Static fluid magnetic resonance urography in evaluation of ureteral ectopia: Experience in 10 pediatric cases

Abstract

Introduction: Ectopic ureters are often very difficult to diagnose with conventional imaging modalities especially in children. Magnetic resonance urography (MRU) has been recently investigated as a problem-solving tool for the evaluation of various congenital urogenital anomalies with favorable results.

Aim of the work: To assess the value of static fluid MRU in diagnosing ectopic ureters in childhood.

Patientsand methods: Ten out of 14 pediatric patients with suspected ureteral ectopia (as suggested by clinical or conventional imaging techniques) were included in this study and prospectively studied by MRUaiming to confirmthe suspected diagnosis. The examinations were done on 1.5T machines using static fluid T2W-MRU sequences. Ultrasound examinations were done for all patients. Voiding cystourethrogram (VCUG) was done for 8 patients to exclude vesico-ureteric reflux or urethral anomalies.

Results: All studied patients had dilated collecting systems. Static fluid MRU was able to detect the site of ectopic ureteric insertion in all 10 patients. It was superior to ultrasound in evaluation of 8 cases with complex duplex systems. In one patient with multiple congenital anomalies, MRU clearly demonstrated the urinary and extra-urinary anomalies. The final diagnosis was confirmed by surgical or endoscopic data in all patients.

Conclusions: In dilated collecting systems, static fluid MRU can provide detailed assessment of the collecting systems and ureters as well as adequately detect ureteral ectopia. MRU should be recommended whenever a ureteric insertion anomaly is suspected.

Keywords: Magnetic resonance urography; MRU; Ectopic ureter; Ureteral ectopia; Ureteric insertion anomalies