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Ultrasonography to visualize the upper urinary tract in children with meningomyelocele

Kate Abrahamsson1, Ulf Jodal, Eira Stokland

  • 1The Paediatric Uro-Nephrologic Centre, The Queen Silvia Children's Hospital, Göteborg University, Göteborg, Sweden. kaab0001@telia.com

BJU International
|September 19, 2006
PubMed

Insights

Ultrasonography (US) is often difficult for evaluating renal length and dilatation in children with meningomyelocele (MMC) due to severe spinal angulation or obesity. Dilatation is evaluable in over 90% of cases, while renal length is evaluable in about 70%.

Area of Science:

  • Pediatric Nephrology
  • Medical Imaging
  • Spinal Cord Injury Research

Background:

  • Meningomyelocele (MMC) is a complex congenital condition often associated with spinal deformities and obesity.
  • Ultrasonography (US) is a primary imaging modality for assessing the upper urinary tract in children.
  • Evaluating renal length and dilatation via US can be challenging in pediatric patients with MMC.

Purpose of the Study:

  • To determine the frequency of US evaluation difficulties for renal length and dilatation in children and adolescents with MMC.
  • To assess the impact of severe spinal angulation and high body mass index (BMI) on US image quality in this population.

Main Methods:

  • Retrospective analysis of US records from 160 children with MMC (1996-2002).
  • Evaluation of US results, body mass index (BMI), and spinal angulation.
  • Categorization of patients based on spinal curvature and BMI.

Main Results:

  • US was not evaluable in 29% of cases (renal length: 22%, dilatation: 1%, both: 6%).
  • Severe spinal angulation significantly reduced US evaluability (51% for renal length, 15% for dilatation).
  • High BMI (≥27 kg/m²) further compromised US evaluation, especially with severe spinal angulation.

Conclusions:

  • Severe spinal angulation and high BMI are significant factors limiting US evaluation of the urinary tract in children with MMC.
  • Despite challenges, US remains a valuable tool, with successful evaluation of dilatation in over 90% and renal length in approximately 70% of unselected MMC patients.
Abstract

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