Clinical use of urinary tract magnetic resonance imaging

MR imaging should not be used to evaluate the majority of the lesions described herein but should be reserved for specific clinical situations. The detection and differential diagnosis of adrenal masses is a legitimate application of this technique. The staging of renal tumors in patients in whom CT fails to do so may be accomplished by MR imaging. Establishment of patency of the renal veins and of surgical shunts involving these veins may be performed by MR imaging if Doppler ultrasonography proves unsatisfactory. MR imaging may differentiate between stable retroperitoneal fibrosis and malignant disease in patients in whom this differential is a problem. Hematomas may be distinguished from nonhemorrhagic fluid collections anywhere in the abdomen or pelvis. In selected patients, the local extent of certain bladder tumors may be evaluated by MR imaging when CT and biopsy fail to do so. In testicular disease, MR imaging may aid in the differential diagnosis of abnormalities that are not sufficiently characterized by ultrasonography, and MR imaging may detect undescended testes in some patients in whom ultrasonography fails to do so. In the future, wider application of fast scanning with bolus administration of soluble paramagnetic contrast agents may refine the differential diagnosis of adrenal masses and aid in the detection of renal masses. MR angiographic techniques ultimately may constitute a screening procedure for renal arteriostenosis. A subset of patients with prostate carcinoma may prove to benefit from local staging of the disease by MR imaging.