title: Chronic urinary obstruction: evaluation of dynamic contrast-enhanced MR urography for measurement of split renal function.
abstract: OBJECTIVE
  To evaluate if measurement of split renal function ( SRF split renal function ) with dynamic contrast material-enhanced ( DCE dynamic contrast enhanced ) magnetic resonance (MR) urography is equivalent to that with renal scintigraphy ( RS renal scintigraphy ) in patients suspected of having chronic urinary obstruction.
  
  
  METHODS
  The study protocol was approved by the institutional ethics committee of the coordinating center on behalf of all participating centers. Informed consent was obtained from all adult patients or both parents of children. This prospective, comparative study included 369 pediatric and adult patients from 14 university hospitals who were suspected of having chronic or intermittent urinary obstruction, and data from 295 patients with complete data were used for analysis. SRF split renal function was measured by using the area under the curve and the Patlak-Rutland methods, including successive review by a senior and an expert reviewer and measurement of intra- and interobserver agreement for each technique. An equivalence test for mean SRF split renal function was conducted with an α of 5%.
  
  
  RESULTS
  Reproducibility was substantial to almost perfect for both methods. Equivalence of DCE dynamic contrast enhanced MR urography and RS renal scintigraphy for measurement of SRF split renal function was shown in patients with moderately dilated kidneys (P < .001 with the Patlak-Rutland method). However, in severely dilated kidneys, the mean SRF split renal function measurement was underestimated by 4% when DCE dynamic contrast enhanced MR urography was used compared with that when RS renal scintigraphy was used. Age and type of MR imaging device had no significant effect.
  
  
  CONCLUSIONS
  For moderately dilated kidneys, equivalence of DCE dynamic contrast enhanced MR urography to RS renal scintigraphy was shown, with a standard deviation of approximately 12% between the techniques, making substitution of DCE dynamic contrast enhanced MR urography for RS renal scintigraphy acceptable. For severely dilated kidneys, a mean underestimation of SRF split renal function of 4% should be expected with DCE dynamic contrast enhanced MR urography, making substitution questionable.
authors.affiliation: From the Departments of Radiology and/or INSERM U947, Nancy University Hospital, Université de Lorraine, Nancy, France (M.C., M.A.G., D.M., M.F., E.M., C.P., P.A.V.); Department of Nuclear Medicine, University of Strasbourg ICube (UMR7537), Strasbourg, France (E.D.); Department of Adult Diagnostic and Interventional Imaging, Pellegrin Hospital University of Bordeaux, Bordeaux, France (N.G.); Department of Nuclear Medicine, AP-HP Bicêtre Hospital, University Paris-Sud, France (A.P.); Department of Nuclear Medicine, AP-HP Bicêtre Hospital, University Paris-Sud, IR4M UMR8081 CNRS, Orsay, France (P.C.R.); PARCC-HEGP (UMR 970), INSERM, Université Paris Descartes, Sorbonne Paris Cité, Paris, France (D.B.); Department of Radiology, North Hospital, Aix-Marseille University (K.C.); Department of Radiology, Hôpital Européen Georges Pompidou, Paris, France (C.A.C.); Department of Radiology, Huriez's Hospital, University Lille Nord de France, France (L.L.); Department of Pediatric Radiology, Hôpital Robert Debré, APHP, Université Paris Diderot, Sorbonne Paris Cité, France (G.S.); and INSERM CIC-EC, Department of Epidemiology, Hôpital Brabois, Vandoeuvre-les-Nancy, F-54500, France (M.S, F.G.).
authors.forename: Michel
authors.initials: M
authors.lastname: Claudon
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Durand
authors.forename: Nicolas
authors.initials: N
authors.lastname: Grenier
authors.forename: Alain
authors.initials: A
authors.lastname: Prigent
authors.forename: Daniel
authors.initials: D
authors.lastname: Balvay
authors.forename: Philippe
authors.initials: P
authors.lastname: Chaumet-Riffaud
authors.forename: Kathia
authors.initials: K
authors.lastname: Chaumoitre
authors.forename: Charles-André
authors.initials: CA
authors.lastname: Cuenod
authors.forename: Marina
authors.initials: M
authors.lastname: Filipovic
authors.forename: Marie-Agnès
authors.initials: MA
authors.lastname: Galloy
authors.forename: Laurent
authors.initials: L
authors.lastname: Lemaitre
authors.forename: Damien
authors.initials: D
authors.lastname: Mandry
authors.forename: Emilien
authors.initials: E
authors.lastname: Micard
authors.forename: Cédric
authors.initials: C
authors.lastname: Pasquier
authors.forename: Guy H
authors.initials: GH
authors.lastname: Sebag
authors.forename: Marc
authors.initials: M
authors.lastname: Soudant
authors.forename: Pierre-André
authors.initials: PA
authors.lastname: Vuissoz
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis* / Q000209:etiology; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D014524:Urethral Obstruction / Q000175:diagnosis* / Q000209:etiology
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals