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  • 1
    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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  • 2
    Keywords: Germany ; renal ; renal function ; RENAL-FUNCTION ; MR ; CHILDREN
    Type of Publication: Journal article published
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  • 3
    Keywords: tumor ; evaluation ; Germany ; PERFUSION ; CT ; DIAGNOSIS ; imaging ; INFORMATION ; SYSTEM ; VISUALIZATION ; VOLUME ; liver ; SITE ; TISSUE ; TUMORS ; SURGERY ; PATIENT ; IMPACT ; primary ; DYNAMICS ; MR ; MRI ; AGE ; magnetic resonance imaging (MRI) ; CHILDREN ; CHILDHOOD ; monitoring ; SOLID TUMORS ; ENHANCEMENT ; methods ; technique ; CHILD ; AGREEMENT ; pediatric ; nephroblastoma ; MEDIA ; three-dimensional ; 3D imaging ; discussion ; pediatrics ; interactive
    Abstract: Introduction: 3D imaging and surgical planning for the treatment of embryonal tumors using different techniques (CT versus MRI) are presently under discussion. Up to now, the main focus has been on visualizing the anatomy. Contrast medium dynamics have not been taken into consideration. The aim of the present study was to establish the technical means of integrating the 3D images from functional MRI data into the anatomical images and to determine clinical applications for this approach. Material and Methods: In 11 patients (mean age: 2.4 years) with solid tumors, 26 diagnostic MRI examinations were performed for primary diagnosis, treatment monitoring, or as part of the surgical planning. Seven children presented with neuroblastomas, three with Wilms' tumor, and one with advanced bilateral nephroblastomatosis. The MRI data were acquired using a 1.5-T system. For post-processing, we used volume rendering software, including an evaluation of perfusion. By using color-coded parametric images and integrating functional information, perfusion could be visualized and used for interactive surgical planning. Macroscopic and microscopic sections served as the gold standard for assessing tissue viability. Results: We were able to integrate the dynamic data into the anatomical images for all patients. A good agreement was found between the results of surgical planning, including perfusion mapping, with the surgical site, subsequently produced macroscopic sections and the results of random microscopic examinations. Conclusions: Perfusion mapping using color-coded parametric images of pediatric abdominal tumors extends the diagnostic techniques currently available. We provide first proof of the possibility of integrating functional information into 3D MR images in children. Monitoring the treatment of nephroblastoma and surgical planning for pediatric embryonal tumors represent potential applications of this technique
    Type of Publication: Journal article published
    PubMed ID: 18302062
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