Renovascular imaging in the NSF Era.

The detection of the association between nephrogenic systemic fibrosis (NSF), a rare but potentially life-threatening disease only encountered in patients with severely impaired renal function, and the previous administration of some Gd-chelates has cast a shadow on the administration of Gd-chelates in patients with chronic renal failure. So far, contrast-enhanced MR-angiography (MRA) was considered the best diagnostic modality in patients with suspected renal disease. This review explores the most appropriate use of renal MRA with a focus on newly developed nonenhanced MRA techniques. Nonenhanced MRA techniques mainly based on SSFP with ECG-gating allow for acceptable spatial resolution to visualize at least the proximal parts of the renal arteries. In addition functional renal imaging techniques and their current clinical role are critically appreciated. J. Magn. Reson. Imaging 2009;30:1323-1334. (c) 2009 Wiley-Liss, Inc.