• R G Nicolaescu 1“Grigore Alexandrescu” Emergency Children’s Hospital 2Carol Davila University of Medicine and Pharmacy of Bucharest, Romania
  • R Capșa 2Carol Davila University of Medicine and Pharmacy of Bucharest, Romania 3Fundeni Clinical Institute
  • T Enache 1“Grigore Alexandrescu” Emergency Children’s Hospital
  • Ioana Gabriela Lupescu 2Carol Davila University of Medicine and Pharmacy of Bucharest, Romania 3Fundeni Clinical Institute
  • I Gherghina 2Carol Davila University of Medicine and Pharmacy of Bucharest, Romania 4”Alessandrescu-Rusescu” Mother and Child’s Health Institute
Keywords: mr urography, congenital obstructive uropathies


Congenital obstructive Uropathies are a leading cause of Chronic Kidney Disease in children.  The gold-standard for renal functional imaging is Diuretic Renal Scintigraphy. Different alternatives to Renal Scintigraphy have been suggested, many of them based on Magnetic Resonance Imaging (MRI). The accurate morphologic details of MRI with its more specific application - MR-Urography are well known. The prospect of adding functional information is very attractive, as it will make the MRU a comprehensive “all in one” examination for obstructive uropathies. We chose to investigate DCE MR urography and DTI as tools for the evaluation of congenital obstructive uropathies. Also, we suggest a different technique that describes the urinary flow in the collecting system – phase contrast imaging of the urinary flow in the renal pelvis. Therefore we performed three different studies, all with different sets of patients.


Chevalier RL. Congenital Urinary Tract Obstruction: The Long View. Adv Chronic Kidney Dis [Internet]. 2015 Jul;22(4):312–9.

Garne E, Loane M, Wellesley D, Barisic I, EUROCAT Working Group. Congenital hydronephrosis: Prenatal diagnosis and epidemiology in Europe. J Pediatr Urol [Internet]. 2009 Feb;5(1):47–52.

Lee RS, Cendron M, Kinnamon DD, Nguyen HT. Antenatal Hydronephrosis as a Predictor of Postnatal Outcome: A Meta-analysis. Pediatrics [Internet]. 2006 Aug 1;118(2):586–93.

Riccabona M, Avni FE, Blickman JG, Dacher J-N, Darge K, Lobo ML, et al. Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol [Internet]. 2008 Feb 11;38(2):138–45.

Ulman I, Jayanthi VR, Koff SA. The long-term followup of newborns with severe unilateral hydronephrosis initially treated nonoperatively. J Urol [Internet]. 2000 Sep;164(3 Pt 2):1101–5.

Grenier N, Trillaud H, Combe C, Degrèze P, Jeandot R, Gosse P, et al. Diagnosis of renovascular hypertension: feasibility of captopril-sensitized dynamic MR imaging and comparison with captopril scintigraphy. Am J Roentgenol [Internet]. 1996 Apr;166(4):835–43.

Michaely HJ, Schoenberg SO, Oesingmann N, Ittrich C, Buhlig C, Friedrich D, et al. Renal Artery Stenosis: Functional Assessment with Dynamic MR Perfusion Measurements—Feasibility Study. Radiology [Internet]. 2006 Feb;238(2):586–96.

Szolar DH, Preidler K, Ebner F, Kammerhuber F, Horn S, Ratschek M, et al. Functional magnetic resonance imaging of human renal allografts during the post-transplant period: preliminary observations. Magn Reson Imaging [Internet]. 1997;15(7):727–35.

McDaniel BB, Jones RA, Scherz H, Kirsch AJ, Little SB, Grattan-Smith JD. Dynamic Contrast-Enhanced MR Urography in the Evaluation of Pediatric Hydronephrosis: Part 2, Anatomic and Functional Assessment of Uteropelvic Junction Obstruction. Am J Roentgenol [Internet]. 2005 Dec 23;185(6):1608–14.

Rohrschneider WK, Haufe S, Wiesel M, Tönshoff B, Wunsch R, Darge K, et al. Functional and Morphologic Evaluation of Congenital Urinary Tract Dilatation by Using Combined Static-Dynamic MR Urography: Findings in Kidneys with a Single Collecting System. Radiology [Internet]. 2002 Sep 1;224(3):683–94.

Grattan-Smith JD, Little SB, Jones RA. MR urography evaluation of obstructive uropathy. Pediatr Radiol [Internet]. 2008 Jan 11;38(S1):49–69.

Vivier P-H, Dolores M, Taylor M, Dacher J-N. MR urography in children. Part 2: how to use ImageJ MR urography processing software. Pediatr Radiol [Internet]. 2010 May 25;40(5):739–46.

Özkan MB, Marterer R, Tscheuner S, Yildirim UM, Ozkan E. The role of kidney diffusion tensor magnetic resonance imaging in children. Egypt J Radiol Nucl Med [Internet]. 2016 Dec 1;47(4):1599–611.

Jaimes C, Darge K, Khrichenko D, Carson RH, Berman JI. Diffusion tensor imaging and tractography of the kidney in children: feasibility and preliminary experience. Pediatr Radiol [Internet]. 2014 Jan 11;44(1):30–41.

Wang W, Pui MH, Guo Y, Wang L, Wang H, Liu M. 3T magnetic resonance diffusion tensor imaging in chronic kidney disease. Abdom Imaging [Internet]. 2014 Aug 13;39(4):770–5.

Tewes S, Gueler F, Chen R, Gutberlet M, Jang M-S, Meier M, et al. Functional MRI for characterization of renal perfusion impairment and edema formation due to acute kidney injury in different mouse strains. Long D, editor. PLoS One [Internet]. 2017 Mar 20;12(3):e0173248.

Razek AAKA, Al-Adlany MAAA, Alhadidy AM, Atwa MA, Abdou NEA. Diffusion tensor imaging of the renal cortex in diabetic patients: correlation with urinary and serum biomarkers. Abdom Radiol [Internet]. 2017 May 2;42(5):1493–500.

Lupica R, Mormina E, Lacquaniti A, Trimboli D, Bianchimano B, Marino S, et al. 3 Tesla-Diffusion Tensor Imaging in Autosomal Dominant Polycystic Kidney Disease: The Nephrologist’s Point of View. Nephron [Internet]. 2016;134(2):73–80.

Feng Q, Ma Z, Zhang S, Wu J. Usefulness of diffusion tensor imaging for the differentiation between low-fat angiomyolipoma and clear cell carcinoma of the kidney. Springerplus [Internet]. 2016;5:12.

Artz NS, Sadowski EA, Wentland AL, Grist TM, Seo S, Djamali A, et al. Arterial spin labeling MRI for assessment of perfusion in native and transplanted kidneys. Magn Reson Imaging [Internet]. 2011 Jan;29(1):74–82.

Detre JA, Zhang W, Roberts DA, Silva AC, Williams DS, Grandis DJ, et al. Tissue specific perfusion imaging using arterial spin labeling. NMR Biomed [Internet]. 1994 Mar;7(1–2):75–82.

Li L-P, Vu AT, Li BSY, Dunkle E, Prasad P V. Evaluation of intrarenal oxygenation by BOLD MRI at 3.0T. J Magn Reson Imaging [Internet]. 2004 Nov;20(5):901–4.

Prasad P V, Epstein FH. Changes in renal medullary pO2 during water diuresis as evaluated by blood oxygenation level-dependent magnetic resonance imaging: effects of aging and cyclooxygenase inhibition. Kidney Int [Internet]. 1999 Jan;55(1):294–8.

Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods 2012 97. 2012 Jun 28;

Ries M, Jones RA, Basseau F, Moonen CT, Grenier N. Diffusion tensor MRI of the human kidney. J Magn Reson Imaging [Internet]. 2001 Jul;14(1):42–9.

Palmucci S, Cappello G, Attinà G, Foti PV, Siverino ROA, Roccasalva F, et al. Diffusion weighted imaging and diffusion tensor imaging in the evaluation of transplanted kidneys. Eur J Radiol open [Internet]. 2015;2:71–80.

Chuck NC, Steidle G, Blume I, Fischer MA, Nanz D, Boss A. Diffusion Tensor Imaging of the Kidneys: Influence of b-Value and Number of Encoding Directions on Image Quality and Diffusion Tensor Parameters. J Clin Imaging Sci [Internet]. 2013;3:53.

Nicolaescu R, Lupescu I, Preda E, Capsa R, Gherghina I. Diffusion Tensor Imaging-A New Biomarker for Evaluation of Renal Function: Preliminary Results and Literature Review. Rom J Urol [Internet]. 2017;16(1):9–14.

Zhang JL, Rusinek H, Chandarana H, Lee VS. Functional MRI of the kidneys. J Magn Reson Imaging [Internet]. 2013 Feb;37(2):282–93.

Zhang JL, Rusinek H, Bokacheva L, Chen Q, Storey P, Lee VS. Use of cardiac output to improve measurement of input function

How to Cite
Nicolaescu, R., Capșa, R., Enache, T., Lupescu, I., & Gherghina, I. (2019). FUNCTIONAL MR UROGRAPHY - PRINCIPLES AND APPLICATIONS IN CONGENITAL OBSTRUCTIVE UROPATHIES. Romanian Journal of Clinical Research, 2(1), 8-16.