Urinary tract imaging in infancy

Imaging of the Pediatric Urinary System

Recent advances in pediatric urinary tract imaging include development of alternative imaging methods without use of ionizing radiation; evolving understanding of the relationship of urinary tract infection, vesicoureteral reflux, and renal scarring, including the important role of dysfunctional voiding; development of a consensus nomenclature and risk-based classification for fetal and antenatal urinary tract dilation; advances in the understanding of sporadic and inherited renal cystic disease; and a proposed modification of the Bosniak criteria for distinguishing complex renal cysts from cystic renal tumors in children.

Pediatric uroradiology: state of the art

Recent years have witnessed major strides in imaging modalities, including US and contrast-enhanced voiding urosonography, fluoroscopy, CT and MRI, and these have significantly impacted paediatric uroradiology. The trend is towards reduced or no radiation exposure and combined morphological and functional imaging. This review presents the currently available and recommended modalities in modern paediatric uroradiology practice.

Obstructive diseases of the urinary tract in children: lessons from the last 15 years

Imaging urinary tract obstruction is a common query in paediatric uroradiology. With the advent of a more conservative treatment approach, the task of imaging today is to distinguish as early as possible those kidneys that do not require surgery, from those that will deteriorate and lose function and/or growth potential and thus benefit from surgery. At present, in spite of significant advancements in imaging and the introduction of diuretic paediatric MR-urography, there is still no reliable a-priori pro-futuro assessment. Thus, repeated follow-up imaging is often necessary for monitoring. Imaging usually starts with US; the major additional complementary and more function-oriented tools are diuretic renal scintigraphy and MR-urography. The frequency and timing as well as the detailed protocol vary within institutions, partly because of differences in the criteria that are used for indicating surgery. Intra-venous urography (IVU) for obstruction has practically vanished apart from for a few exceptions, and the "Whitaker" test is today seldom performed, being reserved for complicated cases.