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Faure A, Merrot T, Sala Q, Chaumoitre K, Guys JM, Bourliere-Najean B, Torrents J, Mundler O, Lechevallier E, Alessandrini P. Value of diagnosis imaging in the evaluation of the severity of histological lesions in duplex systems. J Pediatr Urol 2014; 10:361-7. [PMID: 24262607 DOI: 10.1016/j.jpurol.2013.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 10/05/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE In order to determine the effectiveness of imagery in the assessment of the severity of histological lesions in duplex systems in children we compared histology results from heminephrectomies with diagnosis imaging findings [renal ultrasound (US), scintigraphy, unenhanced and contrast-enhanced magnetic resonance imagery (MRI)]. MATERIALS AND METHODS Between 2007 and 2013, 34 children with duplex system underwent surgery. The results from US (n = 34), dimer captosuccinic acid scintigraphy (n = 23) and MRI (n = 16) were compared with histological data. Five histological lesions were found (chronic interstitial inflammation, interstitial fibrosis, tubular atrophy, glomerulosclerosis and dysplasia) and categorized as severe (>25%) or moderate (≤ 25%). RESULTS Severe histological lesions were found in 76.5% and moderate lesions in 23.5%. Radiological features were compared with histological results. In US, severe parenchymal thinning was associated with chronic interstitial inflammatory. The absence of parenchymal enhancement and/or severe cortical thinning in MR urography (MRU) was significantly associated with interstitial fibrosis. All poorly functioning poles were associated with severe histological lesions (p = 0.091), but not to a specific category of lesions. CONCLUSIONS MRI sensibility was excellent (90%) in the diagnosis of poorly functioning pole. Severe thinning on US and minimal pole function on MRU can be used to predict the severity of histological lesions.
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Affiliation(s)
- Alice Faure
- Department of Pediatric Surgery, Hospital Nord, APHM, Aix-Marseille University, Chemin des Bourrely, Marseille 13015, France.
| | - Thierry Merrot
- Department of Pediatric Surgery, Hospital Nord, APHM, Aix-Marseille University, Chemin des Bourrely, Marseille 13015, France
| | - Quentin Sala
- Department of Nuclear Medicine, Hospital Timone, APHM, Aix-Marseille University, Marseille, France
| | - Kathia Chaumoitre
- Department of Medical Imaging, Hospital Nord, APHM, Aix-Marseille University, Marseille, France
| | - Jean-Michel Guys
- Department of Pediatric Surgery, Hospital Timone, APHM, Aix-Marseille University, Marseille, France
| | - Brigitte Bourliere-Najean
- Department of Pediatric Radiology, Hospital Timone, APHM, Aix-Marseille University, Marseille, France
| | - Julia Torrents
- Department of Pathology, Hospital Timone, APHM, Aix-Marseille University, Marseille, France
| | - Olivier Mundler
- Department of Nuclear Medicine, Hospital Timone, APHM, Aix-Marseille University, Marseille, France
| | - Eric Lechevallier
- Department of Urology, Hospital Conception, APHM, Aix-Marseille University, Marseille, France
| | - Pierre Alessandrini
- Department of Pediatric Surgery, Hospital Nord, APHM, Aix-Marseille University, Chemin des Bourrely, Marseille 13015, France
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