Document Detail

Gadolinium-enhanced magnetic resonance fluoroscopy used as micturating cystourethrography: experiences in adult male patients.
MedLine Citation:
PMID:  14501489     Owner:  NLM     Status:  MEDLINE    
RATIONALE AND OBJECTIVE: To approach the concept of magnetic resonance (MR) imaging-monitored micturating cystourethrography (MRMCU) by using gadolinium-enhanced real-time MR fluoroscopy. METHODS: MRMCU was performed in 21 male patients (27-76 years) subsequent to gadolinium excretory MR urography. Patients were examined in supine position at 1.5 T. For MR fluoroscopy of the urethra during micturition, we used a T1-weighted single-slice gradient-echo sequence with continuous radial k-space acquisition. Image reconstruction was obtained with the sliding-window technique reaching a frame rate of 25/s. The image plane was guided interactively through the urethra, the bladder and the ureters without stopping the scan. RESULTS: Two patients were unable to void in supine position. With MR fluoroscopy, the flow of gadolinium-enhanced urine through the urethra was visualized in 19 patients, in 14 of whom with complete demonstration of the urethral anatomy subdivided into 5 segments. Four urethral segments were identified in 1 patient, 3 segments in 2 patients, 2 segments in 3 patients, and 1 segment in 1 patient. MRMCU demonstrated changes in the urethral anatomy and the urine flow in 2 patients with a neobladder and in 1 patient with hypertrophy of the prostate. Subject to the limitation of antegrade gadolinium application, interactive MRMCU allowed to determine whether the ureters were enhanced by gadolinium or not. CONCLUSION: Gadolinium-enhanced MR fluoroscopy using radial k-space acquisition has achieved complete demonstration of the segmental anatomy of the urethra in 74% of the male adult patients who were able to accomplish micturition. Although MR fluoroscopy was able to visualize the gadolinium-enhanced ureters, the current data do not permit to conclude that MRMCU can demonstrate vesicoureteral reflux, especially in children.
Claus Nolte-Ernsting; Arndt Glowinski; Tobias Schaeffter; Gerhard Adam; Rolf W Günther
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Investigative radiology     Volume:  38     ISSN:  0020-9996     ISO Abbreviation:  Invest Radiol     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-22     Completed Date:  2004-04-20     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  617-24     Citation Subset:  IM    
Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
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MeSH Terms
Contrast Media*
Fluoroscopy / methods
Gadolinium DTPA / diagnostic use*
Image Enhancement / methods
Magnetic Resonance Imaging / methods*
Middle Aged
Ureter / anatomy & histology*,  radiography
Urethra / anatomy & histology*,  radiography
Urography / methods
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

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