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  • 1
    Keywords: tumor ; Germany ; THERAPY ; CT ; imaging ; INFORMATION ; TOOL ; VISUALIZATION ; VOLUME ; NEW-YORK ; DIFFERENTIATION ; TUMORS ; computed tomography ; NUCLEAR-MEDICINE ; PATIENT ; kidney ; MRI ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; TRIAL ; TRIALS ; METASTASIS ; chemotherapy ; COMPUTED-TOMOGRAPHY ; CHILDREN ; nuclear medicine ; MANAGEMENT ; PREOPERATIVE CHEMOTHERAPY ; radiology ; ONCOLOGY ; CHILDHOOD ; THERAPIES ; monitoring ; NUCLEAR ; USA ; EXTENT ; CHILD ; pediatric ; BONE METASTASES ; nephroblastoma ; SIOP ; MEDICINE ; three-dimensional ; INTERNATIONAL-SOCIETY ; PARTIAL NEPHRECTOMY ; IMAGING CHARACTERISTICS ; INTRAVASCULAR EXTENSION ; UNILATERAL WILMS-TUMOR
    Abstract: Magnetic resonance imaging (MRI) presents the main diagnostic tool for differentiation and staging of renal tumors in childhood. Nephroblastoma is the most common malignant tumor in children. Radiological findings play an important role in therapy study trials of SIOP (International Society of Pediatric Oncology), especially for indicating preoperative chemotherapy. In the past few years MRI has gained great importance in imaging of nephroblastoma and has replaced computed tomography (CT). The aim of this review is to present the diagnostic possibilities of MRI in relation to the requirements of therapy studies. For nephroblastoma, MRI provides important information about tumor extent and distant metastasis. A special focus of MRI in distant staging is venous extent of the tumor into the inferior vena cava. In addition, MRI has an important role in monitoring chemotherapy and in preoperative planning by volume rendering and three-dimensional postprocessing
    Type of Publication: Journal article published
    PubMed ID: 18193429
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  • 2
    Keywords: evaluation ; IMAGES ; SYSTEM ; PATIENT ; renal function ; CONTRAST AGENT ; MR ; RAT-KIDNEY ; SEQUENCE ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; ECHO ; SCINTIGRAPHY ; intravenous ; MR imaging ; KIDNEY-FUNCTION ; DIURESIS RENOGRAPHY ; DYNAMIC GD-DTPA ; GADOLINIUM-DTPA COMPLEX ; GLOMERULAR-FILTRATION ; PARTIAL URETERAL OBSTRUCTION ; radioisotope renography ; urinary tract obstruction ; URINARY-TRACT OBSTRUCTION ; urodynamics
    Abstract: Renal function evaluation in the pediatric patient is generally based on scintigraphic examinations where a baseline gamma- camera renography is used to determine single kidney function, and diuresis renography is obtained to assess urinary drainage from the pelvicalyceal system. Magnetic resonance imaging also permits the evaluation of renal functional processes using fast dynamic sequences. Principally, an agent cleared by renal excretion is intravenously injected and its cortical uptake, parenchymal transport, and eventually its urinary excretion are followed with serial images. Different approaches have been presented most of which are based on T1-weighted gradient- recalled echo sequences with short TR and TE and a low flip angle obtained after intravenous injection of Gd-DTPA or Gd- DOTA. These techniques permit renal functional assessment using different qualitative and quantitative parameters; however, most of these methods are not suitable for the evaluation of urinary tract dilatation in infants and children. For the diagnostic work-up of children with congenital urinary tract obstruction and malformation a technique was developed which permits quantitative determination of single kidney function, in addition to evaluating urinary excretion disturbances analogous to that possible with scintigraphy
    Type of Publication: Journal article published
    PubMed ID: 12695825
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  • 3
    Keywords: Germany ; renal ; renal function ; RENAL-FUNCTION ; MR ; CHILDREN
    Type of Publication: Journal article published
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  • 4
    Keywords: animal, animals, DECLINE, EXPRESSION, FETAL SHEEP, fibrosis, FOLLOW-UP, Germany, glomerular filtrati
    Abstract: The significance of delayed tissue tracer transit (TTT) of Tc-99m-mercaptoacetyltriglycine (Tc-99m-MAG3) has not been systematically evaluated in hydronephrosis. We sought to demonstrate that delayed TTT accompanies both functional decline and histomorphologic restructuring. Methods: Twenty 2- to 3-mo-old piglets with surgically induced partial unilateral ureteral stenosis were examined with magnetic resonance urography (MRU) to evaluate morphology and with 99mTc-MAG3 diuretic renography (DR) to determine single-kidney function (SKF), evaluate the response to furosemide stimulation (RFS), and assess TTT. All animals had DR and MRU before and after surgery and a third DR after surgery. Piglets were sacrificed after the final DR for renal histology. A total histologic score (THS) was generated. Results: Preoperative DR demonstrated nonobstructive RFS, timely TTT, and balanced SKF in all 20 kidneys. After ureteral ligature, MRU demonstrated pelvic dilatation in all piglets. The postoperative DRs revealed 12 kidneys with delayed TTT in one or both follow-ups. In these 12 kidneys, the SKF declined from 51% +/- 4% to 18% +/- 14%, and the THS was 9.0 +/- 4.0. Three kidneys always had timely TTT, balanced SKF, and a THS of 1.8 +/- 0.3. The contralateral, nonoperated kidneys had timely TTT and a THS of 1.2 +/- 0.9. Postoperative scintigrams showed that 3 of 8 kidneys (38%) with an obstructive RFS had timely TTT, which demonstrates that TTT and RFS are not equivalent. Conclusion: In hydronephrosis, a delayed TTT of Tc-99m-MAG3 accompanies both functional decline and histomorphologic restructuring in obstruction. According to the literature, a delayed TTT is determined by the filtration fraction of the kidneys and appears to identify an obstruction-mediated upregulated renin-angiotensin system
    Type of Publication: Journal article published
    PubMed ID: 18552148
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