Ultrasonic features of multicystic dysplastic kidney: expanded diagnostic criteria.

Stuck, K J; Koff, Stephen A.; Silver, Terry M.

doi:10.1148/radiology.143.1.7063729

“…Os critérios para inclusão na análise foram: 1) diagnóstico ecográfico do RDM, de acordo com os critérios propostos por Stuck et al 7 ; 2) mínimo de dois exames ultrasonográficos; 3) mínimo de 6 meses de seguimento; e 4) ausência de cromossomopatias e associação de múltiplas malformações. Os critérios de Stuck et al 7 , adotados para estabelecer o diagnóstico do RDM foram: A) presença de interfaces entre os cistos; B) localização não-medial do maior cisto; C) ausência de seio renal identificável; D) presença de múltiplos cistos não-comunicantes de tamanhos variados; e E) ausência de parênquima renal identificável. Houve perda de seguimento de duas crianças, as quais foram excluídas da análise.…”

Section: Pacientes E Métodosunclassified

Conservative management of multicystic dysplastic kidney: clinical course and ultrasound outcome

Rabelo¹,

Oliveira²,

Silva³

et al. 2005

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Objective: The aim of this study was to describe the clinical course and ultrasound outcome of prenatally detected multicystic dysplastic kidney.Methods: Fifty-three children with unilateral multicystic dysplastic kidney detected by prenatal ultrasound between 1989 and 2004 were included in the analysis. All children were submitted to conservative management with follow-up visits every six months. Follow-up ultrasound examinations were performed at six-month intervals during the first two years of life and yearly thereafter. The following clinical parameters were evaluated: blood pressure, urinary tract infection, renal function, and growth. The following ultrasound parameters were evaluated: involution of multicystic dysplastic kidney and contralateral renal growth. Results:The mean follow-up time was 68 months. Two children presented hypertension during follow-up and five had urinary tract infection (only one with recurrent episodes). There was no malignant degeneration of multicystic dysplastic kidney. A total of 334 ultrasound scans were analyzed. US scan demonstrated involution of the multicystic dysplastic kidney in 48 (90%) cases, including complete involution in nine (17%). The involution rate was faster in the first 30 months of life. There was progressive compensatory renal hypertrophy of the contralateral renal unit; the rate of growth was greater in the first 24 months of life. Conclusion:The results of prolonged follow-up of children with conservatively managed multicystic dysplastic kidney suggest that clinical approach is safe, the incidence of complications is small, and that there is a clear tendency for multicystic dysplastic kidney to decrease in size. Our data also suggest that the involution rate of multicystic dysplastic kidney as well as the growth of the contralateral kidney is greater in the first 24 months of life. ResumoObjetivo: Descrever o curso clínico e a evolução ultra-sonográfica de pacientes com rim displásico multicístico tratados conservadoramente.Métodos: Foram incluídoa no estudo 53 crianças com rim displá-sico multicístico unilateral diagnosticado pela ultra-sonografia fetal entre 1989 e 2004. Todos os pacientes foram submetidos a protocolo sistemático, incluindo tratamento conservador e exames clínicos, laboratoriais e ultra-sonográficos periódicos. Os exames foram realizados com periodicidade de 6 meses, nos 2 primeiros anos, e anualmente, após esse período. No curso clínico, foram avaliados: pressão arterial, infecção do trato urinário, função renal e crescimento dos pacientes. Na evolução ecográfica, foram avaliados a involução do rim displásico multicístico e o crescimento do rim contralateral.Resultados: O tempo médio de seguimento foi de 68 meses. Dois pacientes apresentaram hipertensão arterial no seguimento. Cinco tiveram infecção urinária (apenas um com episódios repetidos). Não houve degeneração maligna do rim displásico multicístico. Foram realizados 334 exames ultra-sonográficos seriados. Houve involução do rim displásico multicístico em 90% dos casos,...

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“…The inclusion criteria were the following: 1) echographic diagnosis of MDK according to the criteria proposed by Stuck et al;. 7 2) at least two ultrasound scans; 3) at least six months of follow-up; and 4) absence of chromosome disorders and association of multiple malformations. The criteria proposed by Stuck et al, which were used to establish the diagnosis of MDK, were: A) presence of interfaces between cysts; B) non-medial location of the largest cyst; C) absence of identifiable renal sinus; D) presence of different-sized, non-communicating multiple cysts and E) absence of identifiable renal parenchyma.…”

Section: Methodsmentioning

confidence: 99%

Tratamento conservador do rim displásico multicístico: curso clínico e ultra-sonográfico

Rabelo¹,

Oliveira²,

Silva³

et al. 2005

J. Pediatr. (Rio J.)

0

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Objective: The aim of this study was to describe the clinical course and ultrasound outcome of prenatally detected multicystic dysplastic kidney.Methods: Fifty-three children with unilateral multicystic dysplastic kidney detected by prenatal ultrasound between 1989 and 2004 were included in the analysis. All children were submitted to conservative management with follow-up visits every six months. Follow-up ultrasound examinations were performed at six-month intervals during the first two years of life and yearly thereafter. The following clinical parameters were evaluated: blood pressure, urinary tract infection, renal function, and growth. The following ultrasound parameters were evaluated: involution of multicystic dysplastic kidney and contralateral renal growth.Results: The mean follow-up time was 68 months. Two children presented hypertension during follow-up and five had urinary tract infection (only one with recurrent episodes). There was no malignant degeneration of multicystic dysplastic kidney. A total of 334 ultrasound scans were analyzed. US scan demonstrated involution of the multicystic dysplastic kidney in 48 (90%) cases, including complete involution in nine (17%). The involution rate was faster in the first 30 months of life. There was progressive compensatory renal hypertrophy of the contralateral renal unit; the rate of growth was greater in the first 24 months of life. Conclusion:The results of prolonged follow-up of children with conservatively managed multicystic dysplastic kidney suggest that clinical approach is safe, the incidence of complications is small, and that there is a clear tendency for multicystic dysplastic kidney to decrease in size. Our data also suggest that the involution rate of multicystic dysplastic kidney as well as the growth of the contralateral kidney is greater in the first 24 months of life.J Pediatr (Rio J). 2005;81(5):400-4: Multicystic kidney, management, hypertension, ultrasonography.

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“…US criteria are clear and make misdiagnosis of a cystic malignancy unlikely when these criteria are identified by an ultrasonographer experienced in pediatrics 46 I. Those inexperienced with recognizing the US features of MCDK may misdiagnose it for severe ureteropelvic junction obstruction.…”

Section: Confirm the Diagnosis Of Mcdk Is Correct (Grade A)mentioning

confidence: 99%

Multicystic dysplastic kidney (MCDK) in the neonate: The role of the urologist

Psooy

¹

2016

CUAJ

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Ultrasonic features of multicystic dysplastic kidney: expanded diagnostic criteria.

Cited by 119 publications

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Conservative management of multicystic dysplastic kidney: clinical course and ultrasound outcome

Conservative management of multicystic dysplastic kidney: clinical course and ultrasound outcome

Tratamento conservador do rim displásico multicístico: curso clínico e ultra-sonográfico

Multicystic dysplastic kidney (MCDK) in the neonate: The role of the urologist

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