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Fetal MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) assessment in the evaluation of renal development: preliminary experience in normal kidneys

Valutazione dello sviluppo dei reni fetali mediante risonanza magnetica fetale con sequenze pesate in diffusione (DWI) e relative mappe di ADC: studio preliminare su feti con reni normali

  • Paediatric Radiology/Radiologia Pediatrica
  • Published:
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Abstract

Purpose

The study aimed to investigate the correlation between apparent diffusion coefficient (ADC) and gestational age by applying diffusion-weighted imaging (DWI) in the study of normal fetal kidneys.

Materials and methods

We performed magnetic resonance (MR) imaging on 88 fetuses (gestational age range 17–40 weeks) after ultrasound had ruled out urinary system malformations. A multiplanar study of the urinary system was obtained by using conventional T2-weighted sequences and echoplanar imaging (EPI). DW sequences with ADC maps were subsequently acquired, and kidney ADC values were correlated with gestational age by diving the fetuses into six groups according to age.

Results

We found a correlation between ADC values and gestational age. The ADC values, ranging from 0.99 to 1.62×10−3 mm2/s [mean 1.22; 95% confidence interval (CI) 1.19–1.25, standard deviation (SD) 0.147], showed a tendency to decrease with increasing gestational age. The relationship between ADC values and gestational age was expressed by a linear regression equation: ADC (mm2/s)=1.69–0.0169 (GA) (R2=37.7%, R2 ADJ=37.0%, p<0.005, Pearson correlation=−0.614).

Conclusions

DWI with ADC mapping provides functional information on fetal renal parenchyma development and may thus become a useful tool in the management of pregnancy and treatment of the newborn child.

Riassunto

Obiettivo

Applicare le sequenze pesate in diffusione (DWI) nello studio dei reni fetali, per valutare l’esistenza di una correlazione fra coefficiente di diffusione apparente (ADC) ed età gestazionale nei feti sani.

Materiali e metodi

Abbiamo studiato con esame RM 88 feti (età gestazionale 17–40 settimane), già valutati con esame ecografico che escludeva malformazioni del tratto urinario. L’apparato urinario fetale è stato studiato con sequenze T2 pesate ultraveloci; successivamente sono state acquisite sui reni fetali sequenze DWI (con calcolo automatico delle mappe di ADC) ed i valori di ADC messi in relazione con l’età gestazionale, suddividendo i feti in sei gruppi in base all’età gestazionale. La normale funzionalità renale è stata confermata dopo la nascita attraverso dati clinico-laboratoristici ed ecografia renale.

Risultati

Abbiamo riscontrato che i valori di ADC, compresi fra 0,99 e 1,62×10−3 mm2/s (media 1,22; 95% CI 1,19–1,25; deviazione standard 0,147) tendono a decrescere con l’aumentare delle settimane di gestazione. La migliore correlazione è stata espressa dall’equazione di regressione lineare: ADC (mm2/s)=1,69–0,0169 (GA) (R2=37,7%, R2 ADJ=37,0%, p<0,005, correlazione di Pearson=–0,614). Conclusioni. Le sequenze DWI ed le mappe di ADC, fornendo informazioni funzionali sullo sviluppo del parenchima renale fetale, risultano di grande utilità soprattutto nella gestione della gravidanza e nel management post-natale.

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Authors and Affiliations

  1. Istituto di Scienze Radiologiche-Policlinico Umberto I, Università degli Studi “Sapienza” Roma, Viale Regina Elena 324, 00161, Roma, Italy

    L. Manganaro, A. Francioso, S. Savelli, A. Tomei, F. Fierro, M. Di Maurizio, F. Coratella, A. Perrone, L. Ballesio, A. Giancotti, L. Porfiri & M. Marini

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  1. L. Manganaro
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  2. A. Francioso
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  3. S. Savelli
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  4. A. Tomei
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  5. F. Fierro
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  6. M. Di Maurizio
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  7. F. Coratella
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  8. A. Perrone
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  9. L. Ballesio
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  10. A. Giancotti
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  11. L. Porfiri
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Correspondence to A. Francioso.

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Manganaro, L., Francioso, A., Savelli, S. et al. Fetal MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) assessment in the evaluation of renal development: preliminary experience in normal kidneys. Radiol med 114, 403–413 (2009). https://doi.org/10.1007/s11547-009-0382-x

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  • DOI: https://doi.org/10.1007/s11547-009-0382-x

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