Zafer Özmen, Fatma Aktaş, İlkay Koray Bayrak, Serdar Savaş Gül, Türkay Yalın

Çocukluk Dönemi Obstrüktif Böbrek Hastalıklarında Dinamik Manyetik Rezonans Ürografinin Tanı Değeri

Amaç: Bu çalışmanın amacı, pediatrik üriner sistem hastalıklarının tanısında dinamik manyetik rezonans ürografi (MRÜ)’nin fonksiyonel olarak tanı değerini araştırmak ve obstrüktif patolojilerde obstrüksiyonun derecesinin belirlenmesinde dinamik MRÜ’nin doğruluğunu ortaya koymaktır. Materyal ve Metod: Çalışmaya diüretik renal sintigrafi (DRS)’den önce veya sonra dinamik MRÜ ile değerlendirilen toplam 33 hasta dahil edildi. Hastaların yaşları 1 ay ile 18 yıl (ortalama yaş=7.03 yıl) arasında değişmekteydi. Obstrüksiyonun tanısında standart test olarak DRS kabul edilerek, dinamik MRÜ’nin sensitivite, spesifite, pozitif prediktif değeri ve negatif prediktif değeri hesaplandı.Bulgular: Dinamik MRÜ ve DRS sonuçları arasında fonksiyonel olarak farklılık bulunup bulunmadığını araştırmak için bağımlı gruplarda t testi yapıldı. Split renal fonksiyon açısından dinamik MRÜ ve DRS sonuçları arasında istatistiksel olarak anlamlı farklılık saptanmadı (p=0.978). Sonuç: Çalışmamızda dinamik MRÜ ve DRS sonuçları arasında renal fonksiyonların değerlendirilmesi bakımından çok güçlü ve yüksek bir tutarlılık ve uyum saptadık. Dinamik MRÜ’nin eksresyon açısından normal ve anormal böbrekleri ayırtetmedeki etkinliğini %100 olarak saptadık.

Anahtar Kelimeler:

Dinamik manyetik rezonans ürografi, diüretik renal sintigrafi, böbrek, obstrüksiyon

Diagnostic Value Of Dynamic Magnetic Resonance Urography In Childhood Obstructive Kidney Diseases

Purpose: The aim of this study was to investigate the functional value of dynamic magnetic resonance urography (MRU) for the diagnosis of pediatric urinary system diseases, to establish the accuracy of dynamic MRU in determination of obstructive pathologies.Materials and methods: A Total of 33 patients that were evaluated with diuretic renal scintigraphy (DRS) either before or after dynamic MRU examination were included in the study. Their age varied from 1 month to 18 years (mean age was 7.03 years). Accepting DRS as the standard test for diagnosis of obstruction, sensitivity, specificity, and positive predictive and negative predictive values of dynamic MRU were calculated.Results: In order to find whether there was a functional difference between dynamic MRU and DRS measurement results, dependent t-test for paired samples was used .There was no statistically significant difference between (p = 0.978) in split renal function(SRF) results which calculated from dynamic MRU and DRS examinations. Conclusions: We found a very strong and highly significant correlation and consistency between dynamic MRU and DRS methods in terms of evaluation of renal functions. Dynamic MRU is 100% effective for discrimination of normal and abnormal kidneys in terms of excretion.

Keywords:

Dynamic magnetic resonance urography, diuretic renal scintigraphy, kidney, obstruction,

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