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01-01-2014 | Urogenital

MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging

Authors: Pierre-Hugues Vivier, Asmaa Sallem, Marion Beurdeley, Ruth P. Lim, Julien Leroux, Jérome Caudron, Cyril Coudray, Agnès Liard, Isabelle Michelet, Jean-Nicolas Dacher

Published in: European Radiology | Issue 1/2014

Abstract

Objectives

To evaluate the performance of diffusion-weighted imaging (DWI) against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1-WI) in children.

Methods

Thirty-nine consecutive patients (mean age 5.7 years) with suspected acute pyelonephritis underwent magnetic resonance imaging (MRI) including DWI and (the reference standard) Gd-T1-WI. Each study was read in double-blinded fashion by two radiologists. Each kidney was graded as normal or abnormal. Sensitivity and specificity of DWI were computed. Agreement between sequences and interobserver reproducibility were calculated (Cohen κ statistic and the McNemar tests).

Results

Thirty-two kidneys (41 %) had hypo-enhancing areas on Gd-T1-W images. The sensitivity and specificity of DWI were 100 % (32/32) and 93.5 % (43/46). DWI demonstrated excellent agreement (κ = 0.92,) with Gd-T1-W, with no significant difference (P = 0.25) in detection of abnormal lesions. Interobserver reproducibility was excellent with DWI (κ = 0.79).

Conclusion

DWI enabled similar detection of abnormal areas to Gd-T1-WI and may provide an injection-free means of evaluation of acute pyelonephritis.

Key points

• Diffusion weighted magnetic resonance imaging (DWI) can confirm acute pyelonepritis.

• DWI provided comparable results to gadolinium enhanced T1-W MRI in acute pyelonepritis.

• Contrast medium injection could be avoided for diagnosing acute pyelonephritis by MRI.

• MRI with T2-WI and DWI provide a fast and comprehensive diagnostic tool.

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Title: MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging
Authors: Pierre-Hugues Vivier
Asmaa Sallem
Marion Beurdeley
Ruth P. Lim
Julien Leroux
Jérome Caudron
Cyril Coudray
Agnès Liard
Isabelle Michelet
Jean-Nicolas Dacher
Publication date: 01-01-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 1/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2971-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging

Abstract

Objectives

Methods

Results

Conclusion

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key points

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