Magnetic Resonance Imaging in Diagnosis of Complications of Renal and Ureteral Injuries in Different Periods of Traumatic Disease

ORIGINAL ARTICLE
Zavazhat M. Magomedova, Elena A. Egorova, Dmitry A. Lezhnev, Margarita V. Smislenova

 
International Journal of Biomedicine. 2021;11(3):342-345.
DOI: 10.21103/Article11(3)_OA10
Originally published September 9, 2021

Abstract: 

The aim of this study was to evaluate the effectiveness of MRI in diagnosing combined renal and ureteral injuries at different periods of traumatic disease (TD).
Methods and Results: We analyzed the results of diagnostics and treatment of 139 patients (80 women and 59 men) with renal and ureteral injuries aged between 18 and 72 years. There were 67(48.2%) patients in the period of acute reaction to trauma, 40(28.8%) patients with early manifestations, and 32(23%) patients in the period of late manifestations. In 127(91.4%) patients, an urgent plain abdominal X-ray was performed without any preliminary preparation. USI of the abdominal and retroperitoneal space was performed in 108(77.7%) patients in the stage of the primary assessment of renal injury as it was a rapid non-invasive investigation. A whole-body MSCT was performed in 131(94.2%) patients, using the nonionic contrast agents Ultravist (350mg I/ml) and Omnipaque (350mg I/ml). MRI was performed in 125(89.9%) patients, including cases of pregnancy and a medical history of allergies. Contrast-enhanced MSCT had a high diagnostic efficiency in assessing complications in kidney and ureteral injuries at different periods of TD (accuracy of 89.2% for acute reaction, 88.8% for early manifestations, and 89.5% for late manifestations). MRI of the kidneys and ureters was indicated in periods of early and late manifestations of TB to detect renal complications in cases with a discrepancy between clinical manifestations and the results obtained by ultrasound and MSCT (accuracy of 87.5% for early manifestations and 89.9% for late manifestations).

Keywords: 
magnetic resonance imaging • multislice computed tomography • trauma • kidney • ureter
References: 
  1. Smolyar AN. [Blunt abdominal trauma. Kidneys injury. Part 3]. Pirogov Russian Journal of Surgery. 2016;(6):4-13. [Article in Russian].
  2. Komyakov BK, Soroka IV, Savello VE, Shanava GSh, Basek IV. [Features of the diagnosis of renal complications of concomitant renal injury in the acute and early periods of traumatic diseases]. Biomed J. 2011;12:1467-1477.. [Article in Russian].
  3. Perkins ZB, Captur G, Bird R, Gleeson L, Singer B, O'Brien B. Trauma induced acute kidney injury. PLoS One. 2019 Jan 25;14(1):e0211001. doi: 10.1371/journal.pone.0211001.
  4. Eriksson M, Brattström O, Mårtensson J, Larsson E, Oldner A. Acute kidney injury following severe trauma: Risk factors and long-term outcome. J Trauma Acute Care Surg. 2015 Sep;79(3):407-12. doi: 10.1097/TA.0000000000000727. 
  5. Pushkar DYu, Kasyan GR. Errors and complications in urogynecology. M.: GEOTAR-Media, 2017. [In Russian].
  6. Wieczorek AP, Woźniak MM, Tyloch JF. Errors in the ultrasound diagnosis of the kidneys, ureters and urinary bladder. J Ultrason. 2013 Sep;13(54):308-18. doi: 10.15557/JoU.2013.0031. 
  7. Vasiliev AYu, Vinogradova OA. [Multislice computed tomography in the diagnosis of postoperative changes in the ureter]. Radiology and Practice. 2017;2(62):6-13. [Article in Russian].
  8. Martínez-Piñeiro L, Djakovic N, Plas E, Mor Y, Santucci RA, Serafetinidis E, Turkeri LN, Hohenfellner M; European Association of Urology. EAU Guidelines on Urethral Trauma. Eur Urol. 2010 May;57(5):791-803. doi: 10.1016/j.eururo.2010.01.013. 

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Received June 21, 2021.
Accepted July 27, 2021.
©2021 International Medical Research and Development Corporation.