Optimizing functional MR urography: prime time for a 30-minutes-or-less fMRU

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• 作者：Jorge Delgado ; Maria A. Bedoya ; Melkamu Adeb ; Robert H. Carson…
• 关键词：Children ; Functional magnetic resonance urography (fMRU) ; Magnetic resonance imaging ; Positioning ; Scan time ; Urinary tract
• 刊名：Pediatric Radiology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：45
• 期：9
• 页码：1333-1343
• 全文大小：585 KB
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• 作者单位：Jorge Delgado (1)
  Maria A. Bedoya (1)
  Melkamu Adeb (1)
  Robert H. Carson (1)
  Ann M. Johnson (1) (2)
  Dmitry Khrichenko (1)
  Douglas A. Canning (3)
  Kassa Darge (1) (2)
  
  1. Department of Radiology, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA
  2. Department of Radiology, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
  3. Division of Urology, Department of Surgery, The Children’s Hospital of Philadelphia, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Pediatrics
  Neuroradiology
  Nuclear Medicine
  Ultrasound
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1998

文摘

Background Current protocols for functional MR urography (fMRU) require long scan times, limiting its widespread use. Objective Our goal was to use pre-defined criteria to reduce the number of sequences and thus the examination time without compromising the morphological and functional results. Materials and methods The standard fMRU protocol in our department consists of eight sequences, including a 17-min dynamic post-contrast scan. Ninety-nine children and young adults (43 male, 56 female, mean age 7?years) were evaluated with this protocol. Each sequence was retrospectively analyzed for its utility and factors that affect its duration. Results Mean scan time to perform the eight sequences, without including the variable time between sequences, was 40.5?min. Five sequences were categorized as essential: (1) sagittal T2 for planning the oblique coronal plane, (2) axial T2 with fat saturation for the assessment of corticomedullary differentiation and parenchymal thickness, (3) coronal 3-D T2 with fat saturation for multiplanar and 3-D reconstructions, (4) pre-contrast coronal T1 with fat saturation to ensure an appropriate scan prior to injecting the contrast material and (5) the coronal post-contrast dynamic series. Functional information was obtained after 8?min of dynamic imaging in the majority of children. The coronal fat-saturated T2, coronal T1, and post-contrast sagittal fat-saturated T1 sequences did not provide additional information. Because of the effects of pelvicalyceal dilation and ureteropelvic angle on the renal transit time, prone position is recommended, at least in children with high-grade pelvicalyceal dilation. Conclusion Comprehensive fMRU requires approximately 19?min for sequence acquisition. Allowing for time between sequences and motion correction, the total study time can be reduced to about 30?min. Four pre-contrast sequences and a shortened post-contrast dynamic scan, optimally with the child in prone position, are sufficient.