Imaging of fetal cystic kidney disease: multicystic dysplastic kidney versus renal cystic dysplasia
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FETAL IMAGING
Imaging of fetal cystic kidney disease: multicystic dysplastic kidney versus renal cystic dysplasia Mariana L. Meyers 1,2
&
Amy L. Treece 3 & Brandon P. Brown 4,5 & Vijaya M. Vemulakonda 2,6
Received: 30 January 2020 / Revised: 6 May 2020 / Accepted: 15 June 2020 / Published online: 19 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract With the advent of routine prenatal imaging, the number of renal anomalies identified prenatally has significantly increased; however, the underlying etiologies of these anomalies and the clinical significance of these findings remains unclear. This confusion is especially true for the prenatal diagnosis of cystic renal changes. The terms “cystic kidney disease” and “renal cystic dysplasia” encompass myriad renal diseases. Although renal cystic dysplasia in infants shares many similarities with multicystic dysplastic kidney (MCDK), it is important to distinguish MCDK from other etiologies that would lead to renal cysts, to ensure proper patient diagnosis and appropriate counseling regarding risks and to guide clinical management. The purpose of this review is to highlight the multiple etiologies of cystic kidney disease, including genetic associations, associations with underlying syndromes, and associations with underlying anatomical abnormalities. Here we focus on prenatal imaging, associated pathological findings, and clinical significance, with an emphasis on the defining characteristics of MCDK as compared to other forms of cystic renal disease. Keywords Cystic kidney disease . Fetus . Kidney . Magnetic resonance imaging . Multicystic dysplastic kidney . Renal cystic dysplasia
Introduction Fetal MRI has become an adjunct imaging modality to US in the evaluation of complex genitourinary anomalies, including renal cystic disease. The improved resolution and
* Mariana L. Meyers [email protected] 1
Department of Radiology – Pediatric Section, University of Colorado School of Medicine and Children’s Hospital Colorado, 13123 E. 16th Ave., Mail stop B125-Radiology, Aurora, CO 80045, USA
2
Colorado Fetal Care Center, Children’s Hospital Colorado, Aurora, CO, USA
3
Department of Pathology – Pediatric Section, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
4
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
5
The Fetal Center at Riley Children’s Health, Indianapolis, IN, USA
6
Department of Surgery – Urology Section, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
anatomical detail of the renal parenchyma offered by MRI can assist with identification, localization and characterization of renal cysts, which might be less clearly visualized on US imaging [1–4]. MRI is also a helpful complementary method of evaluating genitourinary fetal anomalies in cases of maternal obesity or oligo-anhydramnios. Thus, it adds value to prenatal diagnosis, prognostication, family co
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