Abstract

Background: The aim of this case series was to assess the role of MR urography in urinary tract obstruction. Static fluid and excretory urography can be combined with conventional MR imaging for comprehensive evaluation of urinary tract. Material and methods: Our study was a prospective study of patients presenting with dilated urinary system on sonography. After taking detailed patient history, thorough clinical examination was conducted followed by multimodality imaging approach. The initial imaging work up began with ultrasonography and then Intravenous urography (IVU) followed by MR urography as per protocol in patients whom diagnosis was not clear on IVU. Provisional diagnosis was given and compared with the final diagnosis achieved by surgery or clinical and imaging follow up as applicable. Results: 10 patients had urinary tract obstruction due to cystocele (2 cases), urinoma (3 cases) carcinoma of sigmoid colon (2 cases), benign prostatic hypertrophy (1 case), leiomyosarcoma of cervix (1 case) and retroperitoneal metastasis of gastric carcinoma (1 case). 9 cases were correctly diagnosed by MRU while 1/2 case of cystocele was identified on IVU. No contrast excretion was found in all cases of urinoma and carcinoma of sigmoid colon. In BPH bilateral hydronephrosis was seen. Leimyosarcoma case showed a soft tissue density in pelvis with bilateral lateral displacement of ureters. Conclusion: MRU is a non- invasive radiation free imaging modality that offers higher diagnostic ability than conventional urography for morphologic and functional evaluation of urinary tract disorders and can be used as an accurate alternative to IVU.