title: Interactive magnetic resonance voiding cystourethrography (iMRVC) for vesicoureteric reflux (VUR) in unsedated infants: a feasibility study.
abstract: OBJECTIVE
  The current reference standard for diagnosing vesicoureteric reflux is the X-ray-based Micturating CystoUrethroGram (MCUG). The aim of this study was to evaluate the feasibility of performing interactive Magnetic Resonance voiding cysto-urethrography (iMRVC) in un-sedated infants.
  
  
  METHODS
  Twelve infants underwent conventional single-cycle MCUG followed by iMRVC. In iMRVC, patients were examined using an in-house developed fluoroscopic pulse sequence, which allows on-the-fly control of image contrast and geometry. A single acquisition was performed during bladder filling, during and after micturition, with interactive control over imaging parameters. Images were assessed for diagnostic quality and presence of VUR.
  
  
  RESULTS
  Every case of reflux identified with MCUG was identified on iMRVC (100% sensitivity). Over 24 renal units, there was 88% concordance (21/24) according to the presence of reflux between the two methods. There were three "false positives" detected by MRI, giving a specificity of 83.3%, PPV of 66.7% and NPV of 100%.
  
  
  CONCLUSIONS
  iMRVC is a feasible method for evaluating the renal tract in infants without the need for radiation or sedation. A formal evaluation is required to establish its diagnostic potential.
authors.affiliation: Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Box 219, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
authors.forename: Owen J
authors.initials: OJ
authors.lastname: Arthurs
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Edwards
authors.forename: Ilse
authors.initials: I
authors.lastname: Joubert
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Graves
authors.forename: Pat A K
authors.initials: PA
authors.lastname: Set
authors.forename: David J
authors.initials: DJ
authors.lastname: Lomas
mesh_terms: D015331:Cohort Studies; D016292:Procedural Sedation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015641:Radiography, Interventional / Q000379:methods*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014521:Urethra / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000000981:diagnostic imaging*