Renal sonography in pediatric patients. A comparative study between sonography and urography

Renal sonograms of 260 children were compared with the corresponding excretory urograms. Since each kidney was evaluated separately 520 sonographic and urographic findings could be compared. The study is based on single investigations only, serial investigations were not included. 326 kidneys could be classified as being normal, primarily on the basis of the urogram. By sonography only 10 out of these 326 were misinterpretated as being pathological, 2 by urography. 194 kidneys could be classified as being pathological either by urography or- if necess -by other methods. In 16 out of these 194 no evidence for a pathological process could be found in the sonogram (7 cases of destructive pyelonephritis, 3 cases of double kidneys, 2 cases of slight obstruction of urine flow, 2 cases of small kidneys, 2 cases of ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of preversial ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of prevesical ureterolith, 1 case of ureteral bud). In 2 cases pathological alterations of the kidney was found by both methods, however, the diagnosis differed. Nonfunctioning kidneys were found in 15 cases. In all of these the sonogram provided important complementary information. Our results show 1) that by a systematic application of sonography the early diagnosis of urinary tract malformations can be improved 2) that renal sonography provides the basis for a stricter application of excretory urography and 3) that by the combination of both methods the diagnosis of renal diseases can be improved.