Complementary role of magnetic resonance imaging in the study of the fetal urinary system

Prenatal diagnosis of congenital anomalies of genito-urinary system on fetal magnetic resonance imaging

“…We found MRI to be especially useful in evaluating bilateral MCDK cases as the associated lack of amniotic had compromised the sonic window. Our observation that MRI is helpful in differentiating MCDK from hydronephrosis is in consonance with similar observations recorded in earlier studies [1,5,10,11]. According to these studies, MRI is helpful in displaying the disease morphology in a better manner, and in MCDK, it shows multiple variable-sized non-communicating cortical and medullary cysts having hyperintense T2 signal and low DWI signal.…”

“…Genito-urinary system (GUS) anomalies constitute an important and relatively common subset of fetal anomalies encountered in routine antenatal practice, comprising approximately 30-50% of all malformations detected on prenatal scans or at birth [1,2]. They exhibit a wide range of severity ranging from simple pyelectasis to conditions incompatible with life such as bilateral renal agenesis.…”

The Role of MRI in Evaluation of Fetal Urinary Tract Anomalies with Normal and Abnormal Volume Amniotic Fluid

“…The depiction of multicystic pelvic mass composed of bladder and hydrometrocolpos, ascites, hydronephrosis and abnormal rectal position should lead to the diagnosis of cloaca malformation. 13,14 Ascites in this case is due to urine refluxing via fallopian tube. Hydronephrosis is occurred due to bladder obstruction by pouch.…”

The use of fetal MRI for renal and urogenital tract anomalies

“…Since the implementation of routine prenatal ultrasound (US) screening during pregnancy 40 years ago, studies have shown that fetal anomalies are detected in approximately 2% of all fetuses. Genitourinary (GU) tract abnormalities are the most common among these, accounting for 30% to 50% of all structural anomalies present at birth or identified at the time of prenatal US . These include a wide range of abnormalities both morphologically as well as in terms of severity, for example, from mild pyelectasis over bilateral multicystic dysplastic kidneys to bilateral renal agenesis.…”

“…However, there may be technical limitations that can hamper the use of US such as fetal positioning, maternal obesity, shadowing from bone, and oligohydramnios; the latter being more frequently associated with urinary tract anomalies. In these circumstances, or when sonography is inconclusive, MRI provides important additional information, certainly as faster sequences become available, which minimize motion hence improve image quality . There are three areas where MRI can add value: (a) adequate morphological examination and additional tissue contrast from MRI to improve the diagnostic accuracy, (b) the detection of additional anomalies not detected by sonography, and (c) the provision of information regarding renal function .…”