Non-contrast Enhance MRA and Diffusion Weighted Imaging for a non invasive and safe morphological-functional MR study in patients with renal insufficiency

Renal insufficiency is a serious healthcare problem. The Iodine renal toxicity and the link of Gadolinium to Nephrogenic Systemic Fibrosis makes conventional imaging of the severely malfunctioning kidneys not safe for the patient. Functional imaging in nephrology where anatomy and physiology are jointly considered, is a necessary diagnostic tool in patients with renal insufficiency in general and more particularly in patients with renal artery stenosis (RAS); in this last group it is important to assess ischemic injury of the renal parenchyma in order to predict the benefit or a revascularization procedure [1]. Non contrast Enhanced MRA techniques such as Time-SLIP (Time-Spatial Labeling Inversion Pulse) can be used to explore safely the renal arteries [2] and Diffusion-weighted imaging (DWI) could be integrated to the protocol for an “all-in-one” morphological–functional MR study to assess renal parenchyma function [3]. The aim of this preliminary study was to explore the clinical value of a totally safe “all-in-one” MR protocol in patients with moderate to severe renal insufficiency and suspected RAS.