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(Radiology. 2000;216:237-241.)
© RSNA, 2000

Genitourinary Imaging

Spinal Dysraphism at MR Urography: Initial Experience1

Michael M. Maher, MD, FRCSI, FRCR, Tripuraneni A. S. Prasad, MSc, FFR (RCSI), John M. Fitzpatrick, MCh, FRCSI, John Corr, MCh, FRCSI, David H. Williams, PhD, Joseph T. Ennis, MD, FRCR and John G. Murray, MSc, MRCPI, FRCR

1 From the Departments of Radiology (M.M.M., T.A.S.P., J.T.E., J.G.M.) and Urology (J.M.F., J.C.), Mater Misericordiae Hospital, Eccles St, Dublin 7, Ireland, and the Department of Statistics, University College, Dublin, Ireland (D.H.W.). From the 1998 RSNA scientific assembly. Received April 29, 1999; revision requested June 15; final revision received December 21; accepted November 12. Address correspondence to J.G.M.

PURPOSE: To prospectively evaluate the role of magnetic resonance (MR) urography in the radiologic assessment of patients with spinal dysraphism.

MATERIALS AND METHODS: Fourteen patients with spinal dysraphism were referred for MR urography with half-Fourier rapid acquisition with relaxation enhancement (RARE) (repetition time msec/echo time msec = 11.9/95) and RARE (2,800/1,100) sequences on a 1.5-T MR machine. Six patients did not tolerate MR urography owing to claustrophobia (n = 4) or flexion deformities (n = 2), giving a final success rate of 57% (eight patients). Two patients had a single kidney (one after nephrectomy, one with a crossed-fused ectopic kidney). Images were jointly assessed by two radiologists and compared with excretory urographic studies. The signal intensity ratio and contrast-to-noise ratio were also calculated.

RESULTS: Visualization of the kidneys, pelvicaliceal system, and ureters was better with half-Fourier RARE than with RARE imaging, whereas visualization of the bladder was comparable with both sequences. The mean signal intensity ratios for half-Fourier RARE and RARE sequences, respectively, were 16.2 ± 3.65 and 19.2 ± 3.65 (P = .58, factorial analysis of variance model), whereas the mean contrast-to-noise ratios were 55.4 ± 5.16 and 47.8 ± 5.16 (P = .34). Cortical scarring was depicted more clearly at MR urography than at excretory urography, whereas a renal calculus seen at excretory urography was not detected at MR urography.

CONCLUSION: MR urography was feasible in 57% of patients with spinal dysraphism and is a safe, accurate method of evaluating the upper urinary tract.

Index terms: Kidney, MR, 81.121416, 81.121419 • Spine, developmental defect, 30.145 • Urography, 80.1221




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