Skip to main content
SpringerLink
Log in

Characterizing upper urinary tract dilation on ultrasound: a survey of North American pediatric radiologists’ practices

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Radiologists commonly evaluate children first diagnosed with urinary tract dilation on prenatal ultrasound (US).

Objective

To establish how North American pediatric radiologists define and report findings of urinary tract dilation on US.

Materials and methods

A web-based survey was sent to North American members of the Society for Pediatric Radiology (SPR) from January to February 2014. Reporting practices and interpretation of three image-based cases using free text were queried. Responses to close-ended questions were analyzed with descriptive statistics, while free-text responses to the three cases were categorized and analyzed as (1) using either descriptive terminology or an established numerical grading system and (2) as providing a quantitative term for the degree of dilation.

Results

Two hundred eighty-four pediatric radiologists answered the survey resulting in a response rate of 19.0%. There is a great variety in the terms used to describe urinary tract dilation with 66.2% using descriptive terminology, 35.6% using Society for Fetal Urology (SFU) grading system and 35.9% measuring anterior-posterior diameter (APD) of the renal pelvis. There is no consensus for a normal postnatal APD or the meaning of hydronephrosis. For the same images, descriptions vary widely in degree of severity ranging from normal to mild to severe. Similar variability exists among those using the SFU system. Ninety-seven percent say they believe a unified descriptive system would be helpful and 87.7% would use it if available.

Conclusion

Pediatric radiologists do not have a standardized method for describing urinary tract dilation but have a great desire for such a system and would follow it if available.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Ismaili K, Hall M, Donner C et al (2003) Results of systematic screening for minor degrees of fetal renal pelvis dilatation in an unselected population. Am J Obstet Gynecol 188:242–246

    Article  PubMed  Google Scholar 

  2. Livera LN, Brookfield DS, Egginton JA et al (1989) Antenatal ultrasonography to detect fetal renal abnormalities: a prospective screening programme. BMJ 298:1421–1423

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Sairam S, Al-Habib A, Sasson S et al (2001) Natural history of fetal hydronephrosis diagnosed on mid- trimester ultrasound. Ultrasound Obstet Gynecol 17:191–196

    Article  CAS  PubMed  Google Scholar 

  4. Siddique J, Lauderdale DS, VanderWeele TJ et al (2009) Trends in prenatal ultrasound use in the United States: 1995 to 2006. Med Care 47:1129–1135

    Article  PubMed  Google Scholar 

  5. You JJ, Alter DA, Stukel TA et al (2010) Proliferation of prenatal ultrasonography. CMAJ 182:143–151

    Article  PubMed Central  PubMed  Google Scholar 

  6. Martin JA, Hamilton BE, Osterman MJK et al (2013) Births: final data for 2012. Natl Vital Stat Rep 62:1–27

    Google Scholar 

  7. Coplen DE, Austin PF, Yan Y et al (2006) The magnitude of fetal renal pelvic dilatation can identify obstructive postnatal hydronephrosis, and direct postnatal evaluation of management. J Urol 176:724–727

    Article  PubMed  Google Scholar 

  8. Lee RS, Cendron M, Kinnamon DD et al (2006) Antenatal hydronephrosis as a predictor of postnatal outcome: a meta-analysis. Pediatrics 118:586–593

    Article  PubMed  Google Scholar 

  9. Coelho GM, Bouzada MC, Pereira AK et al (2007) Outcome of isolated antenatal hydronephrosis: a prospective cohort study. Pediatr Nephrol 22:1727–1734

    Article  PubMed  Google Scholar 

  10. Barbosa JA, Chow JS, Benson CB et al (2012) Postnatal longitudinal evaluation of children diagnosed with prenatal hydronephrosis: insights in natural history and referral pattern. Prenat Diagn 32:1242–1249

    Article  PubMed  Google Scholar 

  11. Shamshiraz AA, Ravangard SF, Egan JF et al (2012) Fetal hydronephrosis as a predictor of neonatal urologic outcomes. J Ultrasound Med 31:947–954

    Google Scholar 

  12. Burnside ES, Sickles EA, Bassett LW et al (2009) The ACR BI-RADS® experience: learning from history. J Am Coll Radiol 6:851–860

    Article  PubMed Central  PubMed  Google Scholar 

  13. D’Orsi CJ, Mendelson EB, Ikeda DM et al (2003) Breast imaging reporting and data system: ACR BI-RADS – breast imaging atlas. American College of Radiology, Reston

    Google Scholar 

  14. American College of Radiology (2011) Liver imaging reporting and data system version 2013.1. American College of Radiology website. www.acr.org/Quality-Safety/Resources/LIRADS. Published March 2011. Updated 2013. Accessed 1 June 2014

  15. Fernbach SK, Maisels M, Conway JJ (1993) Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol 23:478–480

    Article  CAS  PubMed  Google Scholar 

  16. Onen A (2007) An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis. J Pediatr Urol 3:200–205

    Article  PubMed  Google Scholar 

  17. Riccabona M, Avni FE, Blickman JG et al (2008) Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infections, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol 38:138–145

    Article  PubMed  Google Scholar 

  18. Grignon A, Filion R, Filiatrault D et al (1986) Urinary tract dilatation in utero: classification and clinical applications. Radiology 160:645–647

    Article  CAS  PubMed  Google Scholar 

  19. Odibo AO, Raab E, Elovitz M et al (2004) Prenatal mild pyelectasis: evaluating the thresholds of renal pelvic diameter associated with normal postnatal renal function. J Ultrasound Med 23:513–517

    PubMed  Google Scholar 

  20. Chitty LS, Altman DG (2003) Charts of fetal size: kidney and renal pelvis measurements. Prenat Diagn 23:891–897

    Article  PubMed  Google Scholar 

  21. Toiviainen-Salo S, Garel L, Grignon A et al (2004) Fetal hydronephrosis: is there hops for consensus? Pediatr Radiol 34:519–529

    Article  PubMed  Google Scholar 

  22. Kim SY, Kim MJ, Yoon CS et al (2013) Comparison of the reliability of two hydronephrosis grading systems: The Society for Foetal Urology grading system vs. the Onen grading system. Clin Radiol 68:e484–e490

    Article  PubMed  Google Scholar 

  23. Yoshida J, Tsuchiya M, Tatsuma N et al (2003) Mass screening for early detection of congenital kidney and urinary tract abnormalities in infancy. Pediatr Int 45:142–149

    Article  PubMed  Google Scholar 

  24. Tsai TC, Lee HC, Huang FY (1989) The size of the renal pelvis on ultrasonography in children. J Clin Ultrasound 17:647–651

    Article  CAS  PubMed  Google Scholar 

  25. Blane CE, DiPietro MA, Strouse PJ et al (2003) Pediatric renal pelvic fullness: an ultrasonographic dilemma. J Urol 170:201–203

    Article  PubMed  Google Scholar 

  26. Braga LH, Ruzhynsky V, Pemberton J et al (2014) Evaluating practice patterns in postnatal management of antenatal hydronephrosis: a national survey of Canadian pediatric urologists and nephrologists. Urology 83:909–914

    Article  PubMed  Google Scholar 

  27. Merguerian PA, Herz D, McQuiston L et al (2010) Variation mong pediatric urologists and across 2 continents in antibiotic prophylaxis and evaluation for prenatally detected hydronephrosis: a survey of American and European pediatric urologists. J Urol 184:1710–1715

    Article  PubMed  Google Scholar 

  28. Yiee JH, Tasian GE, Copp HL (2011) Management trends in prenatally detected hydronephrosis: national survey of pediatrician practice patterns and antibiotic use. Urology 78:895–901

    Article  PubMed Central  PubMed  Google Scholar 

  29. Zanetta VC, Rosman BM, Bromley B et al (2012) Variations in management of mild prenatal hydronephrosis among maternal-fetal medicine obstetricians, and pediatric urologists and radiologists. J Urol 188:1935–1939

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Jennifer Boylan in the SPR office for assistance in distribution of our e-mail survey to the SPR membership and collecting data through surveymonkey.com.

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Hasbro Children’s Hospital/Rhode Island Hospital, 593 Eddy St, Providence, RI, 02903, USA

    David W. Swenson

  2. Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Kassa Darge

  3. Biostatistics Core, Boston Children’s Hospital, Boston, MA, USA

    Sonja I. Ziniel

  4. Department of Radiology, Boston Children’s Hospital, Boston, MA, USA

    Jeanne S. Chow

Authors
  1. David W. Swenson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kassa Darge
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sonja I. Ziniel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jeanne S. Chow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David W. Swenson.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Swenson, D.W., Darge, K., Ziniel, S.I. et al. Characterizing upper urinary tract dilation on ultrasound: a survey of North American pediatric radiologists’ practices. Pediatr Radiol 45, 686–694 (2015). https://doi.org/10.1007/s00247-014-3221-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-014-3221-8

Keywords

Search

Navigation