European Radiology

, Volume 13, Issue 12, pp 2680–2687 | Cite as

Potential applications of three-dimensional ultrasound in the pediatric urinary tract: pictorial demonstration based on preliminary results



The aim of this study was to describe the potential of three-dimensional ultrasound (3DUS) in the urinary tract of neonates, infants, and children. The potential applications are illustrated based on our experience in 80 patients using two different 3DUS techniques. Various disease entities throughout the neonatal and pediatric age have been evaluated. The potential of 3DUS is discussed based on comparison with conventional 2DUS or other imaging (as clinically indicated), focused on the potentially improved renal parenchymal volume assessment. In our experience, 3DUS is feasible in neonates, infants, and children without sedation. It reduces imaging time, improves demonstration of complex anatomy and allows for evaluation of anatomy/pathology in any plane. The 3DUS improves volume assessment and follow-up comparison by offering an improved standardization and documentation. Rendered views of the dilated collecting system enable a comprehensive demonstration of hydronephrosis similar to intravenous urography or MR urography images. Additionally, 3DUS offers an ideal tool for training and education. Yet, limitations have to be acknowledged: areas inaccessible for 2DUS; poor quality of the original 2DUS acquisition; limited resolution; patient motion and breathing; cardiac pulsation creating artifacts and misregistration; equipment cost; lack of 3D DICOM standards creating problems with data storage; as well as system-inherent technical limitations. Nevertheless, the 3DUS holds the potential to become a valuable additional imaging tool for sonographic evaluation of the pediatric urinary tract.


3D ultrasound Neonate Children Infants Hydronephrosis Kidney Urinary tract Renal volume 


  1. 1.
    Dacher JN (2001) Diagnostic procedures excluding MRI, nuclear medicine and video-urodynamics. In: Fotter R (ed) Pediatric uroradiology. Springer, Berlin Heidelberg New York, pp 1–15Google Scholar
  2. 2.
    Riccabona M, Sorantin E, Ring E (1998) Application of M-mode sonography to functional evaluation in pediatric patients. Eur Radiol 8:1457–1461CrossRefPubMedGoogle Scholar
  3. 3.
    Sauerbrei EE (1999) Extended field-of-view sonography: utility in clinical practice. J Ultrasound Med 18:335–341PubMedGoogle Scholar
  4. 4.
    Wittingham TA (1999) Tissue harmonic imaging. Eur Radiol 9:323–326CrossRefPubMedGoogle Scholar
  5. 5.
    Babcock DS, Patriquin H, LaFortune M, Duazat M (1996) Power Doppler sonography: basic principles and clinical applications in children. Pediatr Radiol 26:109–115PubMedGoogle Scholar
  6. 6.
    Lee JY, Cho JY, Kim SH (2000) Genitourinary lesions showing twinkling artifacts on color Doppler ultrasound. J Med Ultrasound 8:239–242Google Scholar
  7. 7.
    Riccabona M, Schwinger W, Ring E, Aigner R (2001) Amplitude-coded color Doppler sonography in pediatric renal disease. Eur Radiol 11:861–866PubMedGoogle Scholar
  8. 8.
    Darge K, Tröger J, Duetting T et al. (1999) Reflux in young patients: comparison of voiding US of the bladder and the retrovesical space with echo-enhancement vs voiding cystourethrography for diagnosis. Radiology 210:201–207PubMedGoogle Scholar
  9. 9.
    Riccabona M, Uggowitzer M, Klein E, Lindbichler F, Ebner F, Fotter R (2000) Contrast-enhanced color Doppler sonography in children and adolescents. J Ultrasound Med 19:783–788PubMedGoogle Scholar
  10. 10.
    Merz E (ed) (1993) Ultrasound in obstetrics and gynecology. Lippincott, Williams and Wilkins, Philadelphia New York BaltimoreGoogle Scholar
  11. 11.
    Nelson TR, Pretorius DH, Fenster A, Downey D (1999) Three-dimensional ultrasound. Lippincott, Williams and Wilkins, Philadelphia New York BaltimoreGoogle Scholar
  12. 12.
    Odorico I de, Spaulding KA, Pretorius DH, Lev Toaff AS, Bailey TB, Nelson TR (1999) Normal splenic volumes estimated using three-dimensional ultrasonography. J Ultrasound Med 18:231–236PubMedGoogle Scholar
  13. 13.
    Downey DB, Fenster A (1995) Vascular imaging with a three-dimensional power Doppler system. Am J Roentgenol 65:665–668Google Scholar
  14. 14.
    Elliot TL, Downey DB, Tong S, McLean CA, Fenster A (1996) Accuracy of prostate volume measurements in vitro using three-dimensional ultrasound. Acad Radiol 3:401–406PubMedGoogle Scholar
  15. 15.
    Gilja OH, Thune N, Matre K, Hausken T, Odegaard S, Berstad A (1994) In vitro evaluation of three-dimensional ultrasonography in volume estimation of abdominal organs. Ultrasound Med Biol 20:157–165PubMedGoogle Scholar
  16. 16.
    Nelson TR, Pretorius DH, Sklansky M, Hagen-Ansert S (1996) Three-dimensional echocardiographic evaluation of fetal heart anatomy and function: acquisition, analysis and display. J Ultrasound Med 15:1–9PubMedGoogle Scholar
  17. 17.
    Riccabona M, Nelson TR, Pretorius DH, Davidson TE (1995) Distance and volume measurements using three-dimensional ultrasound. J Ultrasound Med 14:881–886PubMedGoogle Scholar
  18. 18.
    Riccabona M, Nelson TR, Pretorius DH, Davidson TE (1996) In vivo three-dimensional sonographic measurement of organ volume: validation in the urinary bladder. J Ultrasound Med 15:627–632PubMedGoogle Scholar
  19. 19.
    Franke J, Lazovic D, Overhoff HM, Jan U von, Ruhmann O (1997) New approaches to 3D-ultrasonographic imaging of infant hips. Orthopade 26:210–214CrossRefPubMedGoogle Scholar
  20. 20.
    Manco-Johnson M, Thienme G, Cioffi-Ragan D (2000) Three-dimensional ultrasound neonatal neurosonography. In: Timor-Tritsch IE, Monteagudo A, Cohen L (eds) Ultrasound in the prenatal and neonatal brain, 2nd edn. McGraw-Hill, New York, pp 467–488Google Scholar
  21. 21.
    Merton DA, Bega G, Goldberg BB (2001) Multiplanar three-dimensional neonatal neurosonography: initial experiences and potential benefits. J Diagn Med Sonogr 17:3–15Google Scholar
  22. 22.
    Nagdyman N, Walka MM, Kampmann W, Stover B, Obladen M (1999) 3D ultrasound quantification of neonatal cerebral ventricles in different head positions. Ultrasound Med Biol 25:895–900CrossRefPubMedGoogle Scholar
  23. 23.
    Riccabona M, Nelson TR, Resch B, Pretorius DP (2003) Three-dimensional ultrasound in neonatal and pediatric neurosonography. Eur Radiol 13:2082–2093PubMedGoogle Scholar
  24. 24.
    Salerno CC, Pretorius DH, Hilton SVW et al. ( 2000) Three-dimensional ultrasound imaging of the neonatal brain in high risk neonates: a preliminary study. J Ultrasound Med 19:549–554PubMedGoogle Scholar
  25. 25.
    Fritz GA, Riccabona M, Bohdal G, Ring E (2003) Genauigkeit der dreidimensionalen sonographie bei der nierenvolumetrie im kindesalter–Vergleich mit CT/MRT. Fortschr Roentgenstr 175:540–546Google Scholar
  26. 26.
    Tong S, Cardinal HN, McLoughlin RF, Downey DB, Fenster A (1998) Intra- and inter-observer variability and reliability of prostate volume measurement via two-dimensional and three-dimensional ultrasound imaging. Ultrasound Med Biol 24:673–681CrossRefPubMedGoogle Scholar
  27. 27.
    Nelson TR, Pretorius DH, Hull AD, Riccabona M, Sklansky MS, James G (2000) Sources and impact of artifacts on clinical 3DUS imaging. Ultrasound Obstet Gynecol 15:1–11CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Department of RadiologyUniversity Hospital LKH GrazGrazAustria
  2. 2.Department of PediatricsUniversity Hospital LKH GrazGrazAustria

Personalised recommendations