Skip to main content

Advertisement

Log in

Magnetic resonance urography

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Excellent contrast resolution and lack of ionizing radiation make magnetic resonance urography (MRU) a promising technique for noninvasively evaluating the entire urinary tract. While MRU currently lags behind CT urography (CTU) in spatial resolution and efficiency, new hardware and sequence developments have contributed to a resurgence of interest in MRU techniques. By combining unenhanced sequences with multiphase contrast-enhanced and excretory phase imaging, a comprehensive assessment of the kidneys, ureters, bladder, and surrounding structures is possible with image quality rivaling that obtained with other techniques. At the same time, formidable challenges remain to be overcome and further clinical validation is necessary before MRU can replace other forms of urography. In this article, we demonstrate the current potential of MRU to demonstrate a spectrum of urologic pathology involving the kidneys, ureters, and bladder while discussing the limitations and current status of this evolving technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21
Fig. 22
Fig. 23

Similar content being viewed by others

References

  1. Nolte-Ersting CCA, Staatz G, Tacke J, et al. (2003) MR urography today. Abdom Imaging 28:191–209

    Article  Google Scholar 

  2. Roy C, Saussine C, LeBras Y (1996) Assessment of painful ureterohydronephrosis during pregnancy. Eur Radiol 6:334–338

    PubMed  CAS  Google Scholar 

  3. Borthne A, Nordshus T, Reiseter T, et al. (1999) MR urography: the future gold standard in pediatric urogenital imaging? Pediatr Radiol 29:694–701

    Article  PubMed  CAS  Google Scholar 

  4. Chahal R, Taylor K, Eardley I, et al. (2005) Patients at high risk for upper tract urothelial cancer: evaluation of hydronephrosis using high resolution magnetic resonance urography. J Urol 174:478–482

    Article  PubMed  CAS  Google Scholar 

  5. Roy C, Saussine C, Jahn V, et al. (1994) Evaluation of RARE-MR urography in the assessment of ureterohydronephrosis. J Comput Assist Tomogr 18:601–608

    Article  PubMed  CAS  Google Scholar 

  6. Regan F, Bohlman ME, Khazan R, et al. (1996) MR urography using HASTE imaging in the assessment of ureteric obstruction. AJR Am J Roentgenol 167:1115–1120

    PubMed  CAS  Google Scholar 

  7. Roy C, Saussine C, Guth S, et al. (1998) MR urography in the evaluation of urinary tract obstruction. Abdom Imaging 27–34

  8. Karabacakoglu A, Karakose S, Ince O, et al. (2004) Diagnostic value of diuretic-enhanced excretory MR urography in patients with obstructive uropathy. Eur J Radiol 52:320–327

    Article  PubMed  Google Scholar 

  9. Avni FE, Nicaise N, Hall M, et al. (2001) The role of MR imaging for the assessment of complicated duplex kidneys in children: preliminary report. Pediatr Radiol 31:215–223

    Article  PubMed  CAS  Google Scholar 

  10. Grattan-Smith JD, Jones RA (2006) MR urography in children. Pediatr Radiol 36:1119–1132

    Article  PubMed  Google Scholar 

  11. Riccabona M (2004) Pediatric MRU: its potential and its role in the diagnostic work-up of upper urinary tract dilatation in infants and children. World J Urol 22:79–87

    PubMed  Google Scholar 

  12. Jones RA, Easley K, Little SB, et al. (2005) Dynamic contrast-enhanced MR urography in the evaluation of pediatric hydronephrosis. I. Functional assessment. AJR Am J Roentgenol 185:1598–1607

    Article  PubMed  Google Scholar 

  13. Sigmund G, Stoever B, Zimmerhackl LB, et al. (1991) RARE-MR-urography in the diagnosis of upper urinary tract abnormalities in children. Pediatr Radiol 21:416–420

    Article  PubMed  CAS  Google Scholar 

  14. Leyendecker J, Barnes C, Zagoria R (2008) MR urography: technique and clinical applications. Radiographics 28:23–48

    Article  PubMed  Google Scholar 

  15. Hennig J, Friedburg H, Strobel B (1986) Rapid non-tomographic approach to MR myelography without contrast agents. J Comput Assist Tomogr 10:375–378

    PubMed  CAS  Google Scholar 

  16. Hennig J, Nauerth A, Friedburg H (1986) RARE imaging: a fast imaging method for clinical MR. Magn Reson Med 3:823–833

    Article  PubMed  CAS  Google Scholar 

  17. Hennig J, Friedburg H (1988) Clinical applications and methodological developments of the RARE technique. Magn Reson Imaging 6:391–393

    Article  PubMed  CAS  Google Scholar 

  18. Regan F, Bohlman ME, Khazan R, et al. (1996) MR urography using HASTE imaging in the assessment of ureteric obstruction. AJR Am J Roentgenol 167:1115–1120

    PubMed  CAS  Google Scholar 

  19. Tang Y, Yamashita Y, Namimoto T, et al. (1996) The value of MR urography that uses HASTE sequences to reveal urinary tract disorders. AJR Am J Roentgenol 167:1497–1502

    PubMed  CAS  Google Scholar 

  20. Rothpearl A, Frager D, Subramanian A, et al. (1995) MR urography: technique and preliminary application. Radiology 194:125–130

    PubMed  CAS  Google Scholar 

  21. Hattery R, King B (1995) Technique and application of MR urography. Radiology 194:25

    PubMed  CAS  Google Scholar 

  22. Colville JA, Killeen RP, Buckley O, et al. (2007) Does a full bladder aid upper tract visualization in magnetic resonance urography? Australas Radiol 51:362–364

    Article  PubMed  CAS  Google Scholar 

  23. Hughes J, Jan W, Goodie J, et al. (2002) MR urography: evaluation of different techniques in non-dilated tracts. Clin Radiol 57:989–994

    Article  PubMed  CAS  Google Scholar 

  24. Nolte-Ernsting C, Adam G, Bucker A, et al. (1997) Contrast-enhanced magnetic resonance urography: first experimental results with a polymeric gadolinium blood pool agent. Invest Radiol 32:418–423

    Article  PubMed  CAS  Google Scholar 

  25. Nolte-Ernsting C, Bucker A, Adam G, et al. (1998) Gadolinium-enhanced excretory MR urography after low-dose diuretic injection: comparison with conventional excretory urography. Radiology 209:147–157

    PubMed  CAS  Google Scholar 

  26. Verswijvel GA, Oyen RH, Van Poppel HP, et al. (2000) Magnetic resonance imaging in the assessment of urologic disease: an all-in-one approach. Eur Radiol 10:1614–1619

    Article  PubMed  CAS  Google Scholar 

  27. Yoshimitsu K, Irie H, Tajima T, et al. (2004) MR imaging of renal cell carcinoma: its role in determining cell type. Radiat Med 22:371–376

    PubMed  Google Scholar 

  28. Tsubota M, Takahara T, Nitatori T, et al. (2004) Utility of cine MR urography of the urinary tract and comparison with static MR urography. Radiat Med 22:212–217

    PubMed  Google Scholar 

  29. Broome DR, Girguis MS, Baron PW, et al. (2007) Gadodiamide-associated nephrogenic systemic fibrosis: why radiologists should be concerned. AJR Am J Roentgenol 188:586–592

    Article  PubMed  Google Scholar 

  30. Sadowski EA, Bennett LK, Chan MR, et al. (2007) Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 242:647–649

    Article  Google Scholar 

  31. Kanal E, Barkovich AJ, Bell C, et al. (2007) ACR guidance document for safe MR practices: 2007. AJR Am J Roentgenol 188:1–27

    Article  Google Scholar 

  32. Marckmann P, Skov L, Rossen K, et al. (2006) Nephrogenic systemic fibrosis: suspected causative role of gadolinium. J Am Soc Nephrol 17:2359–2362

    Article  PubMed  Google Scholar 

  33. Grobner T (2006) Gadolinium: a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis? Nephrol Dial Transplant 21:1104–1108

    Article  PubMed  CAS  Google Scholar 

  34. Ho VB, Choyke PL (2004) MR evaluation of solid renal masses. Magn Reson Imaging Clin N Am 12:413–427

    Article  PubMed  Google Scholar 

  35. Hallscheidt PJ, Bock M, Riedasch G, et al. (2004) Diagnostic accuracy of staging renal cell carcinomas using multidetector-row computed tomography and magnetic resonance imaging: a prospective study with histopathologic correlation. J Comput Assist Tomogr 28:333–339

    Article  PubMed  Google Scholar 

  36. Browne RF, Meehan CP, Colville J, et al. (2005) Transitional cell carcinoma of the upper urinary tract: spectrum of imaging findings. Radiographics 25:1609–1627

    Article  PubMed  Google Scholar 

  37. Wong-You-Cheong JJ, Wagner BJ, Davis CJ Jr (1998) Transitional cell carcinoma of the urinary tract: radiologic-pathologic correlation. Radiographics 18:123–142

    PubMed  CAS  Google Scholar 

  38. Pretorius ES, Wickstrom ML, Siegelman ES (2000) MR imaging of renal neoplasms. Magn Reson Imaging Clin N Am 8:813–836

    PubMed  CAS  Google Scholar 

  39. El-Diasty T, Mansour O, Farouk A (2003) Diuretic contrast-enhanced magnetic resonance urography versus intravenous urography for depiction of nondilated urinary tracts. Abdom Imaging 28:135–145

    Article  PubMed  CAS  Google Scholar 

  40. Blandino A, Gaeta M, Minutoli F, et al. (2002) MR urography of the ureter. AJR Am J Roentgenol 179:1307–1314

    PubMed  Google Scholar 

  41. Grattan-Smith JD, Jones RA (2006) MR urography in children. Pediatr Radiol 36:1119–1132

    Article  PubMed  Google Scholar 

  42. Riccabona M, Simsbrunner J, Ring E, et al. (2002) Feasibility of MR-urography in neonates and infants with abnormalities of the upper urinary tract. Eur Radiol 12:1442–1450

    Article  PubMed  CAS  Google Scholar 

  43. Sudah M, Vanninen R, Partanen K, et al. (2001) MR urography in evaluation of acute flank pain: T2-weighted sequences and gadolinium-enhanced three-dimensional FLASH compared with urography. AJR Am J Roentgenol 176:105–112

    PubMed  CAS  Google Scholar 

  44. Shokeir AA, El Diasty T, Essa W, et al. (2004) Diagnosis of ureteral obstruction in patients with compromised renal function: the role of noninvasive imaging modalities. J Urol 171:2303–2306

    Article  PubMed  Google Scholar 

  45. Spencer JA, Chahal R, Kelly A, et al. (2004) Evaluation of painful hydronephrosis in pregnancy: magnetic resonance urographic patterns in physiological dilatation versus calculous obstruction. J Urol 171:256–260

    Article  PubMed  CAS  Google Scholar 

  46. Grenier N, Pariente JL, Trillaud H, et al. (2000) Dilatation of the collecting system during pregnancy: physiologic vs. obstructive dilatation. Eur Radiol 10:271–279

    Article  PubMed  CAS  Google Scholar 

  47. Tekes A, Kamel I, Imam K, et al. (2005) Dynamic MRI of bladder cancer: Evaluation of staging accuracy. AJR Am J Roentgenol 184:121–127

    PubMed  Google Scholar 

  48. Barentsz JO, Jager GJ, Witjes JA, et al. (1996) Primary staging of urinary bladder carcinoma: the role of MRI and a comparison with CT. Eur Radiol 6:129–133

    Article  PubMed  CAS  Google Scholar 

  49. Kim B, Semelka RC, Ascher SM, et al. (1994) Bladder tumor staging: comparison of contrast-enhanced CT, T1- and T2-weighted MR imaging, dynamic gadolinium-enhanced imaging, and late gadolinium-enhanced imaging. Radiology 193:239–245

    PubMed  CAS  Google Scholar 

  50. Tekes A, Kamel IR, Imam K, et al. (2003) MR imaging features of transitional cell carcinoma of the urinary bladder. AJR Am J Roentgenol 180:771–777

    PubMed  Google Scholar 

  51. Barentsz JO, Jager GJ, van Vierzen PBJ, et al. (1996) Staging urinary bladder cancer after transurethral biopsy: the value of fast dynamic contrast-enhanced MR imaging. Radiology 201:185–193

    PubMed  CAS  Google Scholar 

  52. Kundra V, Silverman P (2003) Imaging in the diagnosis, staging, and follow-up of cancer of the urinary bladder. AJR Am J Roentgenol 180:1045–1054

    PubMed  Google Scholar 

  53. Garcia-Valtuille R, Garcia-Valtuille AI, Abascal F, et al. (2006) Magnetic resonance urography: a pictorial overview. Br J Radiol 79:614–626

    Article  PubMed  CAS  Google Scholar 

  54. Leyendecker JR, Childs DD (2007) Kidneys and MR urography (3T vs. 1.5T). Magn Reson Imaging Clin N Am 15:373–382

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John R. Leyendecker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leyendecker, J.R., Gianini, J.W. Magnetic resonance urography. Abdom Imaging 34, 527–540 (2009). https://doi.org/10.1007/s00261-008-9403-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-008-9403-9

Keywords

Navigation