ASSESSMENT OF PAINFUL URETEROHYDRONEPHROSIS DURING PREGNANCY BY MR UROGRAPHY

The purpose of this study was to assess the value of the fast imaging sequence called RARE (rapid acquisition with relaxation enhancement) M R urography (or RMU) in pregnant women with painful ureterohydronephro sis. A total of 17 pregnant women with an acute flank pain were examin ed with RMU. Results were compared with those of US, X-rays and the ev olution of symptoms. The gold standard techniques used to evaluate the results of MR urography were US when it showed the entire dilated uri nary tract and the nature of the obstruction (9 cases), limited intrav enous urography (IVU) when performed (3 cases) or endoscopic procedure (5 cases). The accuracy of RMU in the detection of urinary tract dila tion and the localization of the level of obstruction was excellent (s ensitivity 100% in our series). the determination of the type of obstr uction, intrinsic vs extrinsic, was always exact. The RMU technique al one could not specify the exact nature of the obstruction. The RMU tec hnique is able to differentiate a physiological from a pathological ur eterohydronephrosis during pregnancy. It could be considered as the pr ocedure of choice when US failed to establish the differential diagnos is.