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AJR 2000; 175:1697-1702
© American Roentgen Ray Society

MR Virtual Endoscopy of the Upper Urinary Tract

Emanuele Neri1, Piero Boraschi2, Davide Caramella1, Luigi Battolla1, Roberto Gigoni2, Nicola Armillotta1, Giovanni Braccini2 and Carlo Bartolozzi1

1 Department of Oncology, Transplants and Advanced Technologies in Medicine, Division of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
2 Second Department of Radiology, Pisa University Hospital, 56100, Pisa, Italy.

OBJECTIVE. We investigated the feasibility of applying surface-rendered virtual endoscopy to the visualization of the upper urinary tract by processing unenhanced MR urography data sets.

SUBJECTS AND METHODS. Twenty-six patients, having neoplastic lesions (n = 9), calculi (n = 8), pelviureteric junction stenoses (n = 4), postoperative fibrotic strictures (n = 3), and extrinsic compressions of the ureter (n = 2), underwent unenhanced MR urography. Virtual endoscopy of the upper urinary tract was obtained using a thresholding technique and surface-rendering MR urography data sets.

RESULTS. Virtual endoscopy of the renal pelvis and calices was feasible in all cases on the side of the urinary obstruction. Virtual endoscopy of the ureter was obtained for a diameter of at least larger than 5 mm. The nondilated side could be partially explored in 11 cases (43%). The mean virtual endoscopy threshold required for the visualization of the urinary tract was 157.36-159.94. The mean time for virtual endoscopy was 13.8 min. Endoluminal masses were found in three (12%) of 26 cases on the renal pelvis (corresponding to neoplastic lesions), and occlusions, in 23 (88%) of 26 on the pelviureteric junction and ureter (neoplastic lesions and other abnormalities).

CONCLUSION. Virtual endoscopy of MR urography data sets is feasible in patients with urinary tract dilatation. Virtual endoscopy displays the renal pelvis, calices, and ureter and, moreover, can show endoluminal changes caused by abnormalities.


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