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Hi, I Have Read That Mri And Ct Yrography Are
Question: Hi,
I have read that mri and ct yrography are similar for imaging the upper urinary tract. I have access to tesla 3 at a teaching hospital and prefer no additional radiation after 10+ mri's for 17 lung nodules I've had over the last decade as well as a ct urogram. I'm following up on nerw microhematuria. Thanks so much! XXXXXXX
I have read that mri and ct yrography are similar for imaging the upper urinary tract. I have access to tesla 3 at a teaching hospital and prefer no additional radiation after 10+ mri's for 17 lung nodules I've had over the last decade as well as a ct urogram. I'm following up on nerw microhematuria. Thanks so much! XXXXXXX
Brief Answer:
A 3T MR urogaphy is a good imaging te
Detailed Answer:
Hi,
Thanks for writing in to us.
A 3T MRI machine should be able to generate good images of MR urogram without the use of contrast. I suggest you proceed with the MR urogram done in the 3T MRI facility.
Regards,
A 3T MR urogaphy is a good imaging te
Detailed Answer:
Hi,
Thanks for writing in to us.
A 3T MRI machine should be able to generate good images of MR urogram without the use of contrast. I suggest you proceed with the MR urogram done in the 3T MRI facility.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you! How would the mri without contrast compare with mri w/wo and also ct w/wo contrast? I'm investigating microhematuria and have efgr between 60-90 and thought with contrast might be better. Again thank you! XXXXXXX
Brief Answer:
MR urography 3T with contrast is the best investigation
Detailed Answer:
Hi,
Thanks for writing in to us.
MRI urogram with contrast is always better to check for any small obstructive area.
Non contrast MR urogram images in a 3T machine are also good but the contrast images do have an advantage over non contrast ones.
About comparing investigations, contrast MR urography using 3T is better than contrast CT urography and then there is non contrast MR urography.
Please find link to research literature on the accuracy as follows
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
Regards,
MR urography 3T with contrast is the best investigation
Detailed Answer:
Hi,
Thanks for writing in to us.
MRI urogram with contrast is always better to check for any small obstructive area.
Non contrast MR urogram images in a 3T machine are also good but the contrast images do have an advantage over non contrast ones.
About comparing investigations, contrast MR urography using 3T is better than contrast CT urography and then there is non contrast MR urography.
Please find link to research literature on the accuracy as follows
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you! Do you have concerns with mri contrast? I have had about 7 exams in past 6 yrs mostly of brain. Do you know sensitivity for small renal masses for all 3 imaging protocals? XXXXXXX
Brief Answer:
There are no concerns for contrast if eGFR more than 60
Detailed Answer:
Hi,
Thanks for writing in.
If your eGFR is between 60 and 90 then there are no concerns for a post contrast CT or MRI scan. It is only if GFR is below 60 that we avoid a contrast scan.
Regarding the accuracy of variaous scans, contrast CT has sensitivity over 90 percent and nearly 100 percent for lesions larger than 2 cm and can also help tell us the density pattern of the lesion. MRI is a problem solver used when CT shows lesions with doubtful enhancement. MRI is useful in staging of mass lesions due to soft tissue detail.
Regards,
There are no concerns for contrast if eGFR more than 60
Detailed Answer:
Hi,
Thanks for writing in.
If your eGFR is between 60 and 90 then there are no concerns for a post contrast CT or MRI scan. It is only if GFR is below 60 that we avoid a contrast scan.
Regarding the accuracy of variaous scans, contrast CT has sensitivity over 90 percent and nearly 100 percent for lesions larger than 2 cm and can also help tell us the density pattern of the lesion. MRI is a problem solver used when CT shows lesions with doubtful enhancement. MRI is useful in staging of mass lesions due to soft tissue detail.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you! And to confirm, would mri urology w/wo contrast on a tesla 3 have equal or better sensitivity for a small uit mass compared to ct w/wo contrast? Should I be concerned about all the mri's(7) I've had? Can you give an approximate risk of nephropathy from mri and ct contrast. Thanks so much-I'll try to make this my last question.
XXXXXXX
XXXXXXX
Brief Answer:
Your eGFR levels are favourable for the use of contrast
Detailed Answer:
Hi,
Thanks for writing in to us.
Technically speaking the 3T MRI can show an equal or better sensitivity due to the soft tissue contrast. However limited research has been done for the use of 3T MRI in the study of small lesions so numbers are still not available.
Concerning contrast use, I have found he following literature and I quote
............MRI is indicated in the evaluation of indeterminate renal masses and staging of renal cancer (ACR-Appropriateness Criteria® rating 8), usually favored over contrast-enhanced CT in patients with moderate chronic kidney disease (CKD) (i.e., estimated glomerular filtration rate, eGFR between 30 and 60 mL/min/1.73m2).
Recently, the safety of newer gadolinium-based contrast agents (e.g. macrocyclic), even in patients with stages 4 and 5 CKD (eGFR < 30 mL/min/1.73m2), has been advocated based on the absence of new cases of nephrogenic systemic fibrosis observed in large cohorts of patients.
In addition, non-enhanced sequences, such as arterial spin labeling (ASL), may aid in the evaluation of vascularity in renal masses. Perfusion parameters obtained by ASL are correlated with those obtained by dynamic contrast-enhanced MRI, as well as with vessel density in renal tumors..............
Therefore your eGFR levels are favourable for the use of contrast in CT and MRI scans.
Regards,
Your eGFR levels are favourable for the use of contrast
Detailed Answer:
Hi,
Thanks for writing in to us.
Technically speaking the 3T MRI can show an equal or better sensitivity due to the soft tissue contrast. However limited research has been done for the use of 3T MRI in the study of small lesions so numbers are still not available.
Concerning contrast use, I have found he following literature and I quote
............MRI is indicated in the evaluation of indeterminate renal masses and staging of renal cancer (ACR-Appropriateness Criteria® rating 8), usually favored over contrast-enhanced CT in patients with moderate chronic kidney disease (CKD) (i.e., estimated glomerular filtration rate, eGFR between 30 and 60 mL/min/1.73m2).
Recently, the safety of newer gadolinium-based contrast agents (e.g. macrocyclic), even in patients with stages 4 and 5 CKD (eGFR < 30 mL/min/1.73m2), has been advocated based on the absence of new cases of nephrogenic systemic fibrosis observed in large cohorts of patients.
In addition, non-enhanced sequences, such as arterial spin labeling (ASL), may aid in the evaluation of vascularity in renal masses. Perfusion parameters obtained by ASL are correlated with those obtained by dynamic contrast-enhanced MRI, as well as with vessel density in renal tumors..............
Therefore your eGFR levels are favourable for the use of contrast in CT and MRI scans.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your detailed answers and bearing with me. XXXXXXX
Brief Answer:
Thanks
Detailed Answer:
Hi,
Thanks for sending your queries.
Link for the literature on contrast use and sensitivity of CT for small renal lesions is below.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
Best wishes and good health.
Regards,
Thanks
Detailed Answer:
Hi,
Thanks for sending your queries.
Link for the literature on contrast use and sensitivity of CT for small renal lesions is below.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
Best wishes and good health.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Chail,
I wasn't able to access the link you provided on 2 attempts. Any suggestions?
Thanks again!
XXXXXXX
I wasn't able to access the link you provided on 2 attempts. Any suggestions?
Thanks again!
XXXXXXX
Brief Answer:
Please see the pdf link of article given below
Detailed Answer:
Hi,
Thanks for valuable feed back.
I guess you might be facing viewer restriction problems with the link.
Please see another link to the pdf for the same article given below
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/pdf/nihms873161.pdf
Hoping that it works.
If it does not work then please inform me. I will upload to a file sharing facility andsend you the link.
Regards,
Please see the pdf link of article given below
Detailed Answer:
Hi,
Thanks for valuable feed back.
I guess you might be facing viewer restriction problems with the link.
Please see another link to the pdf for the same article given below
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/pdf/nihms873161.pdf
Hoping that it works.
If it does not work then please inform me. I will upload to a file sharing facility andsend you the link.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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