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Non-contrast-enhanced MR angiography using time-spin labelling inversion pulse technique for detecting crossing renal vessels in children with symptomatic ureteropelvic junction obstruction: comparison with surgical findings

  • Magnetic Resonance
  • Published:
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Abstract

Objectives

Investigate the feasibility and evaluate the accuracy of non-contrast-enhanced MR angiography (NC-MRA) using time-spin labelling inversion pulse (time-SLIP)to identify crossing renal vessels (CRVs) in children requiring surgical treatment of ureteropelvic junction (UPJ) obstructionand compare to laparoscopic findings.

Materials and methods

Nineteen children ranging from 6 to 16 years of age underwent NC-MRA using the time-SLIP technique before surgery. Two independent readers analysed the MRA images. Number of renal arteries and presence or absence of CRVs were identified and compared with surgicalfindings. Image quality was assessed, as well as the presence of CRVs and measurement of renal pelvis diameter. Intra and inter-reader agreement was calculated using Cohen’s kappa coefficient and Bland–Altman plots.

Results

The overall image quality was fair or good in 88% of cases. NC-MRA demonstrated CRVs at the level of the obstruction in 10 children and no CRV in 9 children. All were confirmed intra-operatively except in one of the nine children. Sensitivity, specificity, NPV, PPV for predicting CRVs were 92%, 100%, 100% and 87.5%, respectively, for both readers.

Conclusion

NC-MRA is a good alternative to contrast-enhanced MRA and CT scanning for identifying CRVs in children with symptomatic UPJ.

Key points

• Time-SLIP technique offers acceptable imaging quality for identifying crossing renal vessel.

• Time-SLIP technique is easy to apply to the renal MRA examination.

• Time-SLIP technique is an alternative to contrast-enhanced MRA and CT scanning.

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Abbreviations

CE-MRA:

Contrast-enhanced magnetic resonance angiography

NC-MRA:

Non contrast-enhanced magnetic resonance angiography

Time-SLIP:

Time spin labelling inversion pulse

CRV:

Crossing renal vessel

UPJ:

Uretero pelvic junction

CDS:

Colour Doppler sonography

bSSFP:

Balanced steady state free procession

MAG3:

Mercaptoacetyltriglycine

FSE:

Fast spin echo

TSE:

Turbo spin echo

BBTI:

Black blood inversion time

MIP:

Maximum intensity projection

ICC:

Intra-class correlation coefficient

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Acknowledgments

The scientific guarantor of this publication is Pr Nicolas Sans. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Olivier Meyrignac kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: Prospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, University Hospital Centre of Toulouse Purpan, Place du Docteur Baylac, TSA 40031, 31059, Toulouse, France

    Nicolas Brucher, Julie Vial, Christiane Baunin, David Labarre & Nicolas Sans

  2. Department of Paediatric Surgery, University Hospital Centre of Toulouse Purpan, Hôpital des enfants. 330 avenue de Grande-Bretagne, TSA 70034, 31059, Toulouse, France

    Ourdia Bouali, Olivier Abbo & Philippe Galinier

  3. Department of Radiology, University Hospital Centre of Toulouse Rangueil, 1 avenue du Pr Jean Poulhès, TSA 50032, 31059, Toulouse, France

    Olivier Meyrignac

  4. Department of Paediatric Surgery, Clinique Sarrus Teinturiers, 49 Allée Charles de Fitte, 31300, Toulouse, France

    Michel Juricic

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  1. Nicolas Brucher
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  2. Julie Vial
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Correspondence to Nicolas Brucher.

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Brucher, N., Vial, J., Baunin, C. et al. Non-contrast-enhanced MR angiography using time-spin labelling inversion pulse technique for detecting crossing renal vessels in children with symptomatic ureteropelvic junction obstruction: comparison with surgical findings. Eur Radiol 26, 2697–2704 (2016). https://doi.org/10.1007/s00330-015-4065-9

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  • DOI: https://doi.org/10.1007/s00330-015-4065-9

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