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Background <p>Fetal renal developmental abnormalities are among the most common congenital malformations and are associated with adverse perinatal outcomes. Although fetal magnetic resonance imaging (MRI) can provide complementary morphological and quantitative information, gestational age (GA)-specific reference values integrating fetal renal morphology and diffusion parameters remain limited. This study aimed to establish MRI-based reference values for normal fetal renal morphology and apparent diffusion coefficient (ADC) across gestation.</p> Methods <p>In this retrospective single-center observational study, 313 singleton pregnancies (GA 23–38 weeks) with normal postnatal urinary outcomes underwent 1.5T fetal MRI, including T2-weighted and diffusion-weighted imaging sequences. Morphological parameters [anteroposterior, transverse and longitudinal diameters, and mean renal parenchymal thickness (MRPT) and functional parameters T2 relative signal intensity (RSI-T2) and apparent diffusion coefficient (ADC)] were measured for both kidneys. Reproducibility was assessed using intraclass correlation coefficients (ICC). Associations between MRI parameters and GA were evaluated using correlation and linear regression analyses.</p> Results <p>All measured parameters showed good to excellent inter-observer reproducibility. Renal diameters and MRPT increased significantly with GA (<i>r</i> = 0.72–0.89; all <i>P</i> &lt; 0.0001). In contrast, renal ADC values showed moderate negative correlations with GA (right kidney: <i>r</i> =-0.47; left kidney: <i>r</i> =-0.52; both <i>P</i> &lt; 0.0001). The regression equations for ADC (×10<sup>−</sup>3&#xa0;mm²/s) were ADC_right = 3.23 − 0.049 × GA and ADC_left = 3.46 − 0.058 × GA.</p> Conclusions <p>This study provides GA-stratified reference ranges for key morphological and functional MRI parameters of normal fetal kidneys in the second and third trimesters. These quantitative benchmarks may provide a reference framework for fetal renal MRI assessment and for future studies of fetal renal abnormalities.</p> Trial registration <p>Not applicable.</p>

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Gestational age-specific MRI reference values for fetal renal morphology and ADC

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月29日

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  • Yangmei Pu,
  • Shuzhen Ma,
  • Qiyan Wang,
  • Ran Li,
  • Xuejing Zou,
  • Yuchen Liu,
  • Min Kang

摘要

Background

Fetal renal developmental abnormalities are among the most common congenital malformations and are associated with adverse perinatal outcomes. Although fetal magnetic resonance imaging (MRI) can provide complementary morphological and quantitative information, gestational age (GA)-specific reference values integrating fetal renal morphology and diffusion parameters remain limited. This study aimed to establish MRI-based reference values for normal fetal renal morphology and apparent diffusion coefficient (ADC) across gestation.

Methods

In this retrospective single-center observational study, 313 singleton pregnancies (GA 23–38 weeks) with normal postnatal urinary outcomes underwent 1.5T fetal MRI, including T2-weighted and diffusion-weighted imaging sequences. Morphological parameters [anteroposterior, transverse and longitudinal diameters, and mean renal parenchymal thickness (MRPT) and functional parameters T2 relative signal intensity (RSI-T2) and apparent diffusion coefficient (ADC)] were measured for both kidneys. Reproducibility was assessed using intraclass correlation coefficients (ICC). Associations between MRI parameters and GA were evaluated using correlation and linear regression analyses.

Results

All measured parameters showed good to excellent inter-observer reproducibility. Renal diameters and MRPT increased significantly with GA (r = 0.72–0.89; all P < 0.0001). In contrast, renal ADC values showed moderate negative correlations with GA (right kidney: r =-0.47; left kidney: r =-0.52; both P < 0.0001). The regression equations for ADC (×10−3 mm²/s) were ADC_right = 3.23 − 0.049 × GA and ADC_left = 3.46 − 0.058 × GA.

Conclusions

This study provides GA-stratified reference ranges for key morphological and functional MRI parameters of normal fetal kidneys in the second and third trimesters. These quantitative benchmarks may provide a reference framework for fetal renal MRI assessment and for future studies of fetal renal abnormalities.

Trial registration

Not applicable.