Assessment of Pelviureteric Junction Obstruction by Diffusion and Perfusion Parameters on Three Tesla MRI in Comparison with Diuretic Renography | ||||
| Benha Medical Journal | ||||
| Volume 42, Issue 6, June 2025, Page 149-160 PDF (797.29 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/bmfj.2025.345017.2294 | ||||
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| Authors | ||||
Tamer Ahmed1; Hossam Mostafa Gad2; Ahmed Said Mohamed3; Ahmed Magdy Bebars Abdeen  4
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| 1Professor of Radiodiagnosis, Faculty of Medicine, Benha University | ||||
| 2Professor of Radiodiagnosis, Urology and Nephrology Center, Faculty of Medicine, Benha University | ||||
| 3Radiodiagnosis department, Benha University – Faculty of Medicine | ||||
| 4Department of Radiodiagnosis, Faculty of medicine, Benha University | ||||
| Abstract | ||||
| Background: Pelviureteric junction (PUJ) obstruction is a common cause of neonatal and antenatal hydronephrosis, often diagnosed in childhood, but can also affect adults. Diagnosis involves various imaging modalities, with magnetic resonance imaging (MRI) offering high-resolution, non-invasive assessment. Diffusion-weighted MRI (DW-MRI) and dynamic contrast-enhanced (DCE) MRI are advanced techniques that provide functional imaging, while diuretic renography is the established method for evaluating obstruction. This study aims to evaluate the effectiveness of DW-MRI and DCE-MRI parameters compared to diuretic renography in assessing PUJ obstruction. Methods: Thirty patients diagnosed with PUJ obstruction were included in this cross-sectional study conducted at the Urology and Nephrology Center, Mansoura University, Egypt, from October 2023 to September 2024. All patients underwent MRI, including DW-MRI and DCE-MRI, alongside diuretic renography. Results: Significant differences were found between obstructive and non-obstructive groups in diuretic renography, with higher T1/2 and lower glomerular filtration rate (GFR) in obstructive cases (P ≤ 0.001). Apparent diffusion coefficient (ADC) values from DW-MRI significantly differed between groups (P < 0.001). A ROC curve analysis showed that ADC had a sensitivity of 77.8% and specificity of 52.2% for predicting obstruction at a cutoff of 2.17. Conclusion: DW-MRI provides significant functional data that correlates with diuretic renography parameters, demonstrating its potential as a reliable alternative for assessing PUJ obstruction. | ||||
| Keywords | ||||
| Pelviureteric Junction Obstruction; Apparent Diffusion Coefficient; Diffusion-Weighted Imaging; Diuretic; Magnetic Resonance Imaging | ||||
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