Diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient (ADC) determination in normal and pathological fetal kidneys.
OBJECTIVE
To assess the use of diffusion-weighted magnetic resonance imaging (DW-MRI) in the evaluation of the fetal kidney and to estimate age-dependent changes in the apparent diffusion coefficient (ADC) of normal and pathological fetal kidneys.


METHODS
DW-MRI was performed on a 1.5-T machine at 23-38 gestational weeks in 51 pregnant women in whom the fetal kidneys were normal and in 10 whose fetuses had renal pathology (three with suspected nephropathy, three with renal tract dilatation, one with unilateral renal venous thrombosis, and three with twin-twin transfusion syndrome (TTTS)). The ADC was measured in an approximately 1-cm2 region of interest within the renal parenchyma.


RESULTS
ADC values in normal renal parenchyma ranged from 1.1 to 1.8 10(-3) mm2 s-1. There was no significant age-dependent change in the ADC of normal kidneys. In cases of nephropathy, the ADC value was not always pathological but an ADC map could show abnormal findings. In cases of dilatation, the ADC value was difficult to determine when the dilatation was huge. In cases of TTTS, the ADC of the donor twin was higher than that of the recipient twin and the difference seemed to be related to the severity of the syndrome.


CONCLUSIONS
Evaluation of the ADC for fetal kidneys is feasible. Fetal measurement of the ADC value and ADC maps may be useful tools with which to explore the fetal kidney when used in conjunction with current methods. DW-MR images, ADC value and ADC map seem to be useful in cases of suspected nephropathy (hyperechoic kidneys), dilated kidney and vascular pathology (renal venous thrombosis, TTTS).
Chaumoitre
K
K
Department of Medical Imaging, Hôpital Nord, CHU Marseille, France.
Colavolpe
N
N
Department of Medical Imaging, Hôpital Nord, CHU Marseille, France.
Shojai
R
R
Department of Obstetrics, Hôpital Nord, CHU Marseille, France.
Sarran
A
A
Department of Medical Imaging, Hôpital Nord, CHU Marseille, France.
D' Ercole
C
C
Department of Obstetrics, Hôpital Nord, CHU Marseille, France.
Panuel
M
M
Department of Medical Imaging, Hôpital Nord, CHU Marseille, France.
D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000473:pathology*; D005865:Gestational Age; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology* / Q000196:embryology; D007674:Kidney Diseases / Q000473:pathology*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*