Skip to main content
SpringerLink
Log in

Imaging of congenital genitourinary anomalies

  • Neonatal imaging
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Congenital genitourinary anomalies are among the most frequent types of birth defects in neonates. Some anomalies can be a significant cause of morbidity in infancy, while others remain asymptomatic even until adulthood and can be at times the only manifestation of a complex systemic disease. The spectrum of these anomalies results from the developmental insults that can occur at various embryologic stages, and an understanding of the formation of the genitourinary system is helpful in the evaluation and treatment of a child with a congenital genitourinary anomaly. Imaging plays an essential role in the diagnosis of congenital genitourinary anomalies and treatment planning. In this article, we highlight the embryologic and characteristic imaging features of various congenital genitourinary anomalies, demonstrate the utility of different imaging modalities in management, and review specific imaging modalities and protocols for image optimization.

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
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19

Similar content being viewed by others

References

  1. Isert S, Müller D, Thumfart J (2020) Factors associated with the development of chronic kidney disease in children with congenital anomalies of the kidney and urinary tract. Front Pediatr 8:298

    Article  Google Scholar 

  2. Hryhorczuk A, Phelps A, Yu R, Chow J (2021) A radiologist’s role in assessing differences of sex development. Pediatr Radiol. https://doi.org/10.1007/s00247-021-05147-z

    Article  PubMed  Google Scholar 

  3. Behr SC, Courtier JL, Qayyum A (2012) Imaging of Müllerian duct anomalies. Radiographics 32:E233–250

    Article  Google Scholar 

  4. Rehman S, Ahmed D (2021) Embryology, kidney, bladder, and ureter. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK547747/. Accessed 26 Mar 2021

  5. Blake J, Rosenblum ND (2014) Renal branching morphogenesis: morphogenetic and signaling mechanisms. Semin Cell Dev Biol 36:2–12

    Article  Google Scholar 

  6. No authors listed (2015) Urogenital development. Duke Medicine website. https://embryology.oit.duke.edu/urogenital/urogenital.html. Accessed 30 Jun 2021

  7. Levin TL, Han B, Little BP (2007) Congenital anomalies of the male urethra. Pediatr Radiol 37:851–862

    Article  Google Scholar 

  8. Mullen RD, Behringer RR (2014) Molecular genetics of Müllerian duct formation, regression and differentiation. Sex Dev 8:281–296

    Article  CAS  Google Scholar 

  9. Massé J, Watrin T, Laurent A et al (2009) The developing female genital tract: from genetics to epigenetics. Int J Dev Biol 53:411–424

    Article  Google Scholar 

  10. Epelman M, Daneman A, Donnelly LF et al (2014) Neonatal imaging evaluation of common prenatally diagnosed genitourinary abnormalities. Semin Ultrasound CT MRI 35:528–554

    Article  Google Scholar 

  11. Morin CE, McBee MP, Trout AT et al (2018) Use of MR urography in pediatric patients. Curr Urol Rep 19:1–11

    Article  Google Scholar 

  12. Dickerson EC, Dillman JR, Smith EA et al (2015) Pediatric MR urography: indications, techniques, and approach to review. Radiographics 35:1208–1230

    Article  Google Scholar 

  13. Rosenblum S, Pal A, Reidy K (2017) Renal development in the fetus and premature infant. Semin Fetal Neonatal Med 22:58–66

    Article  Google Scholar 

  14. Ramanathan S, Kumar D, Khanna M et al (2016) Multi-modality imaging review of congenital abnormalities of kidney and upper urinary tract. World J Radiol 8:132

    Article  Google Scholar 

  15. Hoffman CK, Filly RA, Callen PW (1992) The “lying down” adrenal sign: a sonographic indicator of renal agenesis or ectopia in fetuses and neonates. J Ultrasound Med 11:533–536

    Article  CAS  Google Scholar 

  16. Shapiro E, Goldfarb DA, Ritchey ML (2003) The congenital and acquired solitary kidney. Rev Urol 5:2–8

    PubMed  PubMed Central  Google Scholar 

  17. Houat AP, Guimarães CTS, Takahashi MS et al (2021) Congenital anomalies of the upper urinary tract: a comprehensive review. Radiographics 41:462–486

    Article  Google Scholar 

  18. Westland R, Schreuder MF, Ket JCF, van Wijk JAE (2013) Unilateral renal agenesis: a systematic review on associated anomalies and renal injury. Nephrol Dial Transplant 28:1844–1855

    Article  Google Scholar 

  19. Kim B, Kawashima A, Ryu JA et al (2009) Imaging of the seminal vesicle and vas deferens. Radiographics 29:1105–1121

    Article  Google Scholar 

  20. Arora SS, Breiman RS, Webb EM et al (2007) CT and MRI of congenital anomalies of the seminal vesicles. AJR Am J Roentgenol 189:130–135

    Article  Google Scholar 

  21. Williams B, Tareen B, Resnick MI (2007) Pathophysiology and treatment of ureteropelvic junction obstruction. Curr Urol Rep 8:111–117

    Article  Google Scholar 

  22. Amling CL, O’Hara SM, Wiener JS et al (1996) Renal ultrasound changes after pyeloplasty in children with ureteropelvic junction obstruction: long-term outcome in 47 renal units. J Urol 156:2020–2024

    Article  CAS  Google Scholar 

  23. Cost NG, Prieto JC, Wilcox DT (2010) Screening ultrasound in follow-up after pediatric pyeloplasty. Urology 76:175–179

    Article  Google Scholar 

  24. Heinlen JE, Manatt CS, Bright BC et al (2009) Operative versus nonoperative management of ureteropelvic junction obstruction in children. Urology 73:521–525

    Article  Google Scholar 

  25. Jennings RW (2000) Prune belly syndrome. Semin Pediatr Surg 9:115–120

    Article  CAS  Google Scholar 

  26. Berrocal T, López-Pereira P, Arjonilla A, Gutiérrez J (2002) Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics 22:1139–1164

    Article  Google Scholar 

  27. Kulkarni B, Chaudhari N (2008) Embryogenesis of bladder exstrophy: a new hypothesis. J Indian Assoc Pediatr Surg 13:57–60

    Article  Google Scholar 

  28. Dunn EA, Kasprenski M, Facciola J et al (2019) Anatomy of classic bladder exstrophy: MRI findings and surgical correlation. Curr Urol Rep 20:48

    Article  Google Scholar 

  29. Pierre K, Borer J, Phelps A, Chow JS (2014) Bladder exstrophy: current management and postoperative imaging. Pediatr Radiol 44:768–786

    Article  Google Scholar 

  30. Ebert A-K, Reutter H, Ludwig M, Rösch WH (2009) The exstrophy–epispadias complex. Orphanet J Rare Dis 4:23

    Article  Google Scholar 

  31. No authors listed (1988) The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Müllerian anomalies and intrauterine adhesions. Fertil Steril 49:944–955

    Article  Google Scholar 

  32. Fajardo RS, DeAngelis GA (2021) Septate uterus. Applied Radiology website. https://www.appliedradiology.com/articles/septate-uterus. Accessed 13 Jul 2021

  33. Wold ASD, Pham N, Arici A (2006) Anatomic factors in recurrent pregnancy loss. Semin Reprod Med 24:25–32

    Article  Google Scholar 

  34. Troiano RN, McCarthy SM (2004) Müllerian duct anomalies: imaging and clinical issues. Radiology 233:19–34

    Article  Google Scholar 

  35. Li S, Qayyum A, Coakley FV, Hricak H (2000) Association of renal agenesis and Mullerian duct anomalies. J Comput Assist Tomogr 24:829–834

    Article  CAS  Google Scholar 

  36. Gell JS (2003) Müllerian anomalies. Semin Reprod Med 21:375–388

    Article  Google Scholar 

  37. Kimberley N, Hutson JM, Southwell BR, Grover SR (2012) Vaginal agenesis, the hymen, and associated anomalies. J Pediatr Adolesc Gynecol 25:54–58

    Article  CAS  Google Scholar 

  38. Mueller GC, Hussain HK, Smith YR et al (2007) Müllerian duct anomalies: comparison of MRI diagnosis and clinical diagnosis. AJR Am J Roentgenol 189:1294–1302

    Article  Google Scholar 

  39. Oppelt P, Renner SP, Kellermann A et al (2006) Clinical aspects of Mayer–Rokitansky–Kuester–Hauser syndrome: recommendations for clinical diagnosis and staging. Hum Reprod 21:792–797

    Article  Google Scholar 

  40. Pittock ST, Babovic-Vuksanovic D, Lteif A (2005) Mayer–Rokitansky–Küster–Hauser anomaly and its associated malformations. Am J Med Genet Part A 135A:314–316

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Children’s Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #81, Los Angeles, CA, 90027, USA

    Patricia T. Acharya, Skorn Ponrartana, Lillian Lai & Fariba Goodarzian

  2. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Patricia T. Acharya, Skorn Ponrartana, Lillian Lai, Evalynn Vasquez & Fariba Goodarzian

  3. Loma Linda University School of Medicine, Loma Linda, CA, USA

    Patricia T. Acharya

  4. Department of Urology, Children’s Hospital Los Angeles, Los Angeles, CA, USA

    Evalynn Vasquez

Authors
  1. Patricia T. Acharya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Skorn Ponrartana
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lillian Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Evalynn Vasquez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fariba Goodarzian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patricia T. Acharya.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Acharya, P.T., Ponrartana, S., Lai, L. et al. Imaging of congenital genitourinary anomalies. Pediatr Radiol 52, 726–739 (2022). https://doi.org/10.1007/s00247-021-05217-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-021-05217-2

Keywords

Search

Navigation