MR Voiding Cystourethrography (MRVC) for Vesicoureteric Reflux in unsedated infants

Introduction Vesico-ureteric reflux (VUR) is a congenital disorder of the paediatric renal tract, which allows the retrograde passage of urine up to the renal pelvis, predisposing to renal infection and consequential scarring, hypertension and renal failure. The current gold standard for diagnosis is the Micturating Cystourethrogram (MCUG), allowing snap-shot imaging of the urethra, bladder and ureters during micturition using X-ray fluoroscopy. This is widely used despite the small induced malignancy risk of ionizing radiation exposure. Several recent studies have tried to establish an MRI equivalent of the MCUG, but the techniques employed thus far have required intravenous (IV) or oral sedation, IV fluids, IV diuretics or gadolinium, or a custom built magnet and coils [1-4]. The aim of this study was to evaluate the feasibility of performing MRVC using only intravesical dilute gadolinium in un-sedated infants with rapid interactive image acquisition on a conventional closed bore magnet.