Normal renal development investigated with fetal MRI

ObjectiveTo evaluate age-dependent changes in fetal kidney measurements with MRI.Patients and methodsFetal MRI examinations were used to study the kidney length (218 fetuses), signal intensities of renal tissue, renal pelvis, and liver tissue on T2-weighted images (223 fetuses), and the whole-kidney apparent diffusion coefficient (107 fetuses). A 1.5 T superconducting unit with a phased array coil was used in patients from 16 to 39 weeks’ gestation. The imaging protocol included T2-weighted single-shot fast spin-echo, T2-weighted balanced angiography and diffusion-weighted sequences. Slice thickness ranged from 3 to 5 mm.ResultsFetal kidney length as a function of gestational age was expressed by the linear regression: kidney length (mm) = 0.190 × gestational age (d) − 8.034 (R2 = 0.883, p < 0.001). Paired t-test analysis showed a highly statistically significant difference between the ratio of renal tissue signal intensity to renal pelvis signal intensity and the ratio of liver signal intensity to renal pelvis signal intensity on T2-weighted images (t = −50.963, d.f. = 162, p < 0.001), with renal tissue hyperintense to liver tissue. The apparent diffusion coefficient in relation to gestational age was described by the equation: ADC (μm2/s) = 0.0302 × square (gestational age (d)) − 14.202 × gestational age (d) + 2728.6 (R2 = 0.225, p < 0.001).ConclusionThe length, signal intensity on T2-weighted images, and apparent diffusion coefficient of the fetal kidney change significantly with gestational age. The presented data may help in the prenatal diagnosis of renal anomalies.