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- Title
Intravoxel incoherent motion magnetic resonance imaging to predict vesicoureteral reflux in children with urinary tract infection.
- Authors
Kim, Jeong; Lee, Chang; Yoo, Kee; Je, Bo-Kyung; Kiefer, Berthold; Park, Yang; Kim, Kyeong; Park, Cheol; Kim, Jeong Woo; Lee, Chang Hee; Yoo, Kee Hwan; Park, Yang Shin; Kim, Kyeong Ah; Park, Cheol Min
- Abstract
<bold>Objectives: </bold>To compare the diffusion parameters of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) between the "reflux" and the "non-reflux" kidneys, and to evaluate the feasibility of using IVIM DWI to predict vesicoureteral reflux (VUR) in children with a urinary tract infection (UTI).<bold>Methods: </bold>Eighty-three kidneys from 57 pediatric patients with a UTI were classified into "reflux" and "non-reflux" groups according to voiding cystourethrography (VCUG) results. The apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (PF) were measured and compared in the renal pelvis of both groups. Four indices (D*/ADC, PF/ADC, D*/D, and PF/D) were calculated and receiver operating characteristic (ROC) curve analyses were performed.<bold>Results: </bold>VURs were detected on VCUG in 21 kidneys. PF and D* were significantly higher in the "reflux" group than in the "non-reflux" group. The indices were all significantly higher. The PF/D index showed the best diagnostic performance in predicting VUR in children with UTI (Az = 0.864).<bold>Conclusion: </bold>PF and D* were significantly higher in the "reflux" kidney than in the "non-reflux" kidney. Our new index (PF/D) could prove useful for predicting VUR.<bold>Key Points: </bold>• IVIM DWI is both radiation-free and contrast media-free. • IVIM DWI index is easily calculated by combining diffusion parameters. • IVIM DWI may help predict VUR in children with UTI. • PF is significantly higher in the "reflux" than the "non-reflux" kidneys. • A new VUR index, PF/D could prove useful for predicting VUR.
- Subjects
VESICO-ureteral reflux; URINARY tract infection diagnosis; MAGNETIC resonance imaging; URINARY tract infections in children; JUVENILE diseases; THERAPEUTICS
- Publication
European Radiology, 2016, Vol 26, Issue 6, p1670
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-015-3986-7