The comparison of magnetic resonance urography with the combination of diuretic renal scintigraphy and urinary ultrasound in the diagnosis and follow up of ureteropelvic junction obstruction

Objectives: To evaluate the efficiency and reliability of MRU in diagnosis and follow up of children with UPJO. Methods: Thedata of64 patients with the diagnosis of primary UPJO were analysed. All patients underwent Anderson-Hynes pyeloplasty and pelvic reduction. Pre- and postoperative results of renal pelvis AP diameter (RPAPD), separated renal function, renal transit time (RTT), and anatomical findings in USG and renal scintigraphywere compared with MRU findings to evaluate the possible differences and analyze the efficiency and reliability of MRU in the management of UPJO. Results: The mean age 7.2 ± 1.8 years. All patients had unilateral hydronephrosis including 16 grade 2, 24 grade 3 and 24 grade 4. Pre- and postoperative RPAPDs in two techniques were also similar (P = 0.084, P = 0.576). Separated renal functions were evaluated by MRU with similar affectivity and sensitivity in DRS (P = 0.867). The comparison of mean pre and postoperative RTT results showed a significant improvement in mean postoperative RTT value (P = 0.024). Conclusions: MRU has the potential to become the imaging study of choice in the diagnosis and follow up of obstructive uropathy, and it may have a more significant role in the management of UPJO in the near future. Keywords: MR urography, ultrasonography, renal scintigraphy, UPJ obstruction, pyeloplasty, children.