Magnetic resonance imaging (MRI) of normal and diseased kidneys shows great promise because of the combined value of anatomical and functional information provided, as well as of specific contrast patterns that can be observed non-invasively. Multicontrast MRI is able to show infiltrative kidney disorders. Diffusion-weighted imaging can assess alterations in renal function and can suggest obstruction or inflammation when present. Due to the low nephrotoxicity, contrast-enhanced MR studies using serial dynamic enhancement with non-specific gadolinium chelates are able to provide information on glomerular filtration. Furthermore, contrast agents such as ultrasmall particles of iron oxide, specific of inflammation, should be used in the near future to detect active from quiescent involvement, both in native kidneys and renal allografts. Early results should indicate that these compounds might differentiate acute tubular necrosis from other acute nephropathies, as well as active proliferative nephropathies from chronic ones. Ongoing studies will obviously demonstrate the value of the combination of these various MRI sequences in the diagnosis of acute renal failure and chronic kidney disease.

Keywords:
Kidney, diseases, Kidney, functional studies, MR imaging, Glomerular filtration, Contrast media, MR, Diffusion-weighted imaging
1.
Dagher PC, Herget-Rosenthal S, Ruehm SG, Jo SK, Star RA, Agarwal R, Molitoris BA: Newly developed techniques to study and diagnose acute renal failure. J Am Soc Nephrol 2003;14:2188–2198.
2.
Jeong JY, Kim SH, Lee HJ, Sim JS: Atypical low-signal-intensity renal parenchyma: causes and patterns. Radiographics 2002;22:833–846.
3.
Chung JJ, Semelka RC, Martin DR: Acute renal failure: common occurrence of preservation of corticomedullary differentiation on MR images. Magn Res Imaging 2001;19:789–793.
4.
Grenier N, Basseau F, Ries M, Tyndal B, Jones R, Moonen C: Functional MRI of the kidney. Abdom Imaging 2003;28:164–175.
5.
Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M: Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 1988;168:497–505.
6.
Thoeny HC, De Keyzer F, Oyen RH, Peeters RR: Diffusion-weighted MR imaging of kidneys in healthy volunteers and patients with parenchymal diseases: initial experience. Radiology 2005;235:911–917.
7.
Muller MF, Prasad PV, Bimmler D, et al: Functional imaging of the kidney by means of measurement of the diffusion coefficient. Radiology 1994;193:711–715.
8.
Namimoto T, Yamashita Y, Mitsuzaki K: Measurement of the apparent diffusion coefficient in diffuse renal disease by diffusion-weighted echo-planar MR imaging. J Magn Res Imaging 1999;9:832–837.
9.
Laissy JP, Menegazzo D, Dumont E, Piekarski JD, Karila-Cohen P, Chillon S, Schouman-Claeys E: Hemodynamic effect of iodinated high-viscosity contrast medium in the rat kidney: a diffusion-weighted MRI feasibility study. Invest Radiol 2000;35:647–652.
10.
Bennett HF, Li D: MR imaging of renal function. Magn Reson Imaging Clin N Am 1997;5:107–126.
11.
Coulam CH, Lee JH, Weddling KL, Spielman DM, Pele NJ, Kee ST, Hill BB, Bouley DM, Derby GC, Myers BD, Sawyer-Glover AM, Sommer FG: Noninvasive measurement of extraction fraction and single-kidney glomerular filtration rate with MR imaging in swine with surgically created renal arterial stenoses. Radiology 2002;223:76–82.
12.
Grenier N, Trillaud H, Combe C, Degreze P, Jeandot R, Gosse P, Douws C, Palussiere J: Diagnosis of renovascular hypertension: feasibility of captopril-sensitized dynamic MR imaging and comparison with captopril scintigraphy. Am J Roentgenol 1996;166:835–843.
13.
Lee VS, Rusinek H, Noz ME, Lee P, Raghavan M, Kramer EL: Dynamic three-dimensional MR renography for the measurement of single kidney function: initial experience. Radiology 2003;227:289–294.
14.
Mandry D, Pedersen M, Odille F, Robert P, Corot C, Felblinger J, Grenier N, Claudon M: Renal functional contrast-enhanced magnetic resonance imaging: evaluation of a new rapid-clearance blood pool agent (p792) in Sprague-Dawley rats. Invest Radiol 2005;40:295–305.
15.
Dupas B, Buzelin MF, Karam G, Vasse N, Metlah K, Bach-Gansmo T: Contrast-enhanced MR imaging of experimental acute renal necrosis. Acta Radiol 2001;42:74–79.
16.
Kobayashi H, Kawamoto S, Jo SK, Sato N, Saga T, Hiraga A, Konishi J, Hu S, Togashi K, Brechbiel MW, Star RA: Renal tubular damage detected by dynamic micro-MRI with a dendrimer-based magnetic resonance contrast agent. Kidney Int 2002;61:1980–1985.
17.
Reith W, Forsting M, Vogler H, Heiland S, Sartor K: Early MR detection of experimentally induced cerebral ischemia using magnetic susceptibility contrast agents: comparison between gadopentetate dimeglumine and iron oxide particles. Am J Neuroradiol 1995;16:53–60.
18.
Trillaud H, Degrèze P, Combe C, Deminière C, Palussière J, Benderbous S, Grenier N: USPIO-enhanced MR imaging of glycerol-induced acute renal failure in the rabbit. Magn Res Imaging 1995;13:233–240.
19.
Franck H, Weissleder R, Brady TJ: Enhancement of MR angiography with iron oxide: preliminary studies in whole-blood phantom and in animals. Am J Roentgenol 1994;162:209–213.
20.
Mergo PJ, Helmberger T, Nicolas AI, Ros PR: Ring enhancement in ultrasmall superparamagnetic iron oxide MR imaging: a potential new sign for characterization of liver tissues. Am J Roentgenol 1996;166:379–384.
21.
Vexler VS, Berthezene Y, Clement O, Muhler A, Rosenau W, Moseley ME, Brasch RC: Detection of zonal renal ischemia with contrast-enhanced MR imaging with a macromolecular blood pool contrast agent. J Magn Reson Imaging 1992;2:311–319.
22.
Laissy JP, Benderbous S, Idee JM, Chillon S, Beaufils H, Schouman-Claeys E: MR assessment of iodinated contrast induced nephropathy in rats using ultrasmall particles of iron oxide. J Magn Reson Imaging 1997;7:164–170.
23.
Laissy JP, Idee JM, Loshkajian A, Benderbous S, Chillon S, Beaufils H, Schouman-Claeys E: Reversibility of experimental acute renal failure in rats: assessment with USPIO-enhanced MR imaging. J Magn Reson Imaging 2000;12:278–288.
24.
Lowenborg EK, Jaremko G, Berg UB: Glomerular function and morphology in puromycin aminonucleoside nephropathy in rats. Nephrol Dial Transplant 2000;15:1547–1555.
25.
Hauger O, Delalande C, Trillaud H, Deminière C, Quesson B, Kahn H, Cambar J, Combe C, Grenier N: MR imaging of intrarenal macrophage infiltration in an experimental model of nephrotic syndrome. Magn Reson Med 1999;41:156–162.
26.
Hauger O, Delalande C, Deminière C, Fouqueray B, Ohayon C, Garcia S, Trillaud H, Combe C, Grenier N: Nephrotoxic nephritis and obstructive nephropathy: evaluation with MR imaging enhanced with ultrasmall superparamagnetic iron oxide. Preliminary findings in a rat model. Radiology 2000;217:819–826.
27.
Strom TB, Carpenter CB: Immunobiology of kidney transplantation; in Brenner BM, Rector FC (eds): The Kidney, ed 4. Philadelphia, Saunders, 1991, pp 2336–2407.
28.
Zhang Y, Dodd SJ, Hendrich KS, William M, Ho C: Magnetic resonance imaging detection of rat renal transplant rejection by monitoring macrophage infiltration. Kidney Int 2000;58:1300–1310.
29.
Hauger O, Delmas Y, Deminière C, Merville P, Combe C, Grenier N: Late Sinerem-enhanced MR imaging of renal diseases: a pilot study. Eur Radiol 2004;14(suppl 2):202 (abstr B-349).
30.
Yang D, Ye Q, Williams M, Sun Y, Hu TCC, Williams DS, Moura JMF, Ho C: USPIO-enhanced dynamic MRI: evaluation of normal and transplanted rat kidneys. Magn Reson Med 2001;46:1152–1163.
31.
Persson PB, Hansell P, Liss P: Pathophysiology of contrast medium-induced nephropathy. Kidney Int 2005;68:14–22.
32.
King BF, Torres VE, Brummer BE, Chapman AB, Bae KT, Glockner JF, Arya K, Felmlee JP, Graham JJ, Guay-Woodford LM, Bennett WM, Klahr S, Hirschman GH, Kimmel PL, Thompson PA, Miller JP; Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease: Magnetic resonance measurements of renal blood flow as a marker of disease severity in autosomal-dominant polycystic kidney disease. Kidney Int 2003;64:2214–2221.
33.
Farres MT, Ronco P, Saadoun D, Remy P, Vincent F, Khalil A, Le Blanche AF: Chronic lithium nephropathy: MR imaging for diagnosis. Radiology 2003;229:570–574.
34.
Meier P, Farres MT, Mougenot B, Jacob L, Le Goas F, Antignac C, Ronco P: Imaging medullary cystic kidney disease with magnetic resonance. Am J Kidney Dis 2003;42:E5–E10.
© 2006 S. Karger AG, Basel
2006
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.