Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
Eur J Radiol. 2018 Nov;108:128-132. doi: 10.1016/j.ejrad.2018.09.025. Epub 2018 Sep 24.
We sought to evaluate the diagnostic value of foetal magnetic resonance imaging (MRI) for multicystic dysplastic kidney (MCDK) disease. We retrospectively identified 55 foetuses with MCDK diagnosed (51 unilateral; 4 bilateral) by foetal MRI. We analysed the anatomical findings by prenatal MRI and compared them with the prenatal ultrasound (US) and postnatal findings. Additional diagnostic information added by MRI was recorded. The gestational age of the 55 foetuses ranged from 22 to 35 weeks (mean, 26.5 ± 3.6 weeks). The age of the pregnant women ranged from 23 to 40 years (mean, 31 ± 4.2 years). All 55 cases were performed at 1.5 T magnetic resonance unit. MRI sequences, including steady-state free precession (SSFP), single-shot fast spin echo (SSFSE), T-weighted imaging (TWI), and diffusion weighted imaging (DWI) sequences. Follow-up was obtained for 53 cases (2 cases of autopsy, 51 cases of postnatal imaging or surgery confirmed). Among the 51 unilateral cases, 16 cases were associated with other urinary tract anomalies, 3 cases with extra-renal anomalies, and the remaining 32 cases without associated anomalies. 2 of 16 cases with contralateral renal agenesis were with oligohydramnios and pulmonary hypoplasia. 2 of 4 bilateral MCDK presented with oligohydramnios and pulmonary hypoplasia. 52 of 53 cases were correctly diagnosed by MRI compared with the final diagnoses; 40 of 53 (75.5%) cases were correctly diagnosed by prenatal ultrasound. Both prenatal ultrasound and MRI failed to correctly diagnose one case bilateral MCDK, and MRI correctly changed the ultrasound diagnosis in 12 cases. Foetal MRI can add additional diagnostic information to prenatal US in the assessment of MCDK, even change the prenatal counselling and decisions.
我们旨在评估胎儿磁共振成像（MRI）在多囊性发育不良肾（MCDK）疾病中的诊断价值。我们回顾性地确定了 55 例经胎儿 MRI 诊断为 MCDK 的胎儿（51 例单侧；4 例双侧）。我们分析了产前 MRI 的解剖学发现，并将其与产前超声（US）和产后发现进行了比较。记录了 MRI 增加的其他诊断信息。这 55 例胎儿的胎龄为 22 至 35 周（平均 26.5±3.6 周）。孕妇年龄为 23 至 40 岁（平均 31±4.2 岁）。所有 55 例均在 1.5T 磁共振仪上进行。MRI 序列包括稳态自由进动（SSFP）、单次激发快速自旋回波（SSFSE）、T 加权成像（TWI）和弥散加权成像（DWI）序列。53 例获得随访（2 例尸检，51 例产后影像学或手术证实）。在 51 例单侧病例中，16 例与其他尿路异常有关，3 例与肾外异常有关，其余 32 例无相关异常。16 例对侧肾发育不全中有 2 例合并羊水过少和肺发育不良。4 例双侧 MCDK 中有 2 例合并羊水过少和肺发育不良。与最终诊断相比，MRI 正确诊断了 53 例中的 52 例；43 例（75.5%）经产前超声正确诊断。产前超声和 MRI 均未能正确诊断 1 例双侧 MCDK，MRI 正确改变了 12 例超声诊断。胎儿 MRI 可以在评估 MCDK 时为产前 US 增加额外的诊断信息，甚至改变产前咨询和决策。
