2012, Number 1
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Med Sur 2012; 19 (1)
Hydronephrosis and pyelonephritis in a pregnant woman: a proposal of MR urography clinical applications
Ramírez-Carmona R, Martínez-López M, Roldán-Valadez E
Language: English
References: 13
Page: 38-45
PDF size: 628.06 Kb.
ABSTRACT
Introductnion. MR urography has been used satisfactorily to evaluate
kidneys, pelvicaliceal system, ureters and bladder, this technique
has the advantage of not using ionizing radiation and also the
potential to provide functional information as CT or even more.
Case report. We present a case of a 25-years-old pregnant woman
with right lumbar pain and probable urolithiasis, the static fluid
MR urography demonstrate extrinsic ureteral compression by the
pregnant uterus at the lower third bilaterally but predominantly right
as well as, right kidney hydronephrosis and pyelonephritis, with the
direction of an MR specialized radiologist, pelvic complementary
images were taken in order to evaluate the ureter-bladder junction
without evidence of urolithiasis.
Discussion. MR urography is based
in two different imaging strategies basically, which can be used
in a complementary manner to cover the mayor aspects in the
diagnosis of the upper urinary tract diseases. The first technique
utilizes unenhanced heavily T2-weighted pulse sequences to obtain
static-fluid images of the urinary tract, even if the renal excretory
function is abnormal. The second MR urography technique is
analogous to conventional intravenous urography and is called excretory
MR urography, in which is necessary to administer intravenously
a non-nephrotoxic gadolinium chelate and after its renal
excretion, the gadolinium-enhanced urine is visualized using fast
T1-weighted fat saturated sequences. Magnetic resonance urography
protocol performed in combination with standard MR imaging
offers a potential to reduce the need for invasive pyelography.
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