This study characterizes the diffusion anisotropy of the human kidney using a diffusion-weighted, single-shot echo planar imaging (EPI) sequence in order to access the full apparent diffusion tensor (ADT) within one breathhold. The fractional anisotropy (FA) of the cortex and the medulla were found to be 0.22 ؎ 0.12 and 0.39 ؎ 0.11, respectively (N ؍ 10), which emphasizes the need for rotationally invariant diffusion measurements for clinical applications. Additional limitations for clinical diffusion imaging on the kidney are the strong susceptibility variations within the abdomen that restrict the use of imaging techniques employing long echo trains, and the severe motion sensitivity that limits the available imaging time to one breath-hold. To overcome these problems an isotropic, diffusion-weighted, segmented EPI protocol that facilitates the acquisition of high-resolution diffusion-weighted images within a single breath-hold was implemented. Using this method, the apparent diffusion coefficient (ADC) of the cortex and medulla were found to be 2. 89 Index terms: diffusion; magnetic resonance imaging; kidney; EPI; fractional anisotropy WATER TRANSPORT is the predominant phenomenon throughout the kidney due to the kidney's major role in water reabsorption and concentration-dilution functions. These movements are mainly located in the tubular cells and are controlled either by active or passive mechanisms, depending on their location in the nephrons. Consequently, the measurement of the diffusion characteristics of the kidney may provide useful insights into the mechanisms of various renal diseases, including chronic renal failure, renal artery stenosis, and uretral obstruction. However, renal diffusion imaging is very challenging due to the extreme motion sensitivity of diffusion-weighted sequences, and the clinical use of this technique has been hampered by both the severe motion artifacts caused by arterial pulsations and respiratory motion. Diffusion-weighted single-shot-EPI (DW-SSEPI) (1), in conjunction with single breath-hold imaging (2-6) and peripheral pulse unit (PPU) triggering, (7) has been suggested as a possible means of overcoming these problems. However, the restriction of the diffusion experiment to a single breathhold limits the possible spatial resolution and the precision of the diffusion measurement (the number of directions for the diffusion weighting, the number of b-values, and the number of averages). As a result, most studies in the literature have measured the ADC in only one direction (2,4 -7), and hence have implicitly assumed that the diffusion characteristics of the kidney are isotropic. Hydration has been shown to increase global ADC values (3), while renal artery stenosis or ureteral obstruction decreased the values (2,3). In cases of acute or chronic renal failure, the cortical and medullary ADC values were significantly lower than in normal kidneys, and the cortical values were highly correlated with the serum creatinine levels (2).Although some studies have implied that t...