title: Diagnostic accuracy of renal pelvic dilatation in determining outcome of congenital hydronephrosis.
abstract: BACKGROUND
  The widespread use of prenatal ultrasonography results in increased recognition of congenital hydronephrosis, a therapeutic and diagnostic challenge. This study was conducted to investigate the natural course of prenatal hydronephrosis and the accuracy of postnatal APD in determining the outcome.
  
  
  METHODS
  All newborns with prenatal hydronephrosis were followed up by ultrasonography after birth. Voiding cystoureterography, diethylene triaamine pentaacetic acid renal scintigraphy, and dimercaptosuccinic acid renal scintigraphy were done if indicated. The receiver operating characteristic curve was plotted to determine the best cutoff for the anterior-posterior pelvic diameter (APD) to distinguish surgical from spontaneously resolving group.
  
  
  RESULTS
  Of 178 neonates, 42 (23%) required surgery. The area under the curve for APD to predict the need for surgery was 0.925 with an APD cutoff of 15 mm. The diagnostic value of APD for determining the need for surgery was determined by sensitivity and specificity of 95.2% and 73.5%, respectively.
  
  
  CONCLUSIONS
  Postnatal APD on ultrasonography has a valuable diagnostic accuracy for requiring surgery and provides a useful guide for parental counseling.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Sharifian
authors.affiliation: Department of Pediatric Nephrology, Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. nasrinesfandiar@gmail.com.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Esfandiar
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Mohkam
authors.forename: Reza
authors.initials: R
authors.lastname: Dalirani
authors.forename: Elaheh
authors.initials: E
authors.lastname: Baban Taher
authors.forename: Arezu
authors.initials: A
authors.lastname: Akhlaghi
mesh_terms: D002675:Child, Preschool; D003937:Diagnosis, Differential; D004106:Dilatation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital / Q000000981:diagnostic imaging*; D007223:Infant; D007231:Infant, Newborn; D007682:Kidney Pelvis / Q000000981:diagnostic imaging*; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal