THE USE OF DYNAMIC MAGNETIC-RESONANCE-IMAGING TO EVALUATE ORTHOTOPIC CONTINENT URINARY-DIVERSION

Objectives, The purpose of this study was to evaluate a dynamic magnet ic resonance (MR) examination in patients after radical cystoprostatec tomy with a neobladder. Methods, All 12 subjects were studied with the injection of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) and showed normal renal enhancement patterns and upper urinary tracts , except 1 patient who had mild right hydronephrosis, All neobladders were also visualized with gadolinium and 9 of 11 patients were able to void on command. There was close agreement in all cases with the MR f indings and other imaging studies. Results. A static and dynamic Gd-DT PA contrast medium MR did image the entire urinary system, similar to a computed tomographic scan or intravenous urogram, Renal function dat a, similar to a renal radioisotope scan, was obtained from the Gd-DTPA scans. A dynamic voiding study provided visualization of the lower ge nitourinary tract similar to a conventional voiding cystourethrogram. Conclusions. We conclude that this single MR technique may provide inf ormation similar to that obtained from multiple standard imaging studi es in the postoperative assessment of the radical cystectomy patient w ith a neobladder. It may be especially helpful in the presence of azot emia or contrast allergy.