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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
Published on: June 21, 2024
Value of ultrasound in evaluation of infants with first urinary tract infection
Iulian Preda1, Ulf Jodal, Rune Sixt
1Department of Pediatrics, Queen Silvia Children's Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
Ultrasound effectively identifies many urinary tract abnormalities in infants but misses some cases of grade III reflux. This noninvasive imaging is valuable for diagnosing infant urinary tract infections, particularly when prenatal screening is limited.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Infant Urology
Background:
- Urinary tract infections (UTIs) in infants can lead to significant renal damage.
- Early diagnosis and management are crucial to prevent long-term complications.
- Identifying structural abnormalities is key in managing infant UTIs.
Purpose of the Study:
- To assess the diagnostic utility of ultrasound in infants with a first UTI.
- To identify important structural urinary tract abnormalities.
- To evaluate ultrasound's role in conjunction with other imaging modalities.
Main Methods:
- A prospective, population-based study of 290 infants (161 male, 129 female) with a first UTI.
- Initial investigations included ultrasound and dimercapto-succinic acid scintigraphy.
- Voiding cystourethrography was performed within two months for further evaluation.
Main Results:
- Ultrasound detected dilatation in 15% and increased kidney length in 28% of infants.
- Sensitivity for detecting scintigraphic abnormalities was 48%; renal length correlated with inflammatory markers.
- Ultrasound identified 30 of 40 significant structural abnormalities, missing 10 cases of dilating reflux (mostly grade III).
Conclusions:
- Ultrasound is a valuable, noninvasive tool for evaluating infants with UTIs, detecting most structural abnormalities except high-grade reflux.
- Its use is particularly recommended in settings with limited prenatal ultrasound screening.
- Further research is needed to explore the clinical significance of renal length correlation with inflammatory parameters in acute UTI.
Purpose:
We evaluated the role of ultrasound in diagnosing and treating infants with a first urinary tract infection with a focus on important structural abnormalities.
Materials And Methods:
In a setting of limited prenatal ultrasound screening this population based, prospective, 3-year study included 161 male and 129 female infants. Ultrasound and dimercapto-succinic acid scintigraphy were performed as initial investigations and voiding cystourethrography was conducted within 2 months.
Results:
Ultrasound revealed dilatation in 15% of patients and increased kidney length in 28%. Sensitivity for detecting scintigraphic abnormality was 48%. Renal length was significantly correlated to inflammatory parameters, including scintigraphic abnormalities. Important structural abnormalities were detected in 40 cases, with 30 on ultrasound, while 10 of 27 cases of dilating reflux (mostly grade III) were missed. Outside the study there were 28 additional cases of structural abnormality, of which 15 were detected prenatally.
Conclusions:
Ultrasound detected most structural abnormalities except grade III reflux. Since it is noninvasive, ultrasound has a place in the evaluation of infants with urinary tract infection, especially in the absence of prenatal ultrasound during late pregnancy. Kidney length in infants with acute infection correlated with inflammatory parameters, and the clinical importance of this finding needs to be studied further.
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Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...