General Remarks

Imaging in children with anomalies of the kidney and the urinary tract with reference to the outcome of renal function

Kenji Shimada
Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health

Abstract

　The purposes of imaging in children with urinary tract infections include detection of renal parenchymal damage and the pathology of lower urinary tract. Ultrasonography, voiding cystourethrography（VCUG）, and radionuclide study currently dominate pediatric imaging to establish appropriate management options. Vesicoureteral reflux is the most common and important underlying disorder to result in UTI, and is detected through VCUG. Renal damage associated with reflux（reflux nephropathy）is closely related to the functional outcome. Children with bilateral renal scarring, unilateral renal scarring and contralateral hypoplastic kidney, or bilateral hypoplastic kidney are at great risk to proceed to renal impairment. For the evaluation of asymptomatic hydronephrosis, ultrasonography and radionuclide study are useful to assess the severity of renal collecting dilatation and separate renal function. There is still no agreement as to the indication for surgery in asymptomatic hydronephrosis.

Keywords：Imaging, Pediatric urology, Renal function