ESPN 50th Annual Meeting

ESPN 2017


 
Correlation of ultrasonographical findings of hydronephrosis/atrophy with 99mTc-DMSA in childhood: a single centre experience from Turkey
YASAR KANDUR 1 AHMET SALAN 2 FATÄ°H TUTEN 3

1- DIVISION OF PEDIATRIC NEPHROLOGY, NECIP FAZIL CITY HOSPITAL, KAHRAMANMARAS, TURKEY
2- DEPARTMENT OF NUCLEAR MEDICINE, NECIP FAZIL CITY HOSPITAL, KAHRAMANMARAS, TURKEY
3- DEPARTMENT OF RADIOLOGY, NECIP FAZIL CITY HOSPITAL, KAHRAMANMARAS, TURKEY
 
Introduction:

We aimed to assess the association of abnormalities (hydronephrosis and/or atrophy) detected on renal ultrasound and DMSA scan with the presence of vesicoureteric reflux on micturiting cystourethrography(MCU) to find out new perspectives

Material and methods:

We retrospectively reviewed the DMSA findings and medical records of pediatric patients  with hydronephrosis and/or atrophy who were at follow-up between January 2013 and December 2016 in our center which is located in the south-east region of Turkey.

Results:

Among 148 pediatric patients (M/F = 60/88), 66 had hydronephosis, 72 had atrophy, and 10 patients had both. The mean age of the children was 56.7 ± 6.1 months (range 3 - 194 months). MCUG study detected VUR in 66 patients. Patients with atrophy were significantly older than patients with hydronephrosis ( 77.8 ± 58.6 vs 39.3 ± 38.9 months, p=0.002). Only 19.4% of the our patients with atrophy had VUR. The rate of VUR was higher in the high-grade group than the mild-to-moderate grade group, although the difference was not statistically significant (80% vs 61%, p=0.199). Patients wiht high grade hydronephrosis had more severe DMSA findings (73% vs 39%). On the other side, 79% of the patients with high grade VUR had severe DMSA findings. A total of 10 patients had both atropy and hydronephrosis all affecting the left side. Six of them had VUR. Severe DMSA findings were more likely in toddlers (age 24-72 months) (48%).This finding was abruptly lowered after 72 months of age.  

Conclusions:

Ultrasonographic findings of atrophy should also be evaluated for vascular renal pathologies in additon to VUR evaluation. In cases of left side renal pathologies of hydronephrosis and or atrophy the patients should closely monitored and furter evaluated even there is no urinary tract infection. Lastly, DMSA may not be necessary in cases with high grade hydronephrosis before MCU.