Update of renal imaging

Significant technical improvements have allowed the use of radiological techniques to play a growing role in the imaging of renal diseases. Noninvasive ultrasound methods (ie, sonography and Doppler) are now positioned as first-line methods for the evaluation of renovascular diseases. Multidetector computed tomography is able to provide high spatial resolution images of the kidneys and renal arterial vessels. Magnetic resonance imaging, which provides higher signal-to-noise ratio and higher spatial and/or temporal resolution, can display both morphological information about renal parenchyma and vessels and functional data, including perfusion, filtration, diffusion, or oxygenation. In renovascular diseases, these techniques have the potential to drive new strategies, including Doppler sonography as a first-line method, followed by computed tomography angiography or magnetic resonance angiography, depending mainly on renal function. Imaging of parenchymal renal diseases is developing toward more quantitative (volumetric and functional measurements) and more specific (through in vivo cell targeting) acquisitions for obtaining the adequate information on tissue characteristics relevant either for diagnosis or for prognosis or treatment follow-up.