MR urography in evaluating obstructive uropathy: one stop shop


  • Dipali Kadam Department of Radiodiagnosis, NKP Salve Institute of Medical Science and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
  • Saurabh Patil Department of Radiodiagnosis, NKP Salve Institute of Medical Science and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
  • Avinash Dhok Department of Radiodiagnosis, NKP Salve Institute of Medical Science and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
  • Meenal Jain Department of Radiodiagnosis, NKP Salve Institute of Medical Science and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India



Excretory urography, Magnetic resonance urography, Obstructive uropathy, Static-fluid urography


Background: Any anatomical or physiological obstruction to flow of urine in urinary tract results in obstructive uropathy which is one of the leading etiologies of renal failure. So, physicians require accurate and early diagnosis of obstructive uropathy to initiate appropriate treatment of these entities for better prognosis of patient. The purpose of the present study aims to determine the feasibility, accuracy and diagnostic potential of combined static and excretory MR Urography in patients of clinical features of obstructive uropathy with sonographically detected hydronephrosis.

Methods: A cross sectional study of 100 patients were carried in the Department of Radio-diagnosis. The results of MR Urography were compared with the results of post-operative findings and clinical follow-up.

Results: In our study of 100 patients of obstructive uropathy, MRU better depicted mild to severe PCS dilatation, renal and ureteric calculi, impaired renal function, extrinsic ureteric and PUJ obstruction. Static-fluid and excretory MR urography provided a comprehensive evaluation of the kidneys, ureters, bladder, vasculature, and soft tissues in patients with symptoms of obstructive uropathy.

Conclusions: MR urography provided a superior imaging of urinary system dilatation, the site and the etiology of obstruction. In conclusions, static and excretory MRU give both morphological and functional information in a single examination without exposure to ionizing radiation and iodinated contrast agent.


Silverman SG, Leyendecker JR, Amis ES. What is the current role of CT urography and MR urography in the evaluation of the urinary tract. Radiology. 2009;250(2):309-23.

Hennig J, Friedburg HG, Frankenschmidt A. Rapid acquisition with relaxation enhancement MR urography: a fast non tomographic imaging procedure for demonstrating the efferent urinary pathways using nuclear magnetic resonance. Der Radiologe. 1987;27(1):45-7.

Leyendecker JR, Barnes CE, Zagoria RJ. MR Urography: techniques and clinical applications. Radiographics. 2008;28(1):23-5.

Abou El-Ghar ME, Shokier AA, Refaie HF, El-Diasty TA. MRI in patients with chronic obstructive uropathy and compromised renal function: a sole method for morphological and functional assessment. Br J Radiol. 2008;81(968):624-9.

Little SB, Jones RA, Grattan-Smith JD. Evaluation of UPJ obstruction before and after pyeloplasty using MR urography. Pediatr Radiol. 2008;38(1):S106–124.

O’Connor OJ, McLaughlin P, Maher MM. MR Urography. Am J Roentgenol. 2010;195(3):W201–20.

Cohnen M, Brause M, May P, Hetzel G, Saleh A, Grabensee B, et al. Contrast enhanced MR urography in the evaluation of renal transplants with urological complications. Clin Nephrol. 2002;58:111-7.

Slovis TL. Magnetic resonance urography (MRU) course introduction. Pediatr Radiol. 2008;38:S1-2.

Karaveli M, Katsanidis D, Kalaitzoglou I, et al. MR urography: anatomical and quantitative information on congenital malformations in children. Niger Med J. 2013;54:136-42.

Childs DD, Leyendecker JR, Gianini J, Hall C. Contrast-enhanced magnetic resonance urography at 3T: clinical feasibility. J Comput Assist Tomogr. 2013;37:29-36.

Garcia-Bournissen F, Shrim A, Koren G. Safety of gadolinium during pregnancy. Canadian Family Physician. 2006;52(3):309-10.

Renjen P, Bellah R, Hellinger JC, Darge K. Advances in uroradiologic imaging in children. Radiol Clin N Am. 2012;50:207-18.

Adeb M, Darge K, Dillman JR, Carr M, Epelman M. Magnetic resonance urography in evaluation of duplicated renal collecting systems. Magn Reson Imaging Clin N Am. 2013;21:717-30.

Dickerson E, Dillman J, Smith E. Pediatric MR urography: Indications, techniques, and approach to review. RadioGraphics. 2015;35:1208-30.

Grenier N, Pariente JL, Trillaud H, Soussotte C, Douws C. Dilatation of the collecting system during pregnancy: physiologic vs obstructive dilatation. Eur Radiol. 2000;10(2):271–9.

Nolte-Ernsting CC, Adam GB, Günther RW. MR urography: examination techniques and clinical applications. Eur Radiol. 2001;11:355-72.

Roy C, Saussine C, Guth S, Horviller S, Tuchmann C, Vasilescu C, et al. MR urography in the evaluation of urinary tract obstruction. Abdom Imag. 1998;23:27-34.

Pradham TS, Duan H, Katsoulakis E, Salame G, Lee YC, Abulafia O. Hydronephrosis as a prognostic indicator of survival in advanced cervix cancer. Int J Gynecol Cancer. 2011;21:1091–6.

Patel K, Foster NR, Kumar A. Hydronephrosis in patients with cervical cancer: an assessment of morbidity and survival. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer. 2015;23(5):1303-9.

Riyach O, Ahsaini M, Kharbach Y, Bounoual M, Tazi MF, El Ammar JE, et al. Bilateral ureteral obstruction revealing a benign prostatic hypertrophy: a case report and review of the literature. J Med Case Reports. 2014;8:42.






Original Research Articles