Transverse comparisons between ultrasound and radionuclide parameters in children with presumed antenatally detected pelvi-ureteric junction obstruction

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• 作者：Hong Phuoc Duong ; Amy Piepsz ; Karim Khelif…
• 关键词：Pelviureteric junction obstruction ; Renogram ; Antenatal ; Pyeloplasty ; Ultrasound
• 刊名：European Journal of Nuclear Medicine and Molecular Imaging
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：42
• 期：6
• 页码：940-946
• 全文大小：156 KB
• 参考文献：1. Piepsz, A, Gordon, I, Brock, J, Koff, S (2009) Round table on the management of renal pelvic dilatation in children. J Pediatr Urol 5: pp. 437-44 CrossRef
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  3. Ismaili, K, Avni, FE, Piepsz, A, Wissing, KM, Cochat, P, Aubert, D (2004) Current management of infants with fetal renal pelvis dilation: a survey by French-speaking pediatric nephrologists and urologists. Pediatr Nephrol 19: pp. 966-71 CrossRef
  4. Gordon, I, Piepsz, A, Sixt, R (2011) Guidelines for standard and diuretic renogram in children. Eur J Nucl Med Mol Imaging 38: pp. 1175-88 CrossRef
  5. Ismaili, K, Piepsz, A (2013) The antenatally detected pelvi-ureteric junction stenosis: advances in renography and strategy of management. Pediatr Radiol 43: pp. 428-35 CrossRef
  6. Piepsz, A, Kuyvenhoven, JD, Tondeur, M, Ham, H (2002) Normalized residual activity: usual values and robustness of the method. J Nucl Med 43: pp. 33-8
  7. Tondeur, M, Nogarede, C, Donoso, G, Piepsz, A (2013) Inter- and intra-observer reproducibility of quantitative renographic parameters of differential function and renal drainage in children. Scand J Clin Lab Investig 73: pp. 414-21 CrossRef
  8. Conway, JJ, Maizels, M (1992) The “well tempered-diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephrosis. A report from combined meetings of The Society for Fetal Urology and members of The Pediatric Nuclear Medicine Council-The Society of Nuclear Medicine. J Nucl Med 33: pp. 2047-51
  9. Ulman, I, Jayanthi, VR, Koff, SA (2000) The long-term follow-up of newborns with severe unilateral hydronephrosis initially treated nonoperatively. J Urol 164: pp. 1101-5 CrossRef
  10. Nogarède, C, Tondeur, M, Piepsz, A (2010) Normalized residual activity and output efficiency in case of early furosemide injection in children. Nucl Med Commun 31: pp. 355-8
  11. Schlotmann, A, Clorius, JH, Clorius, SN (2009) Diuretic renography in hydronephrosis: renal tissue tracer transit predicts functional course and thereby need for surgery. Eur J Nucl Med Mol Imaging 36: pp. 1665-73 CrossRef
  12. Piepsz, A, Tondeur, M, Nogarède, C, Collier, F, Ismaili, K, Hall, M (2011) Can severely impaired cortical transit predict which children with pelvi-ureteric junction stenosis detected antenatally might benefit from pyeloplasty?. Nucl Med Commun 32: pp. 199-205 CrossRef
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  17. Dhillon, HK (1998) Prenatally diagnosed hydronephrosis: the Great Ormond S
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Nuclear Medicine
  Imaging and Radiology
  Orthopedics
  Cardiology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1619-7089

文摘

Purpose The main criteria used for deciding on surgery in children with presumed antenatally detected pelviureteric junction obstruction (PPUJO) are the level of hydronephrosis (ultrasonography), the level of differential renal function (DRF) and the quality of renal drainage after a furosemide challenge (renography), the importance of each factor being far from generally agreed. Can we predict, on the basis of ultrasound parameters, the patient in whom radionuclide renography can be avoided? Methods We retrospectively analysed the medical charts of 81 consecutive children with presumed unilateral PPUJO detected antenatally. Ultrasound and renographic studies performed at the same time were compared. Anteroposterior pelvic diameter (APD) and calyceal size were both divided into three levels of dilatation. Parenchymal thickness was considered either normal or significantly decreased. Acquisition of renograms under furosemide stimulation provided quantification of DRF, quality of renal drainage and cortical transit. Results The percentages of patients with low DRF and poor drainage were significantly higher among those with major hydronephrosis, severe calyceal dilatation or parenchymal thinning. Moreover, impaired cortical transit, which is a major risk factor for functional decline, was seen more frequently among those with very severe calyceal dilatation. However, none of the structural parameters obtained by ultrasound examination was able to predict whether the level of renal function or the quality of drainage was normal or abnormal. Alternatively, an APD Conclusion In the management strategy of patients with prenatally detected PPUJO, nuclear medicine examinations may be postponed in those with an APD 30?mm, major calyceal dilatation and/or parenchymal thinning.