title: Value of diagnosis imaging in the evaluation of the severity of histological lesions in duplex systems.
abstract: OBJECTIVE
  In order to determine the effectiveness of imagery in the assessment of the severity of histological lesions in duplex systems in children we compared histology results from heminephrectomies with diagnosis imaging findings [renal ultrasound (US), scintigraphy, unenhanced and contrast-enhanced magnetic resonance imagery (MRI)].
  
  
  METHODS
  Between 2007 and 2013, 34 children with duplex system underwent surgery. The results from US (n = 34), dimer captosuccinic acid scintigraphy (n = 23) and MRI (n = 16) were compared with histological data. Five histological lesions were found (chronic interstitial inflammation, interstitial fibrosis, tubular atrophy, glomerulosclerosis and dysplasia) and categorized as severe (>25%) or moderate (≤ 25%).
  
  
  RESULTS
  Severe histological lesions were found in 76.5% and moderate lesions in 23.5%. Radiological features were compared with histological results. In US, severe parenchymal thinning was associated with chronic interstitial inflammatory. The absence of parenchymal enhancement and/or severe cortical thinning in MR urography (MRU) was significantly associated with interstitial fibrosis. All poorly functioning poles were associated with severe histological lesions (p = 0.091), but not to a specific category of lesions.
  
  
  CONCLUSIONS
  MRI sensibility was excellent (90%) in the diagnosis of poorly functioning pole. Severe thinning on US and minimal pole function on MRU can be used to predict the severity of histological lesions.
authors.affiliation: Department of Pediatric Surgery, Hospital Nord, APHM, Aix-Marseille University, Chemin des Bourrely, Marseille 13015, France. Electronic address: alice.faure@ap-hm.fr.
authors.forename: Alice
authors.initials: A
authors.lastname: Faure
authors.affiliation: Department of Pediatric Surgery, Hospital Nord, APHM, Aix-Marseille University, Chemin des Bourrely, Marseille 13015, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Merrot
authors.affiliation: Department of Nuclear Medicine, Hospital Timone, APHM, Aix-Marseille University, Marseille, France.
authors.forename: Quentin
authors.initials: Q
authors.lastname: Sala
authors.affiliation: Department of Medical Imaging, Hospital Nord, APHM, Aix-Marseille University, Marseille, France.
authors.forename: Kathia
authors.initials: K
authors.lastname: Chaumoitre
authors.affiliation: Department of Pediatric Surgery, Hospital Timone, APHM, Aix-Marseille University, Marseille, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Guys
authors.affiliation: Department of Pediatric Radiology, Hospital Timone, APHM, Aix-Marseille University, Marseille, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Bourliere-Najean
authors.affiliation: Department of Pathology, Hospital Timone, APHM, Aix-Marseille University, Marseille, France.
authors.forename: Julia
authors.initials: J
authors.lastname: Torrents
authors.affiliation: Department of Nuclear Medicine, Hospital Timone, APHM, Aix-Marseille University, Marseille, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Mundler
authors.affiliation: Department of Urology, Hospital Conception, APHM, Aix-Marseille University, Marseille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Lechevallier
authors.affiliation: Department of Pediatric Surgery, Hospital Nord, APHM, Aix-Marseille University, Chemin des Bourrely, Marseille 13015, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Alessandrini
mesh_terms: D001707:Biopsy, Needle; D002675:Child, Preschool; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007674:Kidney Diseases / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000379:methods; D016016:Proportional Hazards Models; D011877:Radionuclide Imaging / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D018608:Ultrasonography, Doppler / Q000379:methods; D014518:Ureterocele / Q000175:diagnosis / Q000601:surgery; D014567:Urography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Duplex systems; Magnetic resonance urography; Pole nephrectomy; Split renal function; Ureterocele