title: Ultrasonography and renography to visualize upper urinary tract in children with meningomyelocele - a prospective study.
abstract: OBJECTIVE
  Ultrasonography (US) is commonly used to visualize the upper urinary tract in children and adolescents with meningomyelocele (MMC). The aim of this investigation was to prospectively evaluate US in those with spinal angulation or obesity and compare it to the corresponding results obtained by mercaptoacetyltriglycine renography.
  
  
  METHODS
  Twenty-five children and adolescents with MMC and pronounced angulation of the spine or obesity, were prospectively investigated with both US and renography during the period 2006 to 2008.
  
  
  RESULTS
  In 13 (52%) patients the kidneys could not be fully evaluated; in 4 (16%) neither renal size nor pelvic dilation, in 12 (48%) renal length and in 5 (20%) dilation was not accessible. In 23 individuals where dilatation could be evaluated uni- or bilaterally, US was compared to OEE% (%outflow excretion efficiency) at renography. In 1 of these individuals there was normal OEE% while slight dilatation on US was noticed. In 2/15 individuals, split function at renography did not correlate with renal length on US.
  
  
  CONCLUSIONS
  Severe spinal angulation and obesity in individuals with MMC reduced the possibility to evaluate the urinary tract by US. However, it seems that renography could be a reliable alternative to evaluate renal condition in those patients where US is insufficient.
authors.affiliation: The Pediatric Uro-Nephrologic Centre, The Queen Silvia Children's Hospital, Sahlgrenska Academy, University of Gothenburg, SE-416 85 Gothenburg, Sweden.
authors.forename: Kate
authors.initials: K
authors.lastname: Abrahamsson
authors.forename: Eira
authors.initials: E
authors.lastname: Stokland
authors.forename: Rune
authors.initials: R
authors.lastname: Sixt
authors.forename: Ulf
authors.initials: U
authors.lastname: Jodal
mesh_terms: D000293:Adolescent; D002648:Child; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008591:Meningomyelocele / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D011866:Radioisotope Renography / Q000379:methods*; D015203:Reproducibility of Results; D014463:Ultrasonography; D014551:Urinary Tract / Q000000981:diagnostic imaging*