Urinary Ultrasound and Other Imaging for Ureteropelvic Junction Type Hydronephrosis (UPJHN)

Uçar, Adem; Kuruğoğlu, Sebuh

doi:10.3389/fped.2020.00546

Cited by 24 publications

(12 citation statements)

References 96 publications

(143 reference statements)

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“…Cortical thinning seems to be associated not only with the severity of the obstruction of the UPJ but also with the degree of preoperative renal parenchymal loss, the severity of renal function impairment, and the importance of postoperative morbidity following pyeloplasty. [12][13][14][15][16] In this study, multivariate analysis revealed that DRF of more than 50% on radionuclide renal scan is an independent risk factor for adverse outcomes following pediatric pyeloplasty. In accordance with our results, Lee et al 6 investigated the risk factors for postsurgical complications after unstented pyeloplasty in children.…”

Section: Discussionmentioning

confidence: 61%

“…Renal pelvic APD is a quantitative metric based on the measurement of the largest diameter on ultrasound images taken in a transverse plane to evaluate the degree of dilatation of the renal pelvis. 12 Although Li et al 8 found that renal pelvic APD was predictive of negative outcomes following laparoscopic pyeloplasty in children, most authors did not find an association between hydronephrosis grade and postoperative complications. 6,7,9 Numerous studies have validated the use of renal pelvic APD in predicting surgical indication in children with UPJ obstruction-like hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for adverse outcomes after pediatric pyeloplasty: A retrospective cohort study

Zouari,

Dghaies,

Rhaiem

et al. 2023

Int J of Urology

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PurposeTo identify the risk factors for adverse outcomes after pediatric pyeloplasty.MethodsWe conducted a retrospective review of all children under the age of 14 years who underwent primary pyeloplasty for unilateral ureteropelvic junction (UPJ) obstruction at a single teaching hospital in Tunisia between January 1, 2013, and December 31, 2022.ResultsA total of 103 patients were included. Median age of patients at surgery was 27 months (interquartile range [IQR], 13–44). On ultrasound, median renal pelvic anteroposterior diameter was 3.2 cm (IQR, 2.3–4), and the median renal cortex thickness (RCT) was 2.5 mm (IQR, 2–3.5). Median differential renal function (DRF) on preoperative radionuclide renal scan was 40% (IQR, 30–46). Postoperative adverse outcomes occurred in 28 patients (27.2%). These included 19 cases of urinary tract infections (UTIs), 11 cases of UPJ restenosis, four cases of UPJ leakage, two cases of urinoma, and two cases of diversion‐related complications. Multivariate logistic regression analysis revealed two factors significantly and independently related to postoperative negative outcomes: RCT <3 mm and DRF > 50%.ConclusionOur study demonstrated that preoperative RCT on ultrasound of less than 3 mm and preoperative DRF on radionuclide renal scan of more than 50% were independent risk factors for adverse outcomes following pediatric pyeloplasty. These factors could be of interest in identifying, early on, patients who will develop postoperative negative outcomes, giving them more attention and support, and explaining the prognosis to the patient and family.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Risk factors for adverse outcomes after pediatric pyeloplasty: A retrospective cohort study

Zouari,

Dghaies,

Rhaiem

et al. 2023

Int J of Urology

View full text Add to dashboard Cite

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“…Although the quality of ultrasound images has increased considerably in recent years, they still have the disadvantages of a low signal‐to‐noise ratio, signal attenuation and dropout, as well as missing boundaries due to the orientation dependence of acquisition, making the detection of organs and objects of interest particularly challenging 15 . MRU is a promising alternative method, being a single examination able to assess kidneys and the entire urinary tract, as it combines both anatomical and functional information 16 . Through the ROC curve, we found that the AUC values of HV and HV/RV were higher than those of APD (0.972, 0.968).…”

Section: Discussionmentioning

confidence: 99%

Ability of volume measures of hydronephrosis to predict need for surgery and evaluate renal function in children with ureteropelvic junction obstruction

et al. 2021

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Objective To explore the efficacy of quantitative renal volume measures on magnetic resonance urography images in predicting need for surgery among children with ureteropelvic junction obstruction and their ability to evaluate renal function. Methods A total of 88 cases of hydronephrosis in 50 patients were collected between 1 April 2018 and 31 March 2020, including 30 operated kidney and 58 unoperated kidney cases. Clinical data were collected, and quantitative analysis of magnetic resonance urography was performed. Renal volume, hydronephrosis volume and the volume ratio of hydronephrosis (hydronephrosis volume/renal volume) were measured and calculated. We analyzed the relationships between the above indices in the two groups and compared these with renal function. Results Compared with the unoperated kidney group, hydronephrosis volume, renal volume and hydronephrosis volume/renal volume of the operated kidney group increased significantly. Hydronephrosis volume (area under the curve 0.972, 95% confidence interval 0.943–1.000; P < 0.001) and hydronephrosis volume/renal volume (area under the curve 0.968, 95% confidence interval 0.939–0.998; P < 0.001) were superior to ultrasonography and renal function examination in predicting the probability of surgery, and their sensitivity values (hydronephrosis volume/renal volume: 96.67%; hydronephrosis volume: 93.33%) were higher than those of the renal function test (50%). There was a significant difference among different renal function groups in the pairwise comparison of hydronephrosis volume and hydronephrosis volume/renal volume (P < 0.05). Conclusion Quantitative volume measures of hydronephrosis by magnetic resonance urography had a greater ability to predict need for surgery than ultrasonography and dynamic renal imaging, and it can be used as method by which to evaluate surgery. Hydronephrosis volume and hydronephrosis volume/renal volume have greater predictive ability, and play an important role in the deterioration of renal function.

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“…Most of the cases are self-limiting and cause no harm to the kidneys, but about 20% show split renal function deterioration ( 3 ). The main diagnostic facility is ultrasound (US), which enables to define the stage of hydronephrosis and the need of further evaluation ( 4 ). A single US scan alone has inconsistent diagnostic value, and it could not predict the renal function and drainage pattern especially in high-grade hydronephrosis ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Urine Biomarkers Combined With Ultrasound for the Diagnosis of Obstruction in Pediatric Hydronephrosis

et al. 2022

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Introduction: To establish the efficacy of ultrasound (US) combined with urine biomarkers in differentiating patients who require surgical management from those who do not, avoiding invasive investigations.Materials and Methods: From February 2019 to February 2021, all pediatric patients who presented with hydronephrosis were selected for the study. All renal units (RU) were evaluated by US, and fresh frozen voided urine samples were collected at the time of inclusion. Hydronephrosis grade was evaluated by the Society for Fetal Urology (SFU) and an alternative grading system (AGS). Patients who had high-grade hydronephrosis on US were referred to renal scan (RS) or intervention, when there was an increase of dilatation in subsequent follow-up images. Fresh frozen urine from the control group with no history of renal diseases and no renal anomalies on US was collected. We compared differences of US parameters combined with urine biomarkers between surgically and non-surgically managed patients and between the groups of patients when they were stratified by different RS findings and analyzed whether urinary biomarkers give any additional value to US. Instead of the anterior–posterior diameter (APD), we used its ratio with mid-parenchymal thickness. The additional efficacy of biomarkers to US was calculated when the US component was derived to a cumulative APD/mid-parenchymal ratio.Results: Sixty-four patients with hydronephrosis were prospectively included in the study accounting for a total of 81 patient visits and 162 RUs evaluated. A control group of 26 patients was collected. The mean age at inclusion in the hydronephrosis group was 43.7(±45.5) months, and a mean age in a control group was 61.2(±41.3) months. The cumulative APD/mid-parenchymal ratio combined with urinary albumin, β2 microglobulin (β2-M), and urinary neutrophil gelatinase-associated lipocalcin may have a better performance in the prediction of surgical intervention than the cumulative APD/mid-parenchymal ratio alone (p = 0.1). The best performance to detect the increased tissue transit time and obstructive curve on RS was demonstrated by the β2-M creatinine ratio. An increased cumulative APD/mid-parenchymal ratio with biomarkers together had a fairly good sensitivity and specificity for detection of DRF < 40%.Conclusions: According to our data, the APD/mid-parenchymal ratio alone has good efficacy in prediction of surgery and abnormal RS findings especially when combined with urine biomarkers.

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Urinary Ultrasound and Other Imaging for Ureteropelvic Junction Type Hydronephrosis (UPJHN)

Cited by 24 publications

References 96 publications

Risk factors for adverse outcomes after pediatric pyeloplasty: A retrospective cohort study

Risk factors for adverse outcomes after pediatric pyeloplasty: A retrospective cohort study

Ability of volume measures of hydronephrosis to predict need for surgery and evaluate renal function in children with ureteropelvic junction obstruction

Urine Biomarkers Combined With Ultrasound for the Diagnosis of Obstruction in Pediatric Hydronephrosis

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