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Postnatal imaging of neonates with prenatally diagnosed genitourinary abnormalities: a practical approach

Monica Epelman1, Teresa Victoria, Kevin E Meyers

  • 1Department of Radiology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. epelman@email.chop.edu

Pediatric Radiology
|March 8, 2012
PubMed

Insights

Prenatal imaging advances have shifted neonatal genitourinary abnormality evaluation towards asymptomatic infants. Ultrasound (US) and fetal MRI guide imaging and surveillance, optimizing care for these neonates.

Area of Science:

  • Pediatric Radiology
  • Neonatal Imaging
  • Genitourinary Abnormalities

Background:

  • Prenatal ultrasound (US) and fetal MRI have altered referral patterns for neonatal genitourinary abnormalities.
  • Most neonates evaluated for these conditions are asymptomatic, requiring multidisciplinary consultation, imaging, and surveillance.
  • Reviewing prenatal studies is crucial for prognostic information and potentially avoiding repeat examinations.

Purpose of the Study:

  • To discuss a practical approach to postnatal imaging of neonates with genitourinary anomalies.
  • To present and illustrate important genitourinary anomalies in this age group.

Main Methods:

  • Ultrasound (US) as the first-line modality for morphological assessment.
  • Combination of US with MAG-3 scanning for anatomical and functional information.
  • Increasing role of MRI and MR urography as comprehensive "one-stop-shop" examinations.
  • Fluoroscopic examinations reserved for specific diagnostic needs like excluding vesicoureteral reflux or urethral obstruction.

Main Results:

  • Prenatal imaging provides crucial prognostic information.
  • US combined with MAG-3 offers both anatomical and functional data.
  • MRI and MR urography provide comprehensive anatomical and functional assessment.
  • Fluoroscopy aids in diagnosing specific conditions like reflux and obstruction.

Conclusions:

  • Modern imaging techniques like fetal MRI and US have refined the diagnostic pathway for neonatal genitourinary anomalies.
  • A systematic approach integrating various imaging modalities ensures efficient and accurate evaluation.
  • Understanding the strengths of each imaging modality is key to optimizing care for neonates with genitourinary abnormalities.

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