Magnetic Resonance Imaging of the Kidney

Abstract

This chapter describes the correct imaging technique for the magnetic resonance (MR) examination of the kidney, from the fundamental morphologic sequences to the MR urography sequences up to diffusion sequences. The basic MR features of vascular and infectious renal diseases and solid benign and malignant renal tumors up to the cystic renal tumors are described. The advanced applications of the MR technique in the kidney are described as a general introduction to the following chapters describing the different renal pathologies.

Cross-sectional imaging plays a critical role in the detection and work-up of renal pathologies. Even if computed tomography (CT) is still playing the leader, the role of magnetic resonance imaging (MRI) is ever increasing, thanks to its better tissue contrast resolution and the absence of radiation exposure; furthermore, it can be used as a problem-solving modality when CT findings are nondiagnostic (Radiol Clin North Am 41(5):877–907, 2003). Although the nephrogenic systemic fibrosis was recently recognized, the gadolinium-based contrast agents used in MRI, are still safe and can be used even in atopic patients and in patients with moderate impairment of renal function (estimated glomerular filtration rate >30 mL/min/1.73 m2) (Perez-Rodrigue et al. 2009).

While MRI has been shown to be useful in the detection and characterization of renal masses, in the staging of cancers, and in the evaluation of urinary tract anomalies and obstructive disease, attempts are being made to use it for assessment of renal function, such as perfusion, glomerular filtration rate, or intrarenal oxygen measurement (Eur Radiol 11(3):355–372, 2001; Eur Radiol 17(11):2780–2793, 2007; Radiology 250(2):309–323, 2009).