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MR Urography: Techniques and Clinical Applications¹

¹ From the Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157. Recipient of a Cum Laude award for an education exhibit at the 2006 RSNA Annual Meeting. Received April 23, 2007; revision requested May 15 and received August 10; accepted August 14. J.R.L. is a consultant with GE Healthcare and is with the speakers’ bureau for the Bracco Group, R.J.Z. is a consultant with Tyco Healthcare (Valleylab); the remaining author has no financial relationships to disclose. Address correspondence to J.R.L. (e-mail: jleyende{at}wfubmc.edu).

Magnetic resonance (MR) urography comprises an evolving group of techniques with the potential for allowing optimal noninvasive evaluation of many abnormalities of the urinary tract. MR urography is clinically useful in the evaluation of suspected urinary tract obstruction, hematuria, and congenital anomalies, as well as surgically altered anatomy, and can be particularly beneficial in pediatric or pregnant patients or when ionizing radiation is to be avoided. The most common MR urographic techniques for displaying the urinary tract can be divided into two categories: static-fluid MR urography and excretory MR urography. Static-fluid MR urography makes use of heavily T2-weighted sequences to image the urinary tract as a static collection of fluid, can be repeated sequentially (cine MR urography) to better demonstrate the ureters in their entirety and to confirm the presence of fixed stenoses, and is most successful in patients with dilated or obstructed collecting systems. Excretory MR urography is performed during the excretory phase of enhancement after the intravenous administration of gadolinium-based contrast material; thus, the patient must have sufficient renal function to allow the excretion and even distribution of the contrast material. Diuretic administration is an important adjunct to excretory MR urography, which can better demonstrate nondilated systems. Static-fluid and excretory MR urography can be combined with conventional MR imaging for comprehensive evaluation of the urinary tract. The successful interpretation of MR urographic examinations requires familiarity with the many pitfalls and artifacts that can be encountered with these techniques.

© RSNA, 2008

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Invited Commentary

Keyanoosh Hosseinzadeh
RadioGraphics 2008 28: 46-48. [Full Text] [PDF]

This article has been cited by other articles:

				O. Buckley, J. Colville, W. C. Torreggiani, and J. R. Leyendecker Re: MR Urographic Techniques RadioGraphics, May 1, 2008; 28(3): 907 - 908. [Full Text] [PDF]

				K. Hosseinzadeh Invited Commentary RadioGraphics, January 1, 2008; 28(1): 46 - 48. [Full Text] [PDF]