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Damasio MB, Donati F, Bruno C, Darge K, Mentzel HJ, Ključevšek D, Napolitano M, Ozcan HN, Riccabona M, Smets AM, Sofia C, Stafrace S, Petit P, Ording Müller LS. Update on imaging recommendations in paediatric uroradiology: the European Society of Paediatric Radiology workgroup session on voiding cystourethrography. Pediatr Radiol 2024; 54:606-619. [PMID: 38467874 DOI: 10.1007/s00247-024-05883-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/13/2024]
Abstract
Voiding cystourethrography (VCUG) is a fluoroscopic technique that allows the assessment of the urinary tract, including the urethra, bladder, and-if vesicoureteral reflux (VUR) is present-the ureters and the pelvicalyceal systems. The technique also allows for the assessment of bladder filling and emptying, providing information on anatomical and functional aspects. VCUG is, together with contrast-enhanced voiding urosonography (VUS), still the gold standard test to diagnose VUR and it is one of the most performed fluoroscopic examinations in pediatric radiology departments. VCUG is also considered a follow-up examination after urinary tract surgery, and one of the most sensitive techniques for studying anatomy of the lower genitourinary tract in suspected anatomical malformations. The international reflux study in 1985 published the first reflux-protocol and graded VUR into five classes; over the following years, other papers have been published on this topic. In 2008, the European Society of Paediatric Radiology (ESPR) Uroradiology Task Force published the first proposed VCUG Guidelines with internal scientific society agreement. The purpose of our work is to create a detailed overview of VCUG indications, procedural recommendations, and to provide a structured final report, with the aim of updating the 2008 VCUG paper proposed by the European Society of Paediatric Radiology (ESPR). We have also compared VCUG with contrast-enhanced VUS as an emergent alternative. As a result of this work, the ESPR Urogenital Task Force strongly recommends the use of contrast-enhanced VUS as a non-radiating imaging technique whenever indicated and possible.
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Affiliation(s)
- Maria Beatrice Damasio
- Pediatric Radiology Department, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147, Genoa, Italy.
| | - Francesco Donati
- Pediatric Surgery Department, University of Genova, Genoa, Italy
| | - Costanza Bruno
- Radiology Department, AOUI Verona (Azienda Ospedaliera Universitaria Integrata), Verona, Italy
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Hans-Joachim Mentzel
- Section of Pediatric Radiology, Department of Radiology, Universitätsklinikum Jena, Jena, Germany
| | - Damjana Ključevšek
- Department of Radiology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
| | - Marcello Napolitano
- Department of Pediatric Radiology and Neuroradiology, V. Buzzi Children's Hospital, Milan, Italy
| | - H Nursun Ozcan
- Department of Radiology/Division of Pediatric Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | | | - Anne M Smets
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Carmelo Sofia
- Department of Biomedical Sciences and Morphologic and Functional Imaging, University of Messina, Messina, Italy
| | - Samuel Stafrace
- McMaster University and McMaster Children's Hospital, Hamilton, ON, Canada
| | - Philippe Petit
- Department of Pediatric Radiology, Hopital Timone Enfants, Aix Marseille-Université, Marseille, France
| | - Lil-Sofie Ording Müller
- Division of Radiology and Nuclear Medicine, Department of Paediatric Radiology, Oslo University Hospital, Oslo, Norway
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2
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Staub E. Current and potential methods to assess kidney structure and morphology in term and preterm neonates. Anat Rec (Hoboken) 2023. [PMID: 36883787 DOI: 10.1002/ar.25195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/25/2023] [Accepted: 02/21/2023] [Indexed: 03/09/2023]
Abstract
After birth, the kidney structure in neonates adapt to the functional demands of extrauterine life. Nephrogenesis is complete in the third trimester, but glomeruli, tubuli, and vasculature mature with the rapidly increasing renal blood flow and glomerular filtration. In preterm infants, nephrogenesis remains incomplete and maturation is slower and may be aberrant. This structural and functional deficit has life-long consequences: preterm born individuals are at higher risk for chronic kidney disease and arterial hypertension later in life. This review assembles the literature on existing and potential methods to visualize neonatal kidney structure and morphology and explore their potential to longitudinally document the developmental deviation after preterm birth. X-rays with and without contrast, fluoroscopy and computed tomography (CT) involve relevant ionizing radiation exposure and, apart from CT, do not provide sufficient structural details. Ultrasound has evolved into a safe and noninvasive high-resolution imaging method which is excellent for longitudinal observations. Doppler ultrasound modes can characterize and quantify blood flow to and through the kidneys. Microvascular flow imaging has opened new possibilities of visualizing previously unseen vascular structures. Recent advances in magnetic resonance imaging display renal structure and function in unprecedented detail, but are offset by the logistical challenges of the imaging procedure and limited experience with the new techniques in neonates. Kidney biopsies visualize structure histologically, but are too invasive and remain anecdotal in newborns. All the explored methods have predominantly been examined in term newborns and require further research on longitudinal structural observation in the kidneys of preterm infants.
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Affiliation(s)
- Eveline Staub
- Department of Neonatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- University of Sydney Northern Clinical School, Royal North Shore Hospital, St Leonards, New South Wales, Australia
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3
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Mohammad SA, Rawash LM, AbouZeid AA. Imaging of urinary tract in children in different clinical scenarios: a guide for general radiologists. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Children are frequently referred to the pediatric radiology department due to complaints related to the urinary tract.
Main body
We aimed to describe common clinical scenarios in paediatric urology practice and their recommended imaging diagnostic algorithms. Practical imaging approach to following common clinical scenarios and the common radiological findings are discussed: (A) perinatal urinary tract dilatation and other congenital anomalies; (B) recurrent urinary tract infection; (C) enuresis and daytime urinary incontinence; (D) abdominal masses; (E) flank pain; (F) hematuria; (G) trauma; (H) nonpalpable testis, ambiguous genitalia and common urogenital sinus anomalies; and I) renovascular hypertension
Conclusions
Imaging investigations should be tailored according to the clinical presentation in a stepwise approach aiming for optimum patients’ care.
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4
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Sorantin E, Stücklschweiger G. Durchleuchtung – Dosis, Handling, praktische Anwendungen. ROFO-FORTSCHR RONTG 2021; 193:S69-S72. [PMID: 34470073 DOI: 10.1055/a-1394-3520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Erich Sorantin
- Klinische Abteilung für Kinderradiologie, Univ.-Klinik für Radiologie, Medizinische Universität Graz
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5
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Ferrara D, Esposito F, Blasio R, Mamone R, Severino R, Di Serafino M, Pecoraro C, Zeccolini M. Role of color Doppler ultrasound in the early diagnosis of a major complication after percutaneous renal biopsy: two case reports. J Ultrasound 2018; 21:343-349. [PMID: 30311148 DOI: 10.1007/s40477-018-0326-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 09/24/2018] [Indexed: 12/29/2022] Open
Abstract
Percutaneous renal biopsy (PRB) is an important procedure in the diagnostic and prognostic evaluation of renal disorders. Despite the relative simplicity, it can be a possible cause of iatrogenic renovascular injury. We describe two cases of iatrogenic pseudoaneurysm, a major post-biopsy complication, in two pediatric patients with persistent micro- and macro-hematuria, promptly diagnosed using color Doppler ultrasound, confirmed with renal arteriography and treated with embolization.
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Affiliation(s)
- Dolores Ferrara
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
- Radiology Department, Santobono-Pausilipon Children Hospital, Mario Fiore ST 6, Naples, Italy.
| | - Francesco Esposito
- Radiology Department, Santobono-Pausilipon Children Hospital, Mario Fiore ST 6, Naples, Italy
| | - Roberta Blasio
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Rosanna Mamone
- Radiology Department, Santobono-Pausilipon Children Hospital, Mario Fiore ST 6, Naples, Italy
| | - Rosa Severino
- Emergency Radiology Department, San Carlo Hospital, Potenza, Italy
| | | | - Carmine Pecoraro
- Nephrology and Urology Unit AORN Santobono-Pausilipon, Naples, Italy
| | - Massimo Zeccolini
- Radiology Department, Santobono-Pausilipon Children Hospital, Mario Fiore ST 6, Naples, Italy
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6
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Xu N, Wu YP, Li XD, Lin MY, Zheng QS, Chen SH, Li JF, Wei Y, Xue XY. Risk of upgrading from prostate biopsy to radical prostatectomy pathology: Is magnetic resonance imaging-guided biopsy more accurate? J Cancer 2018; 9:3634-3639. [PMID: 30310522 PMCID: PMC6171015 DOI: 10.7150/jca.26791] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/25/2018] [Indexed: 01/26/2023] Open
Abstract
Background: This study compared magnetic resonance imaging-guided biopsy (MRI-GB) and transrectal ultrasound guided biopsy (TRUS-GB) with the final histology of the radical prostatectomy (RP) specimen. Methods: Our subjects were 229 patients with prostate cancer (PCa), proven histopathologically using MRI-GB or TRUS-GB, who underwent RP at our center between December 2015 and December 2016. The main group included 92 patients who underwent MRI-GB and the control group included 137 patients who underwent 12-core TRUS-GB. Histological findings for RP specimens were compared with those from biopsies. We also evaluated predictors of upgraded Gleason score (GS), using uni- and multivariate analyses. Results: Upgraded GS between biopsy and RP specimen occurred to 22.7% (52/229) of the cohort overall. In univariate analysis, prostate-specific antigen density (PSAD) (P<0.001), prostate volume (PV) < 30 ml (P<0.001), biopsy modality (P=0.027), biopsy GS (P=0.032) and measured MRI lymph node metastasis (P=0.018) were prognostic factors. Multivariate logistic regression analysis showed PV < 30 ml (P<0.001) and biopsy modality (P=0.001) were independent predictors of upgraded GS. Conclusions: MRI-GB may enhance the diagnostic accuracy of prostate cancer detection in final histopathology with lower rate of upgraded GS than TRUS-GB. Also, PV < 30 ml and biopsy modality were independent predictors of upgraded GS.
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Affiliation(s)
- Ning Xu
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Yu-Peng Wu
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Xiao-Dong Li
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Min-Yi Lin
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Qing-Shui Zheng
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Shao-Hao Chen
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Jun-Feng Li
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Yong Wei
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Xue-Yi Xue
- Departments of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
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7
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Vivier PH, Augdal TA, Avni FE, Bacchetta J, Beetz R, Bjerre AK, Blickman J, Cochat P, Coppo R, Damasio B, Darge K, El-Ghoneimi A, Hoebeke P, Läckgren G, Leclair MD, Lobo ML, Manzoni G, Marks SD, Mattioli G, Mentzel HJ, Mouriquand P, Nevéus T, Ntoulia A, Ording-Muller LS, Oswald J, Papadopoulou F, Porcellini G, Ring E, Rösch W, Teixeira AF, Riccabona M. Standardization of pediatric uroradiological terms: a multidisciplinary European glossary. Pediatr Radiol 2018; 48:291-303. [PMID: 29138893 PMCID: PMC5790858 DOI: 10.1007/s00247-017-4006-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 01/23/2023]
Abstract
To promote the standardization of nephro-uroradiological terms used in children, the European Society of Paediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication between different clinicians involved in pediatric urology and nephrology.
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Affiliation(s)
- Pierre-Hugues Vivier
- Radiology, Ramsay - Générale de Santé, service de Radiologie, Hôpital Privé de l'Estuaire, 505 rue Irène Joliot Curie, 76620, Le Havre, France. .,Pediatric Radiology, University Hospital Charles Nicolle, Rouen, France.
| | - Thomas A. Augdal
- Pediatric Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Fred E. Avni
- Pediatric Radiology, Jeanne de Flandre Hospital, Lille University hospitals, Lille, France
| | | | - Rolf Beetz
- Pediatric Nephrology, Center for Paediatric and Adolescent Medicine, University Medical Clinic, Mainz, Germany
| | - Anna K. Bjerre
- Pediatric Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Johan Blickman
- Pediatric Radiology, Golisano Childrens Hospital, Rochester, NY USA
| | - Pierre Cochat
- Pediatric nephrology, Hôpital Femme Mère Enfant, Bron, France
| | - Rosana Coppo
- Pediatric nephrology, Regina Margherita Hospital, Turin, Italy
| | | | - Kassa Darge
- Pediatric Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Alaa El-Ghoneimi
- Pediatric Surgery and Urology, University Hospital Robert Debré, APHP, University of Paris-Diderot, Sorbonne, Paris, France
| | - Piet Hoebeke
- Urology, Ghent University Hospital, Ghent, Belgium
| | - Göran Läckgren
- Pediatric Urology, University Children’s Hospital, Uppsala, Sweden
| | - Marc-David Leclair
- Pediatric Surgery and Urology, Children University Hospital, Nantes, France
| | - Maria-Luisa Lobo
- Radiology, Hospital de Santa Maria, University Hospital, Lisbon, Portugal
| | - Gianantonio Manzoni
- Pediatric Urology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stephen D. Marks
- Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Girolamo Mattioli
- Dinogmi University of Genova, Pediatric Surgery and Urology, Gaslini Institute, Genoa, Italy
| | - Hans-Joachim Mentzel
- Pediatric Radiology, Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Pierre Mouriquand
- Pediatric Urology, Hôpital Mère-Enfant, Hospices Civils de Lyon and Claude Bernard University, Lyon 1, France
| | - Tryggve Nevéus
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Aikaterini Ntoulia
- Pediatric Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA ,Paediatric Radiology, King’s College Hospital, London, UK
| | | | - Josef Oswald
- Pediatric Urology, Hospital of the Sisters of Charity, Linz, Austria
| | | | | | - Ekkehard Ring
- Department of Pediatrics, University Hospital LKH Graz, Graz, Austria
| | - Wolfgang Rösch
- Pediatric Urology, University Medical Center Regensburg, Regensburg, Germany
| | - Ana F. Teixeira
- Pediatric Nephrology, Centro Hospitalar São João, Porto, Portugal
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8
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Vivier PH, Augdal TA, Avni FE, Bacchetta J, Beetz R, Bjerre AK, Blickman J, Cochat P, Coppo R, Damasio B, Darge K, El-Ghoneimi A, Hoebeke P, Läckgren G, Leclair MD, Lobo ML, Manzoni G, Marks SD, Mattioli G, Mentzel HJ, Mouriquand P, Nevéus T, Ntoulia A, Ording-Muller LS, Oswald J, Papadopoulou F, Porcellini G, Ring E, Rösch W, Teixeira AF, Riccabona M. Standardization of pediatric uroradiological terms: A multidisciplinary European glossary. J Pediatr Urol 2017; 13:641-650. [PMID: 29174378 DOI: 10.1016/j.jpurol.2017.05.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/29/2017] [Indexed: 10/19/2022]
Abstract
To promote the standardization of nephro-uroradiological terms used in children, the European Society of Pediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication among different clinicians involved in pediatric urology and nephrology.
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Affiliation(s)
- Pierre-Hugues Vivier
- Radiology, Ramsay - Générale de Santé, Hôpital Privé de l'Estuaire, Le Havre, France; Pediatric Radiology, University Hospital Charles Nicolle, Rouen, France.
| | - Thomas A Augdal
- Pediatric Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Fred E Avni
- Pediatric Radiology, Jeanne de Flandre Hospital, Lille University Hospitals, Lille, France
| | | | - Rolf Beetz
- Pediatric Nephrology, Center for Paediatric and Adolescent Medicine, University Medical Clinic, Mainz, Germany
| | - Anna K Bjerre
- Pediatric Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Johan Blickman
- Pediatric Radiology, Golisano Children's Hospital, Rochester, NY, USA
| | - Pierre Cochat
- Pediatric Nephrology, Hôpital Femme Mère Enfant, Bron, France
| | - Rosana Coppo
- Pediatric Nephrology, Regina Margherita Hospital, Turin, Italy
| | | | - Kassa Darge
- Pediatric Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alaa El-Ghoneimi
- Pediatric Surgery and Urology, University Hospital Robert Debré, APHP, University of Paris-Diderot, Sorbonne, Paris, France
| | | | - Göran Läckgren
- Pediatric Urology, University Children's Hospital, Uppsala, Sweden
| | - Marc-David Leclair
- Pediatric Surgery and Urology, Children University Hospital, Nantes, France
| | - Maria-Luisa Lobo
- Radiology, Hospital de Santa Maria, University Hospital, Lisbon, Portugal
| | - Gianantonio Manzoni
- Pediatric Urology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Stephen D Marks
- Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Girolamo Mattioli
- Dinogmi University of Genova, Pediatric Surgery and Urology, Gaslini Institute, Genova, Italy
| | - Hans-Joachim Mentzel
- Pediatric Radiology, Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Pierre Mouriquand
- Pediatric Urology, Hôpital Mère-Enfant, Hospices Civils de Lyon and Claude Bernard University, Lyon 1, France
| | - Tryggve Nevéus
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Aikaterini Ntoulia
- Pediatric Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Paediatric Radiology, King's College Hospital, London, UK
| | | | - Josef Oswald
- Pediatric Urology, Hospital of the Sisters of Charity, Linz, Austria
| | | | | | - Ekkehard Ring
- Department of Pediatrics, University Hospital LKH Graz, Austria
| | - Wolfgang Rösch
- Pediatric Urology, University Medical Center Regensburg, Regensburg, Germany
| | - Ana F Teixeira
- Pediatric Nephrology, Centro Hospitalar São João, Porto, Portugal
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9
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Riccabona M, Lobo ML, Ording-Muller LS, Thomas Augdal A, Fred Avni E, Blickman J, Bruno C, Damasio B, Darge K, Ntoulia A, Papadopoulou F, Vivier PH. European Society of Paediatric Radiology abdominal imaging task force recommendations in paediatric uroradiology, part IX: Imaging in anorectal and cloacal malformation, imaging in childhood ovarian torsion, and efforts in standardising paediatric uroradiology terminology. Pediatr Radiol 2017; 47:1369-1380. [PMID: 28852767 PMCID: PMC5574969 DOI: 10.1007/s00247-017-3837-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 12/18/2016] [Accepted: 03/09/2017] [Indexed: 12/21/2022]
Abstract
At the occasion of the European Society of Paediatric Radiology (ESPR) annual meeting 2015 in Graz, Austria, the newly termed ESPR abdominal (gastrointestinal and genitourinary) imaging task force set out to complete the suggestions for paediatric urogenital imaging and procedural recommendations. Some of the last missing topics were addressed and proposals on imaging of children with anorectal and cloacal malformations and suspected ovarian torsion were issued after intense discussions and a consensus finding process that considered all evidence. Additionally, the terminology was adapted to fit new developments introducing the term pelvicalyceal dilatation/distension (PCD) instead of the sometimes misunderstood hydronephrosis. The present state of paediatric urogenital radiology was discussed in a dedicated minisymposium, including an attempt to adapt terminology to create a standardised glossary.
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Affiliation(s)
- Michael Riccabona
- Department of Radiology, Division of Pediatric Radiology, University Hospital LKH Graz, Auenbruggerplatz 34, A-8036, Graz, Austria.
| | - Maria-Luisa Lobo
- 0000 0001 2295 9747grid.411265.5Department of Radiology, Hospital de Santa Maria-CHLN, University Hospital, Lisbon, Portugal
| | - Lil-Sofie Ording-Muller
- 0000 0004 0389 8485grid.55325.34Department of Radiology and Nuclear Medicine, Unit for Paediatric Radiology, Oslo University Hospital, Oslo, Norway
| | - A. Thomas Augdal
- 0000 0004 4689 5540grid.412244.5Department of Radiology, University Hospital of North Norway, N-9038 Tromsø, Norway
| | - E. Fred Avni
- Department of Pediatric Radiology, Jeanne de Flandre Hospital, CHRU de Lille, Lille Cedex, France
| | - Johan Blickman
- grid.438870.0Department of Radiology, Golisano Children’s Hospital, Rochester, NY USA
| | - Constanza Bruno
- 0000 0004 1756 948Xgrid.411475.2Radiology Institute, Department of Radiology, AOUI, Verona, Italy
| | - Beatrice Damasio
- 0000 0004 1760 0109grid.419504.dDepartment of Radiology, G. Gaslini Institute, Genoa, Italy
| | - Kassa Darge
- Department of Radiology, The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA USA
| | - Akaterina Ntoulia
- Department of Radiology, The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA USA
| | | | - Pierre-Hugues Vivier
- Radiologie, Hôpital Privé de l’ Estuaire, 505 rue Irène Joliot Curie, Le Havre, France
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10
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Sinha R, Maji B, Sarkar B, Meur S. A prospective audit of complications in 100 consecutive pediatric percutaneous renal biopsies done under real-time ultrasound guidance. Indian J Nephrol 2016; 26:329-334. [PMID: 27795625 PMCID: PMC5015509 DOI: 10.4103/0971-4065.171232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Despite being a common procedure, percutaneous renal biopsy (PRB) carries the potential for complications. The British Association of Paediatric Nephrologist (BAPN) has published standards for pediatric PRB. As Indian data are scarce, we conducted a prospective audit of 100 consecutive pediatric renal biopsies (60% males) under real-time ultrasound guidance. Nephrotic syndrome was the most common indication for PRB (68%) with minimal change disease (30%) and focal segmental glomerulosclerosis (25%) being the most common histopathological lesions. Gross hematuria was observed in six cases. Major complications was noted in one case, who needed longer hospital stay. The result of the audit demonstrated achievability of BAPN standards. In addition, we also show the usefulness of 16 gauge biopsy needle over 18 gauge biopsy needles (median number of glomeruli 25, range 3–90 vs 13, range 6–46, P = 0.001) without any increase in complications. Being a single center study, we do hope that our results will encourage a wider survey on the current state of pediatric PRB.
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Affiliation(s)
- R Sinha
- Division of Paediatric Nephrology, Institute of Child Health, Vision Care Hospital (AMRI Hospitals), Kolkata, West Bengal, India; Division of Paediatric Nephrology, Vision Care Hospital (AMRI Hospitals), Kolkata, West Bengal, India
| | - B Maji
- Division of Paediatric Nephrology, Institute of Child Health, Vision Care Hospital (AMRI Hospitals), Kolkata, West Bengal, India
| | - B Sarkar
- Paediatric Intensive Care, Vision Care Hospital (AMRI Hospitals), Kolkata, West Bengal, India
| | - S Meur
- Paediatric Intensive Care, Vision Care Hospital (AMRI Hospitals), Kolkata, West Bengal, India
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11
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Comparison of image quality and radiation dose between an image-intensifier system and a newer-generation flat-panel detector system — technical phantom measurements and evaluation of clinical imaging in children. Pediatr Radiol 2016; 46:286-92. [PMID: 26481334 DOI: 10.1007/s00247-015-3456-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/04/2015] [Accepted: 08/17/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Many image-intensifier fluoroscopy systems have been replaced by flat-panel detectors in recent years. OBJECTIVE To compare the level of contrast, image resolution and radiation dose between an image-intensifier and a newer-generation flat-panel detector system in a pediatric radiology unit. MATERIALS AND METHODS We compared two systems — a conventional image intensifier and a newer-generation flat-panel system. We measured image quality and radiation dose using a technical phantom. Additionally, we retrospectively compared age-matched fluoroscopic pediatric voiding cystourethrography (n = 15) and upper gastrointestinal investigations (n = 25). RESULTS In phantom studies image contrast was equal while image resolution was higher and mean radiation dose lower using the flat-panel system (P < 0.0001). In pediatric investigations, mean dose area product was significantly reduced on the flat-panel system for upper gastrointestinal investigation (45 ± 38 μGy*m2 vs. 11 ± 9 μGy*m2; P < 0.0001) and for voiding cystourethrography (18 ± 20 μGy*m2 vs. 10 ± 12 μGy*m2; P = 0.04). CONCLUSION The newer flat-panel system performs at lower dose levels with equal to better image quality and therefore seems to be the more suitable technique for pediatric fluoroscopy in comparison to image-intensifier systems.
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Otero HJ, Rubio E, Blask A. Ovary and testicle and everything in between: lesions and imaging in the newborn. Semin Ultrasound CT MR 2015; 36:178-92. [PMID: 26001946 DOI: 10.1053/j.sult.2015.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Assessment of the neonatal reproductive tract requires an understanding of embryology, awareness of common clinical presentations, and familiarity with normal newborn variation. This review of the neonatal reproductive tract emphasizes the use of sonography in the evaluation of developmental, acquired, and neoplastic conditions in male and female newborns. Anchored in embryologic origins, the discussion also includes descriptions of findings that may be encountered in prenatal imaging. Comments on clinical correlation are included to guide appropriate triaging of these complex cases. Imaging pearls and pitfalls are incorporated into this review, including the recognized effects of maternal hormones in female infants.
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Affiliation(s)
- Hansel J Otero
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC.
| | - Eva Rubio
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC
| | - Anna Blask
- Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC
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Riccabona M, Darge K, Lobo ML, Ording-Muller LS, Augdal TA, Avni FE, Blickman J, Damasio BM, Ntoulia A, Papadopoulou F, Vivier PH, Willi U. ESPR Uroradiology Taskforce--imaging recommendations in paediatric uroradiology, part VIII: retrograde urethrography, imaging disorder of sexual development and imaging childhood testicular torsion. Pediatr Radiol 2015; 45:2023-8. [PMID: 26626757 PMCID: PMC4666898 DOI: 10.1007/s00247-015-3452-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/01/2015] [Indexed: 12/29/2022]
Abstract
Three new consensus-based recommendations of the European Society of Paediatric Radiology Uroradiology Taskforce and the European Society of Urogenital Radiology Paediatric Working Group on paediatric uroradiology are presented. One deals with indications and technique for retrograde urethrography, one with imaging in the work-up for disorders of sexual development and one with imaging workflow in suspected testicular torsion. The latter is subdivided to suggest a distinct algorithm to deal with testicular torsion in neonates. These proposals aim to outline effective imaging algorithms to optimise diagnostic accuracy and to harmonize diagnostic imaging among institutions and practitioners.
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Affiliation(s)
- Michael Riccabona
- Department of Radiology, Division of Pediatric Radiology, University Hospital LKH Graz, Auenbruggerplatz 34, 8036, Graz, Austria.
| | - Kassa Darge
- Department of Radiology, The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA USA
| | - Maria-Luisa Lobo
- Department of Radiology, Hospital de Santa Maria-CHLN, University Hospital, Lisbon, Portugal
| | - Lil-Sophie Ording-Muller
- Department of Radiology and Nuclear Medicine, Unit for Paediatric Radiology, Oslo University Hospital, Oslo, Norway
| | - Thomas A. Augdal
- Department of Radiology, University Hospital of Northern Norway, Tromsø, Norway
| | - Fred E. Avni
- Department of Pediatric Radiology, Jeanne de Flandre Hospital, CHRU de Lille, Lille Cedex, France
| | - Johan Blickman
- Department of Radiology, Golisano Children’s Hospital, Rochester, NY USA
| | | | - Aikaterini Ntoulia
- Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | | | | | - Ulrich Willi
- Department of Radiology, Kantonsspital Baden AG, Baden, Switzerland
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ESPR uroradiology task force imaging recommendations in paediatric uroradiology, part VII: standardised terminology, impact of existing recommendations, and update on contrast-enhanced ultrasound of the paediatric urogenital tract. Pediatr Radiol 2014; 44:1478-84. [PMID: 25331025 DOI: 10.1007/s00247-014-3135-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/15/2014] [Accepted: 07/16/2014] [Indexed: 10/24/2022]
Abstract
Our purpose is to harmonise and standardise terminology in paediatric uroradiology, to provide and update recommendations for contrast-enhanced US to standardise imaging and encourage further research, and to assess the impact of the existing recommendations in paediatric urogenital imaging. Based on thorough review of literature and variable practice at several centres and after discussion within urogenital imaging groups as well as with other subspecialties, we propose a standardisation of terminology in urogenital imaging. An update with recommendations on paediatric contrast-enhanced US has been issued based on available literature and reports. Finally, a questionnaire has been used to assess the knowledge, applicability and usefulness of, and the adherence to existing recommendations of the European Society of Paediatric Radiology (ESPR) Uroradiology Task Force. In conclusion, the ESPR is working to improve patient safety and optimise paediatric urogenital imaging. Standardisation of terminology and provision of updated knowledge on contrast-enhanced US in childhood will contribute to this task, ideally reducing the need for invasive or radiating imaging. Not all existing recommendations are commonly known, which limits adherence to these recommendations and the availability of comparable data and evidence for future adaptation of imaging strategies in paediatric uroradiology.
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Lungren MP, Patel MN, Racadio JM, Johnson ND. Ultrasound-guided interventions in children. Eur J Radiol 2014; 83:1582-91. [DOI: 10.1016/j.ejrad.2014.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 04/21/2014] [Indexed: 12/28/2022]
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Ultrasound of the paediatric urogenital tract. Eur J Radiol 2014; 83:1538-48. [DOI: 10.1016/j.ejrad.2014.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 04/07/2014] [Indexed: 02/04/2023]
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