Alterations in corticomedullary differentiation are recognized but are nonspecific. Acute cortical necrosis can be specifically diagnosed when there is a low T2 signal rim at the corticomedullary junction and absence of cortical enhancement following contrast administration [23]. Functional MRI techniques , such as BOLD, AS L, DWI , and DKI that p rovide information on renal p erfusion, oxygenation, and diffusion are still the subject of active research [21,22]. MR Urography There is no relevant literature regarding the use of MRU in the initial evaluation of renal failure of unknown duration. However, nonenhanced contrast MRU may provide additional information in patients with renal failure secondary to obstruction. Radiography Abdomen and Pelvis There is no role for radiography in AKI/CKD other than for evaluation of renal stone disease, which acknowledges that radiography is less sensitive than CT for stone disease [24]. DMSA Renal Scan Tc-99m DMSA scintigraphy is ideal for functional renal cortical imaging and is most useful for detection of focal renal parenchymal abnormalities and scars in the setting of acute or chronic pyelonephritis or for differential renal function. The literature search did not identify any studies regarding the use of Tc-99m DMSA as a first-line test in the evaluation of renal failure of unknown duration. MAG3 Renal Scan The literature search did not identify any studies regarding the use of Tc-99m MAG3 as a first-line test in the evaluation of renal failure of unknown duration. US Kidneys Retroperitoneum US has greatest diagnostic value in the detection of hydronephrosis associated with urinary tract obstruction [4] with a sensitivity >90% for hydronephrosis and bladder distension [26]. However, even in hospitalized patients with AKI, the prevalence of hydronephrosis is low, ranging from 5% to 10%, with obstruction the cause of AKI in <45.2% of patients with hydronephrosis [4,27-29].
Renal Failure. Alterations in corticomedullary differentiation are recognized but are nonspecific. Acute cortical necrosis can be specifically diagnosed when there is a low T2 signal rim at the corticomedullary junction and absence of cortical enhancement following contrast administration [23]. Functional MRI techniques , such as BOLD, AS L, DWI , and DKI that p rovide information on renal p erfusion, oxygenation, and diffusion are still the subject of active research [21,22]. MR Urography There is no relevant literature regarding the use of MRU in the initial evaluation of renal failure of unknown duration. However, nonenhanced contrast MRU may provide additional information in patients with renal failure secondary to obstruction. Radiography Abdomen and Pelvis There is no role for radiography in AKI/CKD other than for evaluation of renal stone disease, which acknowledges that radiography is less sensitive than CT for stone disease [24]. DMSA Renal Scan Tc-99m DMSA scintigraphy is ideal for functional renal cortical imaging and is most useful for detection of focal renal parenchymal abnormalities and scars in the setting of acute or chronic pyelonephritis or for differential renal function. The literature search did not identify any studies regarding the use of Tc-99m DMSA as a first-line test in the evaluation of renal failure of unknown duration. MAG3 Renal Scan The literature search did not identify any studies regarding the use of Tc-99m MAG3 as a first-line test in the evaluation of renal failure of unknown duration. US Kidneys Retroperitoneum US has greatest diagnostic value in the detection of hydronephrosis associated with urinary tract obstruction [4] with a sensitivity >90% for hydronephrosis and bladder distension [26]. However, even in hospitalized patients with AKI, the prevalence of hydronephrosis is low, ranging from 5% to 10%, with obstruction the cause of AKI in <45.2% of patients with hydronephrosis [4,27-29].