title: Intravoxel incoherent motion magnetic resonance imaging to predict vesicoureteral reflux in children with urinary tract infection.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Departments of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, Korea.
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Departments of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, Korea. chlee86@korea.ac.kr.
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Departments of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kee Hwan
authors.initials: KH
authors.lastname: Yoo
authors.affiliation: Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Bo-Kyung
authors.initials: BK
authors.lastname: Je
authors.affiliation: Siemens Healthcare, Oncology Application Development, Erlangen, Germany.
authors.forename: Berthold
authors.initials: B
authors.lastname: Kiefer
authors.affiliation: Departments of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, Korea.
authors.forename: Yang Shin
authors.initials: YS
authors.lastname: Park
authors.affiliation: Departments of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, Korea.
authors.forename: Kyeong Ah
authors.initials: KA
authors.lastname: Kim
authors.affiliation: Departments of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul, 152-703, Korea.
authors.forename: Cheol Min
authors.initials: CM
authors.lastname: Park
mesh_terms: D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D009038:Motion; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014552:Urinary Tract Infections / Q000150:complications*; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: Intravoxel incoherent motion; Magnetic resonance imaging; Pediatrics; Urinary tract infections; Vesico-ureteral reflux