Magnetic resonance urography in pediatric urology.

PURPOSE OF REVIEW: Magnetic resonance urography (MRU) has emerged as a powerful diagnostic tool in the evaluation of the pediatric genitourinary tract. The purpose of this review is to familiarize the reader with the basic techniques, strengths and limitations, as well as the current and potential future applications of MRU in pediatric urology.

RECENT FINDINGS: MRU can provide detailed anatomical information and assess renal function and drainage in a single study. MRU does not employ ionizing radiation and may be utilized in patients with iodine-based contrast allergy or impaired renal function. MRU has been most often 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 and vesicoureteral reflux is limited and technical refinements are required. Potential future applications include fetal MRU, virtual endoscopy, and MRU-guided procedures. The development of new contrast agents and new image-processing software will further enhance the diagnostic potential of MRU in pediatric urology.

SUMMARY: MRU is currently thought of as a problem-solving tool to define anatomy and function when conventional methods fall short. This technique is likely to emerge as the imaging modality of choice for children with complex genitourinary pathology.