دورية أكاديمية
Dynamic Contrast Enhanced-MR CEST Urography: An Emerging Tool in the Diagnosis and Management of Upper Urinary Tract Obstruction
| العنوان: | Dynamic Contrast Enhanced-MR CEST Urography: An Emerging Tool in the Diagnosis and Management of Upper Urinary Tract Obstruction |
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| المؤلفون: | Shaowei Bo, Farzad Sedaghat, KowsalyaDevi Pavuluri, Steven P. Rowe, Andrew Cohen, Max Kates, Michael T. McMahon |
| المصدر: | Tomography, Vol 7, Iss 1, Pp 80-94 (2021) |
| بيانات النشر: | MDPI AG, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Computer applications to medicine. Medical informatics |
| مصطلحات موضوعية: | urinary tract obstructions, ultrasound, CT, contrast enhanced MRI, CEST, Computer applications to medicine. Medical informatics, R858-859.7 |
| الوصف: | Upper urinary tract obstructions (UTOs) are blockages that inhibit the flow of urine through its normal course, leading to impaired kidney function. Imaging plays a significant role in the initial diagnosis of UTO, with anatomic imaging (primarily ultrasound (US) and non-contrast computed tomography (CT)) serving as screening tools for the detection of the dilation of the urinary collecting systems (i.e., hydronephrosis). Whether hydronephrosis represents UTO or a non-obstructive process is determined by functional imaging (typically nuclear medicine renal scintigraphy). If these exams reveal evidence of UTO but no discernable source, multiphase contrast enhanced CT urography and/or dynamic contrast enhanced MR urography (DCE-MRU) may be performed to delineate a cause. These are often performed in conjunction with direct ureteroscopic evaluation. While contrast-enhanced CT currently predominates, it can induce renal injury due to contrast induced nephropathy (CIN), subject patients to ionizing radiation and is limited in quantifying renal function (traditionally assessed by renal scintigraphy) and establishing the extent to which hydronephrosis is due to functional obstruction. Traditional MRI is similarly limited in its ability to quantify function. DCE-MRU presents concerns regarding nephrogenic systemic fibrosis (NSF), although decreased with newer gadolinium-based contrast agents, and regarding cumulative gadolinium deposition in the basal ganglia. DCE-MR CEST urography is a promising alternative, employing new MRI contrast agents and imaging schemes and allowing for concurrent assessment of renal anatomy and functional parameters. In this review we highlight clinical challenges in the diagnosis and management of UTO, identify key advances in imaging agents and techniques for DCE-MR CEST urography and provide perspective on how this technique may evolve in clinical importance. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2379-139X 2379-1381 |
| Relation: | https://www.mdpi.com/2379-139X/7/1/8; https://doaj.org/toc/2379-1381; https://doaj.org/toc/2379-139X |
| DOI: | 10.3390/tomography7010008 |
| URL الوصول: | https://doaj.org/article/f73b39c9d32947fba665c096a87e6a4b |
| رقم الأكسشن: | edsdoj.f73b39c9d32947fba665c096a87e6a4b |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 2379139X 23791381 |
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| DOI: | 10.3390/tomography7010008 |