Role of Magnetic Resonance Urography (MRU) as a Single Imaging Modality in Evaluation of Patients with Pelvi-Ureteric Junction Obstruction

The objective of this study was to evaluate the Role of MRU as a single imaging modality in evaluation of Pelvi-ureteric junction obstruction. 40 patients of hydronephrosis suspected to have PUJ obstruction were enrolled for the study from May 2010 to Nov. 2012. All patients under went USG, intravenous Urography (IVU), Glomerular filtration rate (GFR) Calculation by Cockcroft-Gault formula and renal DTPA Scan for determining split renal function and GFR calculation of each kidney. MRU was done to determine the anatomical details and function of each renal unit. MRU was performed on a 1.5 tesla unit (Magneton Avento; Siemens, Erlangen, Germany). Static T2-weighted Magnetic Resonance Urography (MRU) was performed by using a standard fast spin echo technique. Dynamic study was performed after injecting intravenous diuretic followed by Gadolinium contrast media. Morphological results of MRU were compared with USG, IVU, manual GFR and Renal DTPA scan. The anatomical findings were compared with operative findings.Stastical analysis was performed and data expressed as mean ±SD. MRU GFR, DTPA GFR and manual GFR were compared by Wilcoxson Method. MRU showed morphology in 39 out of 40 patients (97.5%) and a close correlation was observed between DTPA-GFR, and MRU-GFR (P<0.0001). We concluded that MRU can provide complete diagnostic evaluation of entire urinary tract in a single session and has potential to replace multiple investigations.