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MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging

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Abstract

Objectives

To evaluate the performance of diffusion-weighted imaging (DWI) against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1-WI) in children.

Methods

Thirty-nine consecutive patients (mean age 5.7 years) with suspected acute pyelonephritis underwent magnetic resonance imaging (MRI) including DWI and (the reference standard) Gd-T1-WI. Each study was read in double-blinded fashion by two radiologists. Each kidney was graded as normal or abnormal. Sensitivity and specificity of DWI were computed. Agreement between sequences and interobserver reproducibility were calculated (Cohen κ statistic and the McNemar tests).

Results

Thirty-two kidneys (41 %) had hypo-enhancing areas on Gd-T1-W images. The sensitivity and specificity of DWI were 100 % (32/32) and 93.5 % (43/46). DWI demonstrated excellent agreement (κ = 0.92,) with Gd-T1-W, with no significant difference (P = 0.25) in detection of abnormal lesions. Interobserver reproducibility was excellent with DWI (κ = 0.79).

Conclusion

DWI enabled similar detection of abnormal areas to Gd-T1-WI and may provide an injection-free means of evaluation of acute pyelonephritis.

Key points

• Diffusion weighted magnetic resonance imaging (DWI) can confirm acute pyelonepritis.

• DWI provided comparable results to gadolinium enhanced T1-W MRI in acute pyelonepritis.

• Contrast medium injection could be avoided for diagnosing acute pyelonephritis by MRI.

• MRI with T2-WI and DWI provide a fast and comprehensive diagnostic tool.

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Authors and Affiliations

  1. Rouen University Hospital, CHU C. Nicolle, Service de radiopédiatrie, 1 rue de Germont, 76031, Rouen, Cedex, France

    Pierre-Hugues Vivier, Asmaa Sallem, Jérome Caudron & Jean-Nicolas Dacher

  2. Université de Rouen, INSERM U1096, 22 boulevard Gambetta, 76183, Rouen, Cedex, France

    Pierre-Hugues Vivier, Jérome Caudron & Jean-Nicolas Dacher

  3. Rouen University Hospital, CHU C. Nicolle, Service de chirurgie pédiatrique, 1 rue de Germont, 76031, Rouen, Cedex, France

    Marion Beurdeley, Julien Leroux & Agnès Liard

  4. Radiology Department, Austin Health, 145 Studley Rd, Heidelberg, 3084, Victoria, Australia

    Ruth P. Lim

  5. G. E. Healthcare, 24 Avenue de l’Europe CS 20529, 78457, Vélizy Villacoublay Cedex, France

    Cyril Coudray

  6. Rouen University Hospital, CHU C. Nicolle, Service de pédiatrie, 1 rue de Germont, 76031, Rouen, Cedex, France

    Isabelle Michelet

  7. Service d’imagerie pédiatrique et fœtale, INSERM U1096, CHU Charles Nicolle, 1 rue de Germont, 76031, Rouen CEDEX, France

    Pierre-Hugues Vivier

Authors
  1. Pierre-Hugues Vivier
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  2. Asmaa Sallem
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  3. Marion Beurdeley
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  4. Ruth P. Lim
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  5. Julien Leroux
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  9. Isabelle Michelet
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  10. Jean-Nicolas Dacher
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Corresponding author

Correspondence to Pierre-Hugues Vivier.

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Vivier, PH., Sallem, A., Beurdeley, M. et al. MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging. Eur Radiol 24, 19–25 (2014). https://doi.org/10.1007/s00330-013-2971-2

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  • DOI: https://doi.org/10.1007/s00330-013-2971-2

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