Imaging in pediatric urology

Abstract

 Imaging in children with urinary tract infections (UTIs) or prenatally detected urinary tract dilatation (hydronephrosis) is extremly important to permit identification, treatment and evaluation of the children who are at risk for renal damage. A thoughtful diagnostic strategy is necessary to proceed with appropriate management at minimal cost and morbidity to the patient. Ultrasound, voiding cystourethrography (VCUG) and radionuclide study (both static and dynamic scan) currently dominate the radiographic imaging of children with urologic problem. Ultrasound is ideally suited as a screening study and for following patients with known abnormalities because it is non-invasive, inexpensive and safe. Vesicoureteral reflux is the most common abnormality detected in imaging studies and has strong relationship with recurrent UTI. At present contrast VCUG is more frequently performed comparing to other imaging modalities such as radionuclide cystography in Japan. For morphological and functional evaluation of individual kidney, radionuclide study is useful and definitive for assessment of prenatally detected asymptomatic hydronephrosis.