Magnetic resonance urography in pediatric urology.
OBJECTIVE
Magnetic resonance urography (MRU) has evolved into an effective imaging tool for the evaluation of the urinary tract in children. The goal of this article is to describe current techniques and applications of MRU and to review recent advances.


RESULTS
MRU is most commonly applied to the evaluation of hydronephrosis and provides valuable insight into a wide range of obstructive uropathies. MRU was shown to be superior to renal scintigraphy for the diagnosis of pyelonephritis and renal scarring. The use of MRU for the assessment of urolithiasis, vesicoureteral reflux, renal trauma, and fetal urinary tract abnormalities is limited and technical refinements are required. Judicious use of gadolinium-based contrast agents in patients at risk for nephrogenic systemic fibrosis was recently shown to avoid new occurrences. Potential future applications include virtual endoscopy and MRU-guided procedures.


CONCLUSIONS
MRU has the potential to revolutionize imaging of the urinary tract in children. It integrates exquisite anatomical information with a variety of functional data and avoids ionizing radiation. MRU is increasingly employed as a problem solver when conventional imaging studies remain inconclusive and its growing application will likely improve availability and cost in the future.
Cerwinka
Wolfgang H
WH
Georgia Pediatric Urology, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia 30342, USA. wcerwin@emory.edu
Kirsch
Andrew J
AJ
D002648:Child; D003287:Contrast Media / Q000009:adverse effects; D005682:Gadolinium / Q000009:adverse effects; D006801:Humans; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D010372:Pediatrics / Q000379:methods; D011296:Prenatal Diagnosis; D014567:Urography; D014570:Urologic Diseases / Q000175:diagnosis*; D014572:Urology / Q000379:methods
D003287:Contrast Media; D005682:Gadolinium