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Non-contrast-enhanced magnetic resonance angiography for detecting crossing renal vessels in infants and young children: comparison with contrast-enhanced angiography and surgical findings

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Abstract

Background

Knowing that ureteropelvic junction obstruction is due to a crossing renal vessel is essential in choosing the appropriate surgical treatment.

Objective

To evaluate the diagnostic accuracy of non-contrast magnetic resonance (MR) angiography in identifying crossing renal vessels in children younger than 4 years old with unilateral hydronephrosis.

Materials and methods

A retrospective review of preoperative MR urography of children with unilateral hydronephrosis was conducted by two independent readers. The presence or absence of crossing renal vessels was identified and compared with surgical findings.

Results

Twenty-nine patients were included. The disagreement between MR angiography with and without contrast enhancement in detecting a crossing renal vessel was 8%. The disagreement between non-contrast-enhanced MR and surgical findings was 17%. The disagreement between contrast-enhanced MR angiography and surgical findings was 25%. The balanced triggered angiography without contrast enhancement had a sensitivity of 70% (95% confidence interval [CI]: 35-93%) and a specificity of 93% (95% CI: 66-100%). Contrast-enhanced MR angiography had a sensitivity of 56% (95% CI: 21-86%) and a specificity of 91%. (95% CI: 59-100%).

Conclusion

MR without contrast enhancement may be a reliable, valid and safe alternative to contrast-enhanced MR angiography for identifying crossing renal vessels.

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Authors and Affiliations

  1. Radiology Department, IRCCS Istituto Giannina Gaslini, University of Genoa, Largo Gaslini 5, 16147, Genoa, Italy

    Fiammetta Sertorio, Veronica Incarbone, Gian Michele Magnano & Maria Beatrice Damasio

  2. University of Genoa, Via Balbi, 5, 16126, Genoa, Italy

    Fiammetta Sertorio & Michela Cing Yu Wong

  3. Pediatric Surgery Department, IRCCS Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy

    Michela Cing Yu Wong & Girolamo Mattioli

  4. Radiology Department, University of Insubria, Viale Borri, 57, Varese, Italy

    Veronica Incarbone

  5. Epidemiology, Biostatistics and Committees Unit, IRCCS Istituto Giannina Gaslini, University of Genoa, Largo Gaslini 5, 16147, Genoa, Italy

    Angela Pistorio

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  1. Fiammetta Sertorio
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  2. Michela Cing Yu Wong
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Correspondence to Fiammetta Sertorio.

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Sertorio, F., Wong, M.C.Y., Incarbone, V. et al. Non-contrast-enhanced magnetic resonance angiography for detecting crossing renal vessels in infants and young children: comparison with contrast-enhanced angiography and surgical findings. Pediatr Radiol 49, 105–113 (2019). https://doi.org/10.1007/s00247-018-4252-3

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  • DOI: https://doi.org/10.1007/s00247-018-4252-3

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