Pediatric magnetic resonance urography

Magnetic resonance urography (MRU) is a powerful clinical tool that fuses anatomic information with functional data in a single test without the use of ionizing radiation. This article provides an overview of the technical aspects, as well as common clinical applications with an emphasis on the evaluation of hydronephrosis. A fluid challenge is an essential part of our MRU protocol and enables the definition of compensated or decompensated kidneys within the spectrum of hydronephrosis. This classification may have prognostic implications when surgery is being considered. In addition, underlying uropathy can be identified on the anatomical scans and renal scarring can be seen on both the anatomical and dynamic scans. MRU can identify and categorize dysmorphic kidneys in vivo and may provide insight into congenital abnormalities seen in conjunction with vesicoureteric reflux. MRU is still in its infancy and as the technique develops and becomes widely available, it seems likely that it will supplant renal scintigraphy in the evaluation of renal tract disorders in children. J. Magn. Reson. Imaging 2011;33:510–526. © 2011 Wiley-Liss, Inc.