Grading nephroureteral dilatation detected in the first year of life: Correlation with obstruction

M. Maizels*, M. E. Reisman, L. S. Flom, J. Nelson, S. Fernbach, C. F. Firlit, J. J. Conway

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

94 Scopus citations

Abstract

To understand better the significance of pediatric idiopathic nephroureteral dilatation the renal ultrasound images of patients less than 1 year old with hydronephrosis or hydroureteronephrosis were graded and compared to the radiological diagnosis of obstruction as determined by diuresis renography and/or urography. The study included 73 boys and 30 girls with hydronephrosis (76 patients) or hydroureteronephrosis (27). For hydronephrosis obstruction was diagnosed in 56 children (74%) and involved 61 of 97 kidneys (63%). For obstructed kidneys the mean grade of hydronephrosis (3.4 ± 0.7 standard deviation) was statistically different from that of nonobstructed kidneys (1.6 ± 0.8 standard deviation) (p <0.05). When the value to predict obstruction was set at grade 3 hydronephrosis or greater there was an 88% sensitivity and 95% specificity. For hydroureteronephrosis obstruction was diagnosed in 15 of 27 children (56%) and involved 17 of 34 kidneys (50%). The degree of dilatation was weighed as a score to assess the grades of hydronephrosis and ureteral dilatation, namely hydroureteronephrosis score equals grade of hydronephrosis plus grade of ureteral dilatation. In obstructed megaureters the mean hydroureteronephrosis score (5.8 ± 1.0) was statistically different from that for nonobstructed megaureters (mean hydroureteronephrosis score 2.7 ± 1.9) (p <0.001). When the value to predict obstruction was set at hydroureteronephrosis score of 5 or greater there was a 94% sensitivity and 80% specificity. Although ultrasound examination alone cannot be used to diagnose urinary obstruction, the radiological diagnosis of obstruction is linked with the grade of hydronephrosis or score of hydroureteronephrosis.

Original languageEnglish (US)
Pages (from-to)609-614
Number of pages6
JournalJournal of Urology
Volume148
Issue number2 II
DOIs
StatePublished - 1992

Keywords

  • hydronephrosis
  • prenatal diagnosis
  • renography
  • ultrasonic diagnosis

ASJC Scopus subject areas

  • Urology

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