Objective To investigate the value of MRI in the prenatal diagnosis of abnormal fetal kidneys. Methods From December 2014 to March 2016, 51 women underwent MRI and were confirmed as having fetuses with abnormal fetal kidneys when follow up. Their clinical and MRI profiles were analyzed retrospectively, including MRI manifestation, the fetal kidney signal intensity of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC). The signal intensity of DWI and ADC of the abnormal kidney and the normal opposite kidney, and those of the normal and abnormal kidneys in different individuals were compared. The accuracies of MRI and ultrasound in evaluating abnormal fetal kidneys were also compared. Results MRI could accurately demonstrate the morphological features of abnormal fetal kidneys. There was no statistically significant difference between DWI signal intensity and ADC value of the abnormal kidney[368 ± 125,(1.516 ± 0.420)× 10-3 mm2/s] and the normal opposite one[410 ± 125,(1.362 ± 0.251)× 10-3 mm2/s], P values were 0.165 and 0.184,respectively. The DWI signal intensity of normal kidneys(401 ± 124)was higher than that of renal cysts(182 ± 40, P<0.01), and the ADC value of normal kidneys[(1.306 ± 0.252)× 10-3 mm2/s] was lower than that of renal cysts[(2.912 ± 0.235)× 10-3 mm2/s] and multicystic dysplastic kidneys[(1.870 ± 0.654)× 10-3 mm2/s], P values were<0.01 and 0.045, respectively. The diagnostic accuracy of MRI and prenatal ultrasound for abnormal fetal kidneys were 94%(63/67)and 85%(57/67), respectively. However, there was no statistical difference between the two methods (P=0.070). Conclusion MRI have an important role in the prenatal diagnosis and evaluation of abnormal fetal kidneys.%目的：探讨MRI检查在胎儿先天性肾脏异常诊断中的应用。方法回顾性分析2014年12月至2016年3月经随访证实的51例先天性肾脏异常胎儿的产前MRI检查资料，分析胎儿肾脏异常的MRI表现，测量肾脏扩散加权成像（DWI）信号强度和表观扩散系数（ADC）值。比较胎儿正常发育肾脏与异常肾脏、单侧肾脏异常胎儿的异常肾脏与正常肾脏的DWI信号强度、ADC值，比较MRI检查和超声检查对胎儿肾脏异常诊断的准确率。结果 MRI检查能够准确显示胎儿肾脏异常的形态特征；单侧肾脏异常胎儿异常肾脏的DWI信号强度为368±125，ADC值为（1.516±0.420）×10-3 mm2/s；其正常肾脏的DWI信号强度为410±125、ADC值为（1.362±0.251）×10-3 mm2/s，分别比较，差异均无统计学意义（P值分别为0.165和0.184）。正常发育肾脏的DWI信号强度（401±124）高于肾囊肿（182±40；P＜0.01），而其ADC值[（1.306±0.252）×10-3 mm2/s]低于肾囊肿[（2.912±0.235）×10-3 mm2/s]和多囊性发育不良肾[（1.870±0.654）×10-3 mm2/s；分别为P＜0.01和P=0.045]。产前MRI检查对胎儿肾脏异常诊断的准确率为94%（63/67），产前超声的准确率为85%（57/67），两者比较，差异无统计学意义（P=0.070）。结论 MRI检查在胎儿肾脏异常诊断中具有较高的应用价值，为临床医师评估胎儿肾脏异常提供了重要方法。
展开▼
