DIAGNOSTIC VALUE OF SINGLE SHOT FAST SPIN ECHO (SS-FSE) SEQUENCE AND THREE DIMENSIONAL FAST SPIN ECHO (3D-FSE) TECHNIQUE MAGNETIC RESONANCE UROGRAPHY IN EVALUATION OF OBSTRUCTIVE UROPATHY

Abstract

Introduction: Magnetic Resonance Urography (MRU) is a relatively new and developing technique for the evaluation of obstructive uropathy. It offers unique advantages in terms of safety, particularly in patients where exposure to radiation and contrast are of concern. Aims and objectives: The current study aims to evaluate the diagnostic value of SS-FSE and 3D-FSE techniques of MRU in identifying the varied etiology of obstructive uropathy (OU) and grading the level of obstruction. Materials and methods: A prospective cross-sectional study was conducted using demographic and clinical data of obstructive uropathy (OU) patients (n=30) who underwent Magnetic Resonance Urography (MRU) evaluation using SS-FSE and 3D-FSE sequences after informed consent was obtained. Individual case details documented included age, gender, complaint, location of lesion/obstruction, laterality, hydronephrosis grade, blood urea and serum creatinine, urinary pH, calcium, and oxalates levels. Statistical analysis of the data thus documented in a Microsoft Excel sheet was performed using Version 25 SPSS. Results: The study showed calculus obstruction as the leading cause of uropathy in the study population (76.7%, n=23 out of 30 patients) with distal ureter being the most commonly obstructed (39%, n=9 out of 23 patients). Our analysis revealed the overall diagnostic accuracy of SS-FSE (n=22, 95.7%) and 3D FSE (n=23,100%) sequences when used in conjunction to be very similar to that of CT (n=23,100%) in evaluating etiology. Conclusion: The study concludes that both the MRU sequences of single-shot fast echo and three-dimensional fast spin echo sequence have signicantly high diagnostic value in identifying etiology and grading obstructive uropathy (OU). Further advancements in Magnetic Resonance Urography (MRU) sequences can play a major role in developing a comprehensive protocol or even single step investigation for evaluation of Obstructive uropathy.