Abstract
Urinary tract dilatation is identified sonographically in 1–2% of fetuses and reflects a spectrum of possible nephro-uropathies. There is significant variability in the clinical management of individuals with prenatal urinary tract dilatation to postnatal urinary pathologies, because of a lack of consensus and uniformity in defining and classifying urinary tract dilation. Ultrasonography is the first step to screen and diagnose kidneys and the urinary tract diseases of the children. The need for a correct ultrasound approach led to the realization of algorithms aimed at standardizing the procedures, the parameters and the classifications. Our objective was to highlight the strengths of the Classification of Urinary Tract Dilation (UTD) suggested by the Consensus Conference which took place in 2014 with the participation of eight Scientific Societies and was subsequently published on the Journal of Pediatric Urology. Before its spread out, the definition of UTD was not uniform and the ultrasonographic measurements were not clearly defined, leading to misunderstandings between physicians. The Classification by the Consensus Conference of 2014 represents a revolutionary tool for the diagnosis and management of UTD. Furthermore, the parameters suggested by the classification proposed are applicable for both prenatal and postnatal classification, ensuring a correct follow-up in children with UTD whose diagnosis had been already made during pregnancy.
Sommario
Dilatazioni a carico delle vie urinarie vengono identificate nell’ 1–2% dei feti e riflettono uno spettro molto variabile di possibilinefro-uropatie. A causa dell’assenza di un chiaro consenso ed uniformità nella definizione e classificazione di dilatazione a carico delle vie urinarie esiste una notevole variabilità nella gestione clinica di soggetti con questa diagnosi prenatale. L’ecografia rappresenta certamente la metodica di primo livello per l’iniziale individuazione e diagnosi di malattie dei reni e delle vie urinarie. L’esigenza di un corretto approccio ecografico ha portato ad una standardizzazione delle procedure, dei parametri e delle classificazioni. L’obiettivo di questo lavoro è quello di evidenziare i punti di forza della Classificazione della dilatazione delle vie urinarie (Urinary Tract Dilation—UTD) suggerita dalla Consensus Conference tenutasi nel 2014 con la partecipazione di 8 società scientifiche e pubblicata successivamente sul Journal of Pediatric Urology. Prima della sua diffusione, infatti, la definizione di UTD non era uniforme e le misurazioni ecografiche non erano chiaramente definite, dando luogo a incomprensioni o diverse interpretazioni tra i medici coinvolti. La classificazione della Consensus Conference del 2014 rappresenta uno strumento rivoluzionario per la diagnosi e la gestione dell’ UTD. I parametri suggeriti da tale classificazione, inoltre, sono applicabili sia al periodo prenatale che a quello postnatale, assicurando una corretta classificazione e follow-up dei bambini con UTD la cui diagnosi sia stata già posta durante la gravidanza.
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Pelliccia, P., Sferrazza Papa, S., Cavallo, F. et al. Prenatal and postnatal urinary tract dilation: advantages of a standardized ultrasound definition and classification. J Ultrasound 22, 5–12 (2019). https://doi.org/10.1007/s40477-018-0340-3
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DOI: https://doi.org/10.1007/s40477-018-0340-3