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Urinary tract infection in infants and children evaluated by ultrasound
Insights
Ultrasonography is recommended as the initial imaging test for pediatric urinary tract infections (UTIs). Voiding cystourethrography is essential for detecting vesicoureteral reflux, a key factor in recurrent UTIs.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Urology
Background:
- Urinary tract infections (UTIs) are common in children.
- Identifying predisposing abnormalities is crucial for effective management.
- Imaging plays a key role in evaluating pediatric UTIs.
Purpose of the Study:
- To compare the effectiveness of renal ultrasonography, excretory urography, and voiding cystourethrography.
- To determine the optimal imaging sequence for pediatric UTI evaluation.
- To identify imaging modalities best suited for detecting UTI-predisposing factors.
Main Methods:
- Retrospective analysis of imaging procedures in 59 pediatric patients with UTI.
- Evaluation included renal ultrasonography, excretory urography, and voiding cystourethrography.
- Assessment focused on the detection of abnormalities associated with UTIs.
Main Results:
- Voiding cystourethrography uniquely identified vesicoureteral reflux.
- Ultrasonography was more specific than excretory urography, except in cases of renal scarring.
- Abnormal sonograms indicated the need for excretory urography or other follow-up studies.
Conclusions:
- Ultrasonography is recommended as the first-line imaging modality for pediatric UTIs.
- Voiding cystourethrography is essential for detecting vesicoureteral reflux, regardless of sonogram findings.
- Excretory urography is not routinely necessary with normal sonograms but may be indicated for abnormal findings.
Abstract:
Fifty-nine pediatric patients with urinary tract infection (UTI) underwent renal ultrasonography, excretory urography, and voiding cystourethrography. The imaging procedures were analyzed retrospectively to determine their relative effectiveness in detecting abnormalities that might predispose the patient to UTI. Voiding cystourethrography provided valuable information, particularly the presence or absence of vesicoureteral reflux, that could not be obtained from the other procedures. Excretory urography was less specific than ultrasonography in the majority of patients, with the exception of those who had renal scarring. The authors recommended ultrasonography as the initial imaging procedure in the evaluation of children with UTI. When the sonogram is normal, excretory urography is not considered necessary, but voiding cystourethrography is thought to be essential. If sonography is abnormal, excretory urography and/or other follow-up studies are indicated.