Multiparametric MR Urography: State of the Art

Area of Science:

• Radiology and Medical Imaging
• Urologic Imaging

Background:

• CT urography (CTU) is the standard for urinary tract imaging.
• MR urography (MRU) has advanced, offering improved capabilities.

Purpose of the Study:

• To review the evolving role and techniques of MR urography.
• To highlight MRU as an alternative and first-line imaging modality in specific patient groups.

Main Methods:

• Review of conventional MRU techniques (T2-weighted, gadolinium-enhanced imaging).
• Inclusion of advanced techniques: multiparametric MRU (DCE-MRI, DWI), parallel imaging, compressed sensing, and deep learning.

Main Results:

• MRU provides superior contrast resolution and tissue characterization.
• MRU offers equivalent upper tract visualization and similar specificity to CTU for noncalculous diseases.
• Multiparametric MRU and newer techniques enhance diagnostic accuracy and reduce scan times.

Conclusions:

• MRU is a viable alternative to CTU for the general population.
• MRU is a preferred first-line examination for pediatric, pregnant, and contrast-allergic patients.
• Successful interpretation requires optimized techniques and knowledge of potential pitfalls.