New Magnetic Resonance Imaging Methods in Nephrology

Jeff L Zhang; Glen Morrell; Henry Rusinek; Eric E Sigmund; Hersh Chandarana; Lilach O Lerman; Pottumarthi V Prasad; David Niles; Nathan Artz; Sean Fain; Pierre-Hugues Vivier; Alfred K Cheung; Vivian S Lee

Disclosures

Kidney Int. 2014;85(4):768-778. 

In This Article

Abstract and Introduction

Abstract

Established as a method to study anatomic changes, such as renal tumors or atherosclerotic vascular disease, magnetic resonance imaging (MRI) to interrogate renal function has only recently begun to come of age. In this review, we briefly introduce some of the most important MRI techniques for renal functional imaging, and then review current findings on their use for diagnosis and monitoring of major kidney diseases. Specific applications include renovascular disease, diabetic nephropathy, renal transplants, renal masses, acute kidney injury, and pediatric anomalies. With this review, we hope to encourage more collaboration between nephrologists and radiologists to accelerate the development and application of modern MRI tools in nephrology clinics.

Introduction

Long established as a method to study structural changes in disease, such as renal tumors or atherosclerotic vascular disease, magnetic resonance imaging (MRI) to interrogate renal function has only recently begun to come of age. Functional renal MR approaches render added value for MRI over other conventional imaging modalities, with emerging applications in nephrology. As an example, low doses of the conventional contrast agent used in MRI—gadolinium chelates—can be used to measure glomerular filtration rate (GFR) in individual kidneys.[1,2] Techniques borrowed from functional brain mapping known as blood oxygen level–dependent (BOLD) MRI have recently been applied to interrogate renal oxygenation and metabolic rate.[3,4] Renal perfusion can be measured using MRI either by intravenous injection of an exogenous tracer or with endogenous blood labeling methods that do not require contrast injection.

In this article, we briefly review the principles of MR imaging, introduce some of the most important MRI techniques, and then review current findings on their use for diagnosis and monitoring of major kidney diseases. Specific applications include renovascular disease (RVD), diabetic nephropathy (DN), renal transplants, renal masses, acute kidney injury, and pediatric anomalies. Our purpose is to accelerate the application of modern MRI tools in the clinic and to strengthen the collaboration between MRI physicists, radiologists, and nephrologists. We refer the reader to other reviews[5–14] and the cited papers for more technical details.

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