Ultrasound in the diagnosis of hydronephrosis in infants and children

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Abstract
A series of 91 infants and children ranging in age from one day to 15 years and presenting a variety of urologic symptoms was examined by intravenous pyelography and ultrasonic scanning of the kidneys. Ultrasonic examinations were performed without knowledge of the indication for and results of pyelography, in order not to prejudice the interpretation of the results. Pyelography demonstrated hydronephrosis in 20 cases of 181 kidneys examined. The ultrasonic scanning demonstrated hydronephrosis in 19 of these 20 kidneys, the negative result being a case of minimal hydronephrosis. Six kidneys with radiographically dilated pelves were ultrasonically diagnosed as hydronephrosis in three, suspicion of hydronephrosis in one, pelvic dilatation in one and one kidney as normal. In eight kidneys with normal pyelography the ultrasonic scanning suggested hydronephrosis in five and pelvic dilatation in three cases. The criteria used were the demonstration of the dilated renal pelvis and to some extent separation of the calyceal echoes. The results indicate that ultrasonic examination can become a reliable screening procedure in infants and children with urologic symptoms.