Skip to main content

Advertisement

Log in

MR urography in children and adolescents: techniques and clinical applications

  • Pictorial Essay
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Renal and urinary tract imaging is commonly performed in the pediatric population, particularly in the setting of suspected or known congenital anomalies. In most cases, adequate anatomic assessment can be achieved using ultrasound and fluoroscopic techniques, and evaluation of differential renal function and urinary tract drainage can be accomplished with renal scintigraphy. However, in a subset of children, anatomic or functional questions may remain after this routine evaluation. In this setting, magnetic resonance imaging (MRI) tailored to evaluate the kidneys and urinary tract, known as MR urography (MRU), can be used to depict the kidneys, ureters, and urinary bladder in detail and to determine differential renal function and assess urinary tract drainage. The objectives of this review article are to (1) describe pediatric-specific MRI techniques for assessment of the kidneys and urinary tract and (2) present common clinical applications for pediatric MRU where imaging can “add value” in terms of diagnosis and patient management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Queisser-Luft A, Stolz G, Wiesel A, et al. (2002) Malformations in newborn: results based on 30,940 infants and fetuses from the Mainz congenital birth defect monitoring system (1990–1998). Arch Gynecol Obstet 266:163–167

    Article  CAS  PubMed  Google Scholar 

  2. http://www.omim.org/entry/610805. Accessed Nov 2015

  3. Dickerson EC, Dillman JR, Smith EA, et al. (2015) Pediatric MR urography: indications, techniques, and approach to review. Radiographics 35:1208–1230

    Article  PubMed  Google Scholar 

  4. Grattan-Smith JD, Jones RA (2006) MR urography in children. Pediatr Radiol 36:1119–1132

    Article  PubMed  Google Scholar 

  5. Khrichenko D, Darge K (2010) Functional analysis in MR urography—made simple. Pediatr Radiol 40:182–199

    Article  PubMed  Google Scholar 

  6. Adeb M, Darge K, Dillman JR, Carr M, Epelman M (2013) Magnetic resonance urography in evaluation of duplicated renal collecting systems. Magn Reson Imaging Clin N Am 21:717–730

    Article  PubMed  Google Scholar 

  7. Jones RA, Easley K, Little SB, et al. (2005) Dynamic contrast-enhanced MR urography in the evaluation of pediatric hydronephrosis: part 1, functional assessment. AJR Am J Roentgenol 185:1598–1607

    Article  PubMed  Google Scholar 

  8. Jones RA, Votaw JR, Salman K, et al. (2011) Magnetic resonance imaging evaluation of renal structure and function related to disease: technical review of image acquisition, postprocessing, and mathematical modeling steps. J Magn Reson Imaging 33:1270–1283

    Article  PubMed  Google Scholar 

  9. Jones RA, Perez-Brayfield MR, Kirsch AJ, Grattan-Smith JD (2004) Renal transit time with MR urography in children. Radiology 233:41–50

    Article  PubMed  Google Scholar 

  10. Grattan-Smith JD, Little SB, Jones RA (2008) MR urography in children: how we do it. Pediatr Radiol 38(Suppl 1):S3–S17

    Article  PubMed  Google Scholar 

  11. Ergen FB, Hussain HK, Carlos RC, et al. (2007) 3D excretory MR urography: improved image quality with intravenous saline and diuretic administration. J Magn Reson Imaging 25:783–789

    Article  PubMed  Google Scholar 

  12. Delgado J, Bedoya MA, Adeb M, et al. (2015) Optimizing functional MR urography: prime time for a 30-minutes-or-less fMRU. Pediatr Radiol 45:1333–1343

    Article  PubMed  Google Scholar 

  13. Nguyen HT, Herndon CD, Cooper C, et al. (2010) The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol 6:212–231

    Article  PubMed  Google Scholar 

  14. Grattan-Smith JD, Little SB, Jones RA (2008) MR urography evaluation of obstructive uropathy. Pediatr Radiol 38(Suppl 1):S49–S69

    Article  PubMed  Google Scholar 

  15. Parikh KR, Hammer MR, Kraft KH, et al. (2015) Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels? Pediatr Radiol 45:1788–1795

    Article  PubMed  Google Scholar 

  16. Weiss DA, Kadakia S, Kurzweil R, et al. (2015) Detection of crossing vessels in pediatric ureteropelvic junction obstruction: clinical patterns and imaging findings. J Pediatr Urol 11:173.e1–173.e5

    Article  Google Scholar 

  17. Pfister RC, Hendren WH (1978) Primary megaureter in children and adults. Clinical and pathophysiologic features of 150 ureters. Urology 12:160–176

    Article  CAS  PubMed  Google Scholar 

  18. Farrugia MK, Hitchcock R, Radford A, et al. (2014) British Association of Paediatric Urologists consensus statement on the management of the primary obstructive megaureter. J Pediatr Urol 10:26–33

    Article  PubMed  Google Scholar 

  19. Heidemeier A, Kirchhoff-Moradpour A, Staatz G, Riedmiller H, Darge K (2007) Ectopic ureter with urinary dribbling in childhood—a diagnostic challenge: our own experience and review of the literature. Radiologe 47:411–420

    Article  CAS  PubMed  Google Scholar 

  20. Carrico C, Lebowitz RL (1998) Incontinence due to an infrasphincteric ectopic ureter: why the delay in diagnosis and what the radiologist can do about it. Pediatr Radiol 28:942–949

    Article  CAS  PubMed  Google Scholar 

  21. Mandell J, Bauer SB, Colodny AH, Lebowitz RL, Retik AB (1981) Ureteral ectopia in infants and children. J Urol 126:219–222

    CAS  PubMed  Google Scholar 

  22. Gharagozloo AM, Lebowitz RL (1995) Detection of a poorly functioning malpositioned kidney with single ectopic ureter in girls with urinary dribbling: imaging evaluation in five patients. AJR Am J Roentgenol 164:957–961

    Article  CAS  PubMed  Google Scholar 

  23. Figueroa VH, Chavhan GB, Oudjhane K, Farhat W (2014) Utility of MR urography in children suspected of having ectopic ureter. Pediatr Radiol 44:956–962

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jonathan R. Dillman.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dillman, J.R., Trout, A.T. & Smith, E.A. MR urography in children and adolescents: techniques and clinical applications. Abdom Radiol 41, 1007–1019 (2016). https://doi.org/10.1007/s00261-016-0669-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-016-0669-z

Keywords