A Comprehensive Evaluation of Renovascular Disease MR angiography of the renal arteries has rapidly become a clinically accepted tool for the evaluation of patients with suspected renovascular disease (renal artery stenosis). The contrast agent used in MRI, Gd-DTPA, has useful physiologic properties in that it can be used as a marker of glomerular filtration (Figure 1). We have developed low-dose Gd-DTPA MR renography for the quantitative evaluation of kidney function. Our research investigates the clinical application of MR renography combined with MR angiography to provide complementary functional and anatomic evaluation of patients with kidney disease. (NIH funded) MRI For the Diagnosis of Acute Renal Transplant Dysfunction MRI is commonly used to evaluate dysfunctioning renal transplants for causes such as vascular or ureteral stenoses. Our group is exploring the potential for contrast-enhanced studies to detect and distinguish between different causes of intrinsic renal disease, such as delayed graft function (acute tubular necrosis) or acute rejection. Our approach relies on quantification of tracer kinetics using a multicompartmental model of the kidney. (NIH funded) MRI of Cardiac Viability It is well-established that areas of myocardial infarction demonstrate abnormal delayed enhancement following intravenous injections of Gd-DTPA contrast material. The high spatial resolution of MRI permits the detection of subtle myocardial infarct, including subendocardial infarct (non Q wave infarcts), that may otherwise be extremely difficult to diagnose. Our group has been investigating the clinical use of cardiac viability MR studies in a variety of clinical settings. (See Figure 2 below) MRA of Peripheral Vascular Disease New techniques for studying patients with claudication or peripheral vascular disease are being explored, including ultra fast time-resolved contrast-enhanced methods, as well as non-contrast-enhanced methods using gated half-Fourier 3D turbo spin echo techniques (Figure 3).