Objectives: The current reference standard for diagnosing vesicoureteric reflux is the X-ray-based Micturating CystoUrethroGram (MCUG). The aim of this study was to evaluate the feasibility of performing interactive Magnetic Resonance voiding cysto-urethrography (iMRVC) in un-sedated infants.
Methods: Twelve infants underwent conventional single-cycle MCUG followed by iMRVC. In iMRVC, patients were examined using an in-house developed fluoroscopic pulse sequence, which allows on-the-fly control of image contrast and geometry. A single acquisition was performed during bladder filling, during and after micturition, with interactive control over imaging parameters. Images were assessed for diagnostic quality and presence of VUR.
Results: Every case of reflux identified with MCUG was identified on iMRVC (100% sensitivity). Over 24 renal units, there was 88% concordance (21/24) according to the presence of reflux between the two methods. There were three "false positives" detected by MRI, giving a specificity of 83.3%, PPV of 66.7% and NPV of 100%.
Conclusion: iMRVC is a feasible method for evaluating the renal tract in infants without the need for radiation or sedation. A formal evaluation is required to establish its diagnostic potential.