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Ultrasonographic screening of childhood hematuria
S Jequier1, B Cramer, T Petitjeanroget
1Department of Radiology, Montreal Children's Hospital, Quebec.
Insights
Ultrasonography (US) is an effective screening tool for childhood hematuria, often providing additional diagnostic information compared to intravenous urogram (IVU). US can replace IVU in specific cases, guiding further investigations for pediatric kidney conditions.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
Background:
- Hematuria is a common urological complaint in children.
- Diagnostic imaging plays a crucial role in identifying the underlying cause of hematuria.
Purpose of the Study:
- To evaluate the diagnostic utility of ultrasonography (US) compared to intravenous urogram (IVU) and voiding cystourethrogram (VCU) in children with hematuria.
- To determine if US can serve as a primary screening tool for pediatric hematuria.
Main Methods:
- Retrospective analysis of 184 children (aged two days to 18 years) with hematuria.
- Comparison of imaging findings from US, IVU, and VCU.
Main Results:
- US and IVU showed agreement in 83% of diagnoses.
- US provided additional findings in 40% of patients, while IVU detected lesions missed by US in 5.5% of cases.
- US is effective in identifying renal cysts, splenic injuries, and ascites.
Conclusions:
- Ultrasonography is a valuable initial screening method for pediatric hematuria.
- US can potentially replace IVU in managing minor posttraumatic hematuria and glomerular diseases.
- Abnormal US findings can effectively guide subsequent radiological investigations.
Abstract:
We examined 184 children with hematuria, aged two days to 18 years, by ultrasonography (US). Of these, 108 also had an intravenous urogram (IVU) and 28 had a voiding cystourethrogram (VCU). Of these 28, 18 had both an IVU and VCU and 10 had only a VCU in addition to US. The remaining 66 children had US alone. Comparing the results of the 108 US and IVU examinations, these modalities were in agreement in 83% of patients as to the main diagnosis. US gave pertinent additional information in 44 patients (40%) with 56 findings (renal cysts, splenic injuries, ascites, etc.) not detected using IVU. In six patients (5.5%), lesions were missed using US but detected using IVU (e.g. lithiasis, papillary necrosis). In the remaining 58 patients, IVU and US were equally informative. US is an excellent screening method for use in childhood hematuria. It can replace IVU in patients with minor posttraumatic hematuria and in most with glomerular disease (i.e. benign familial hematuria). It will direct the sequence of further radiological investigations in patients with abnormal findings.