Magnetic resonance in renal transplantation: evaluation of post-surgery complications

Kidney transplantation: structural and functional evaluation using MR Nephro-Urography

End-stage-renal disease (ESRD) is a major health issue in the United States, and the Medicare costs of ESRD totaled nearly USD 21 billion in 2005. Renal transplantation has emerged as the treatment of choice in this patient population, providing improved quality of life and lower healthcare costs compared with other treatment options. Imaging evaluation of a graft kidney plays a critical role in the postoperative care of the renal transplant patient. In the past, diagnostic evaluation of the transplant kidney has depended upon a combination of ultrasonography, computed tomography, MRI, and biopsy, used in conjunction with the patient's clinical presentation. However, new and developing advances in MR technology has lead to the development of MR Nephro-Urography (MRNU), which provides both anatomic and functional evaluation of the kidney in a single examination. It is expected that the increasing use of MRNU will have a significant impact on the management of renal transplant patients. This review describes MRNU methodology, examines known posttransplant complications, and highlights the utility of MRNU as a comprehensive imaging examination to diagnose both surgical and medical complications of the transplant kidney.

Renal MR and CT angiography: current concepts

During the past decade, noninvasive CTA and MRA imaging techniques have replaced catheter angiography for evaluation of the renal arteries. This article reviews techniques for optimizing renal MRA and CTA, assesses the advantages and limitations of MRA and CTA, and provides the current indications for renal vascular imaging including renal artery stenosis screening. New and future developments in these rapidly evolving techniques are also discussed.