E1613. See the Fluid, See the Flow: MR Evaluation of Congenital Urinary Tract Anomalies
  1. Sherwin Chiu; Medical College of Georgia at Augusta University
  2. Manish Bajaj; Medical College of Georgia at Augusta University
Magnetic resonance (MR) urography is a powerful, non-invasive modality for evaluating urinary tract anomalies. Through the use of multiphase, multisequence protocols, detailed evaluation of anatomy and physiologic function can be obtained. In the pediatric population, MR is especially beneficial in providing multiplanar and functional assessments without ionizing radiation. The purpose of our educational exhibit is to increase the utilization of MR urography through a review of methodology for performing, interpreting, and correlating examinations.

Educational Goals / Teaching Points
Identify the necessary protocol sequences in performing MR urography. Review pathophysiology and examples of selected urinary tract anomalies. Understand the utility of MR urography in evaluation of urinary tract anatomy and pathology in pediatric patients. Correlate traditional modalities used in urinary tract imaging with MR urography for pediatric patients.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Traditional modalities of evaluating congenital urinary tract anomalies include voiding cystourethrogram, nuclear medicine scans, and ultrasound. While these methods provide valuable information, they can be limited by patient discomfort, technical limitations, and ionizing radiation. As an alternative or adjunct, MR urography generates excellent detail and presents this information in dynamic, multiplanar outputs. By utilizing multiphasic, multisequence protocols, radiologists can carefully evaluate anatomic structures, make correlations with abnormal physiology, and estimate renal function. Examples of anomalies well evaluated by MR urography include variants of collecting system duplication, ectopic ureteral insertions, and intrinsic or extrinsic strictures.

MR urography in pediatric populations provides a plethora of information regarding congenital urinary tract anomalies. By understanding the methodology of performing and interpreting these studies, MR urography is a valuable resource for any radiologist.