The role of non-contrast-enhanced magnetic resonance urography in urinary tract imaging of pediatric patients

Objectives: This study aim to evaluate the indications, anatomical information, and diagnostic contribution of non-contrast-enhanced magnetic resonance urography (MRU) in pediatric patients. Patients and methods: Thirty-three pediatric patients (17 males, 16 females; mean age: 10.6 ± 4.9 years; range, 5 to 17 years) who underwent non-contrast-enhanced MRU between January 2013 and December 2024 were retrospectively reviewed. All examinations were performed using heavily T2-weighted sequences that did not require sedation, and MRU findings were compared with concurrent ultrasonography results. Results: Non-contrast-enhanced MRU provided excellent anatomical resolution, particularly in structural anomalies such as hydroureteronephrosis, ureteropelvic junction and ureterovesical junction stenoses, and duplicated collecting systems. However, non-contrast-enhanced MRU did not offer direct functional assessment of the kidneys. Conclusion: Non-contrast-enhanced MRU is a safe, reproducible, and radiation-free imaging technique for detailed evaluation of the pediatric urinary tract anatomy. It serves as a valuable second-line diagnostic modality in cases where ultrasonography yields inconclusive or limited findings.