Sonography of renal venous thrombosis in neonates and infants: can we predict outcome?
BACKGROUND
The relationship between sonographic features of renal venous thrombosis (RVT) and outcome has not been described in a large series of patients.


OBJECTIVE
To analyze sonographic findings of RVT and their evolution in a large series of patients and to attempt to identify features that might predict outcome.


METHODS
Retrospective analysis of sonograms and medical records of neonates and infants diagnosed with RVT during the period 1998-2007.


RESULTS
Of 22 children (mean age: 3 days; age range: 0-107 days), RVT was bilateral in 12. Of 34 affected kidneys, thrombus in the main renal vein was seen in 17 and typical RVT sonographic findings without main renal vein thrombus were seen in the remaining 17. All children had US follow-up (range: 0.6-97.2 months). Three children with bilateral RVT died. Nine kidneys atrophied. Imaging findings associated with subsequent kidney atrophy included markedly reduced perfusion at diagnosis, subcapsular collections, patchy cortical echotexture and profoundly hypoechoic and irregular renal pyramids. Six patients (eight kidneys) presented with renal calcifications on initial sonogram before 7 days of life, suggesting antenatal RVT.


CONCLUSIONS
Sonography is useful in neonatal and early infant RVT and might help predict renal atrophy. Antenatal RVT appears to be relatively common.
Kraft
Jeannette K
JK
Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
Brandão
Leonardo R
LR
Navarro
Oscar M
OM
D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D011379:Prognosis; D012082:Renal Veins / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000473:pathology