renal cyst and space occupying of the bladder was higher than that of IVP (P < 0.05). The accuracy rate of DTS in the diagnosis of urinary calculi was 93.33%, higher than 63.3% of KUB (P < 0.001). The accuracy rate of DTS in the diagnosis of ureteral stricture was 90%, higher than 65% of IVP (P=0.03). The accuracy of DTS in the diagnosis of hydronephrosis was higher than that of IVP and KUB (P < 0.05). CONCLUSION: In the examination of urinary system-related diseases, high-definition images can be obtained by timely using sectional fusion technology. Compared with conventional IVP, space occupying lesions such as the bladder and kidney can be displayed more clearly with the help of the tomographic fusion technique, which is helpful to improve the possibility of finding lesions and is of great significance in clinical application.


Assuntos
Hidronefrose/diagnóstico por imagem , Obstrução Ureteral/diagnóstico por imagem , Cálculos Urinários/diagnóstico por imagem , Urografia , Feminino , Humanos , Masculino , Tomografia Computadorizada por Raios X/métodos , Urografia/métodos
18.
Pediatr Radiol ; 52(2): 228-248, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35022851

RESUMO

The goal of functional renal imaging is to identify and quantitate irreversible renal damage and nephron loss, as well as potentially reversible hemodynamic changes. MR urography has evolved into a comprehensive evaluation of the urinary tract that combines anatomical imaging with functional evaluation in a single test without ionizing radiation. Quantitative functional MR imaging is based on dynamic contrast-enhanced MR acquisitions that provide progressive, visible enhancement of the renal parenchyma and urinary tract. The signal changes related to perfusion, concentration and excretion of the contrast agent can be evaluated using both quantitative and qualitative measures. Functional evaluation with MR has continued to improve as a result of significant technical advances allowing for faster image acquisition as well as the development of new tracer kinetic models of renal function. The most common indications for MR urography in children are the evaluation of congenital anomalies of the kidney and urinary tract including hydronephrosis and renal malformations, and the identification of ectopic ureters in children with incontinence. In this paper, we review the underlying acquisition schemes and techniques used to generate quantitative functional parameters including the differential renal function (DRF), asymmetry index, mean transit time (MTT), signal intensity versus time curves as well as the calculation of individual kidney glomerular filtration rate (GFR). Visual inspection and semi-quantitative assessment using the renal transit time (RTT) and calyceal transit times (CTT) are fundamental to accurate diagnosis and are used as a basis for the interpretation of the quantitative data. The importance of visual assessment of the images cannot be overstated when analyzing the quantitative measures of renal function.


Assuntos
Rim , Imageamento por Ressonância Magnética , Criança , Humanos , Rim/diagnóstico por imagem , Rim/fisiologia , Pelve Renal , Espectroscopia de Ressonância Magnética , Urografia
19.
Br J Radiol ; 95(1132): 20210949, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-34990261

RESUMO

Excretory urography (EU) had been the most frequently performed imaging modality for uroradiology in the past. With the advances in ultrasonography, and development of cross-sectional urography with CT and MRI, EU is now seldom performed. Consequently, there has been a decline of expertise in this technique. However, EU has multiple advantages such as dynamic nature, easy availability, low cost and radiation burden. These render it potentially very valuable in specific indications like congenital anomalies, urothelial lesions and urinary leaks. This review intends to emphasize the current day relevance of excretory urography, outline the key points of the technique, and describe the pearls and pitfalls of interpretation.


Assuntos
Tomografia Computadorizada por Raios X , Urografia , Estudos Transversais , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia , Urografia/métodos
20.
Q J Nucl Med Mol Imaging ; 66(3): 280-289, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31992688

RESUMO

BACKGROUND: Accuracy of [68Ga]PSMA-11 PET/CT may be hampered by ureter accumulation, mimicking lymph node metastases depending on localization and configuration. The benefit of CT urography for differentiation of lymph node metastasis from urinary tract activity was evaluated in a "PET/CT with low-dose CT" setting. METHODS: Retrospective analysis of PET/CT for primary staging, biochemical recurrence or local treatment planning in patients with prostate cancer. For CT urography (CTU), iodinated contrast agent was administered 10 minutes prior to image acquisition. All potential pathologic (peri)ureteral tracer uptake was assigned to excretory ureteral accumulation or pathological lesion. To assess additional provided benefit of CTU all foci were rated with an introduced scoring system (ranging from 0 pts: CTU not needed; up to 3 pts: no differentiation possible without CTU). Success of ureter contrasting was assessed by measurement of Hounsfield units. Besides benefit for reading urography-enhanced PET/CT, the possible impact on subsequent patient treatment was evaluated. RESULTS: A number of N.=247 patients were included in this study. By CT urography, it was possible to identify each ureter on low-dose CT, with its major part contrasted. In 120/247 (48.6%) patients, urography increased the diagnostic confidence while providing substantial support for interpretation in 60 (24.3%) cases. In 42 (17.0%) patients, urography was clinically relevant (up-/downstaging) with potential impact on subsequent patient care. In 30 of these 42 cases (12.1% of all), discrepant treatment would have resulted from a misdiagnosed tracer accumulation without urography. CONCLUSIONS: CT urography benefits the interpretation of [68Ga]-PSMA-11 PET/CT with low-dose CT and leads to discrepant patient treatment in a small but significant subset of patients (12% in our cohort). The implementation of CT urography into standard protocols of [68Ga]PSMA-11 PET/CT with low-dose CT is recommended.


Assuntos
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Próstata , Radioisótopos de Gálio , Humanos , Metástase Linfática , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Urografia
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