Abstract
Background
For a definitive diagnosis of congenital solitary kidney, renal scintigraphy is suggested as being the gold standard of ruling out ectopic functioning renal tissue, possibly missed by ultrasound. The aim of our study was to test ultrasonography precision in comparison with renal scintigraphy on a larger cohort of congenital solitary kidneys.
Methods
We performed a retrospective unicenter study of children with congenital solitary kidney with no contralateral tissue, who were treated in the period from 1980 to 2017. The findings in children who underwent both abdominopelvic ultrasound and nuclear renal scintigraphy were compared and the accuracy of ultrasound was assessed.
Results
99 children met the inclusion criteria of congenital solitary kidney confirmed with abdominopelvic ultrasound and nuclear renal scintigraphy. The children were predominantly male (61.6%), and the congenital solitary kidney was largely right-sided (55.5%). In 97 cases (98%), ultrasound correctly predicted the absence of functional renal tissue on one side in the renal fossa or in an ectopic location (pelvis or ipsilateral side). The calculated accuracy of abdominopelvic ultrasound in diagnosing congenital solitary kidney was therefore 98%.
Conclusions
Our findings confirm that abdominopelvic ultrasound alone is accurate enough to diagnose congenital solitary kidney. It gives enough information for consideration if further radiological evaluation is still needed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Westland R, Schreuder MF, Ket JC, van Wijk JA (2013) Unilateral renal agenesis: a systematic review on associated anomalies and renal injury. Nephrol Dial Transplant 28:1844–1855. https://doi.org/10.1093/ndt/gft012
Hayes WN, Watson AR, Trent & Anglia MCDK Study Group (2012) Unilateral multicystic dysplastic kidney: does initial size matter? Pediatr Nephrol 27:1335–1340. https://doi.org/10.1007/s00467-012-2141-9
Hiraoka M, Tsukahara H, Ohshima Y, Kasuga K, Ishihara Y, Mayumi M (2002) Renal aplasia is the predominant cause of congenital solitary kidneys. Kidney Int 61:1840–1844. https://doi.org/10.1046/j.1523-1755.2002.00322.x
Sheih CP, Liu MB, Hung CS, Yang KH, Chen WY, Lin CY (1989) Renal abnormalities in school children. Pediatrics 84:1086–1090
Gordon I (1987) Indications for 99mtechnetium dimercapto-succinic acid scan in children. J Urol 137:464–467
Othman S, Al-Hawes A, Al-Maqtari R (2012) Renal cortical imaging in children: 99mTc MAG3 versus 99mTc DMSA. Clin Nucl Med 37:351–355. https://doi.org/10.1097/RLU.0b013e3182443f68
Krill A, Cubillos J, Gitlin J, Palmer LS (2012) Abdominopelvic ultrasound: a cost effective way to diagnose solitary kidney. J Urol 187:2201–2204. https://doi.org/10.1016/j.juro.2012.01.129
Barwick TD, Malhotra A, Webb JAW, Savage MO, Reznek RH (2005) Embryology of the adrenal glands and its relevance to diagnostic imaging. Clin Radiol 60:953–959. https://doi.org/10.1016/j.crad.2005.04.006
Gharagozloo AM, Lebowitz RL (1995) Detection of a poorly functioning malpositioned kidney with single ectopic ureter in girls with urinary dribbling: imaging evaluation in five patients. Am J Roentgenol 164:957–961. https://doi.org/10.2214/ajr.164.4.7726056
Akhavan A, Brajtbord JS, McLeod DJ, Kabarriti AE, Rosenberg HK, Stock JA (2011) Simple, age-based formula for predicting renal length in children. Urology 78:405–410. https://doi.org/10.1016/j.urology.2011.01.008
Nguyen HT, Benson CB, Bromley B, Campbell JB, Chow J, Coleman B, Cooper C, Crino J, Darge K, Herndon CD, Odibo AO, Somers MJ, Stein DR (2014) Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system). J Pediatr Urol 10:982–998. https://doi.org/10.1016/j.jpurol.2014.10.002
Piepsz A, Colarinha P, Gordon I, Hahn K, Olivier P, Roca I, Sixt R, van Velzen J (2009) Guidelines on 99mTc-DMSA scintigraphy in children. Paediatric Committee of the European Association of Nuclear Medicine. https://eanm.org/publications/guidelines/gl_paed_dmsa_scin.pdf. Accessed 1 Oct 2018
Gordon I, Colarinha P, Fettich J, Fischer S, Frökier J, Hahn K, Kabasakal L, Mitjavila M, Olivier P, Piepsz A, Porn U, Sixt R, van Velzen J (2000) Guidelines for standard and diuretic renogram in children. Paediatric Committee of the European Association of Nuclear Medicine. https://eanm.org/publications/guidelines/gl_paed_sdr.pdf. Accessed 1 Oct 2018
Lassmann M, Treves ST (2014) Paediatric Radiopharmaceutical Administration: harmonization of the 2007 EANM paediatric dosage card (version 1.5.2008) and the 2010 North America Consensus guideline. Eur J Nucl Med Mol Imaging. https://eanm.org/publications/guidelines/art10.1007_s00259-014-2731-9.pdf. Accessed 1 Oct 2018
La Scola C, Ammenti A, Puccio G, Lega MV, De Mutiis C, Guiducci C, De Petris L, Perretta R, Venturoli V, Vergine G, Zucchini A, Montini G (2016) Congenital solitary kidney in children: size matters. J Urol 196:1250–1256. https://doi.org/10.1016/j.juro.2016.03.173
Rottenberg GT, De Bruyn R, Gordon I (1996) Sonographic standards for a single functioning kidney in children. Am J Roentgenol 167:1255–1259. https://doi.org/10.2214/ajr.167.5.8911191
Perlman S, Lotan DM, Dekel B, Kivilevitch Z, Hazan Y, Achiron R, Gilboa Y (2016) Prenatal compensatory renal growth in unilateral renal agenesis. Prenat Diagn 36:1075–1080. https://doi.org/10.1002/pd.4938
Hartshorne N, Shepard T, Barr M Jr (1991) Compensatory renal growth in human foetuses with unilateral renal agenesis. Teratology 44:7–10. https://doi.org/10.1002/tera.1420440103
Langer FW, dos Santos D, Dartora EG, Alves GR, Haygert CJ (2015) Ectopic intrathoracic kidney presenting as recurrent pneumonias in a 1-year-old infant: a case report. Lung 193:839–842. https://doi.org/10.1007/s00408-015-9760-4
Bozorgi F, Connolly LP, Bauer SB, Neish AS, Tan PE, Schofield D, Treves ST (1998) Hypoplastic dysplastic kidney with a vaginal ectopic ureter identified by technetium-99m-DMSA scintigraphy. J Nucl Med 39:113–115
Chua ME, Ming JM, Farhat WA (2016) Magnetic resonance urography in the pediatric population: a clinical perspective. Pediatr Radiol 46:791–795
Funding
No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.
Author information
Authors and Affiliations
Contributions
Both authors have made substantive contributions to the article and assume full responsibility for its content; all those who have made substantive contributions to the article have been named as authors.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
A retrospective study was conducted at the University Children’s Hospital in Ljubljana, Slovenia, and was approved by the Slovene National Medical Ethics Committee. A study is in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Grabnar, J., Rus, R.R. Is renal scintigraphy really a necessity in the routine diagnosis of congenital solitary kidney?. Pediatr Surg Int 35, 729–735 (2019). https://doi.org/10.1007/s00383-019-04478-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-019-04478-1