A 5-year audit of 778 neonatal renal scans (Part 1): perplexing pyelectasis and suggested protocol for investigation.
In this 5-year review of 778 neonatal renal scans seen in an Obstetric Hospital, most infants were referred because of antenatal ultrasound findings, 92% with fetal pyelectasis. The results were classified according to the ultrasound findings. The majority of neonates (76%) had a normal postnatal scan. A number had vesicoureteric reflux (VUR) found on a micturating cystourethrogram. Persistant mild to moderate pyelectasis or hydronephrosis (15%) proved to be a normal variant in many infants, but had a similar appearance to those with an early obstructive cause (1%). Pyelectasis has proved to be a poor predictor of VUR. A protocol outlining paediatric management for neonates with persisting pyelectasis is included. There were 59 infants (8%) with a miscellaneous group of renal anomalies, many with a characteristic antenatal ultrasound appearance suggesting the diagnosis. These infants have been separately reported and illustrated (Part 2). Overall, 13% of infants were found to have significant findings of obstruction, VUR or miscellaneous anomalies affecting management.
Acton
Christine
C
Department of Medical Imaging, Mercy Hospital for Women, East Melbourne, Victoria, Australia. cmaryday@hotmail.com
Pahuja
Monica
M
Opie
Gillian
G
Woodward
Alan
A
D002985:Clinical Protocols; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D007682:Kidney Pelvis / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008297:Male; D008485:Medical Audit; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*