Nonnephrotoxic, dynamic, contrast enhanced magnetic resonance urography: Use in nephrology and urology

Purpose: We assessed the value of breath-hold, gadolinium (Gd) enhanced mag netic resonance urography for diagnosing urinary tract disease. Materials and Methods: Dynamic magnetic resonance urography was performed i n 38 consecutive patients presenting with urological disease in whom excret ory urography was contraindicated. Renal function was impaired in 18 cases with a serum creatinine of 140 to 400 mu mol./l. Fast spoiled, gradient ech o sequences were acquired during breath-holding 5, 10 and 15 minutes after intravenous injection of 10 ml. of a Gd chelate. Opacification of the colle cting system was evaluated using a scale of 0 to 3. Diagnostic value of the examinations was also analyzed. Results: Dynamic magnetic resonance urography was sufficient for making the diagnosis in 95% of cases. We identified 71 pathological findings and the surgical anastomosis was always well visualized. Mean image quality score w as 2.34 points for renal calices, 2.86 for renal pelves and 2.48 for ureter s. Image quality significantly improved after injecting a diuretic. Conclusions: Gd enhanced magnetic resonance urography provides quality dyna mic imaging of the urinary tract. It is a new approach for diagnosing urina ry tract disorders in patients in whom excretory urography should be avoide d.