Feasibility and utility of respiratory-gated, gadolinium-enhanced T1-weighted magnetic resonance urography in children

RATIONALE AND OBJECTIVES. TO evaluate the feasibility and utility of respiratory-gated, gadolinium-enhanced T1-weighted magnetic resonance (MR) urography in children. METHODS. In a prospective study, 30 consecutive children, aged 3 weeks to 13.8 years, underwent MR urography, After intravenous injection of low-dose furosemide and gadopentetate dimeglumine, respiratory-gated, coronal, T1-weighted 3D-gradient-echo sequences were obtained at 1.5 T 5 to 30 minutes after contrast administration. Postprocessing of the data was performed using a maximum-intensity projection algorithm, In addition, precontrast half-Fourier rapid acquisition with relaxation enhancement MR urograms were obtained in 29 children. RESULTS. Respiratory-gated, T1-weighted MR urography was successfully performed in all children without the need for sedation. Compared with the final diagnosis, prospective analysis of MR urography images revealed the correct diagnosis in 56 of 58 pelvicaliceal systems (96%). The ureteral morphology was correctly evaluated in 59 of 64 ureters (92%), The method showed limited efficiency for evaluating nonfunctioning renal units. CONCLUSIONS. Respiratory-gated, gadolinium-enhanced T1-weighted MR urography is a feasible and effective diagnostic tool in the assessment of upper urinary tract morphology in children. It is especially useful in depicting nondilated collecting systems and ureters.