Objectives:  This study was designed to assess the role of magnetic resonance imaging (MRI) in refining the diagnosis of prenatally suspected fetal renal abnormalities following screening ultrasound.
Patients and methods:  Twenty pregnant women, with suspected fetal renal abnormality detected during screening ultrasound and more than 14 weeks’ gestation, were included in this observational prospective study at Ain Shams University Maternity Hospital from March 2004 to March 2005 after informed consent and after approval of the study protocol by the institute ethics committee.
Results:  The MRI could diagnose correctly 10 cases of hydronephrosis, one case of polycystic kidney disease (PCKD), one case of RA, two normal case and two cases of intra‐abdominal masses (IA Mass) (16 of 18 cases). The prenatal ultrasound could diagnose correctly eight cases of hydronephrosis, one case of PCKD, one case of renal agenesis, one case of multicystic kidney disease and one case of IA Mass (12 of 18 cases). The prenatal ultrasound and MRI gave different diagnoses in eight cases and gave the same diagnosis in 12 cases. The MRI could diagnose the aetiology of congenital renal cysts in 10 of the 20 studied cases (50%).
Conclusion:  Magnetic resonance imaging can be used as a complementary tool in the assessment of sonographically suspected fetal renal anomalies.