Intravoxel incoherent motion magnetic resonance imaging to predict vesicoureteral reflux in children with urinary tract infection

Jeong Woo Kim, Chang-Hee Lee, Kee Hwan Yoo, Bo-Kyung Je, Berthold Kiefer, Yang Shin Park, Kyeong Ah Kim, Cheol Min Park

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: 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). Methods: 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. Results: 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). Conclusion: 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. Key Points: • 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.

Original languageEnglish
Pages (from-to)1670-1677
Number of pages8
JournalEuropean Radiology
Volume26
Issue number6
DOIs
Publication statusPublished - 2016 Jun 1

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Vesico-Ureteral Reflux
Urinary Tract Infections
Magnetic Resonance Imaging
Perfusion
Kidney
Kidney Pelvis
ROC Curve
Contrast Media

Keywords

  • Intravoxel incoherent motion
  • Magnetic resonance imaging
  • Pediatrics
  • Urinary tract infections
  • Vesico-ureteral reflux

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Intravoxel incoherent motion magnetic resonance imaging to predict vesicoureteral reflux in children with urinary tract infection. / Kim, Jeong Woo; Lee, Chang-Hee; Yoo, Kee Hwan; Je, Bo-Kyung; Kiefer, Berthold; Park, Yang Shin; Kim, Kyeong Ah; Park, Cheol Min.

In: European Radiology, Vol. 26, No. 6, 01.06.2016, p. 1670-1677.

Research output: Contribution to journalArticle

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AU - Lee, Chang-Hee

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AU - Je, Bo-Kyung

AU - Kiefer, Berthold

AU - Park, Yang Shin

AU - Kim, Kyeong Ah

AU - Park, Cheol Min

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AB - Objectives: 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). Methods: 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. Results: 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). Conclusion: 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. Key Points: • 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.

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KW - Urinary tract infections

KW - Vesico-ureteral reflux

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