SONOGRAPHIC SEMIOTICS OF URETEROHYDRONEPHROSIS IN CHILDREN

Aim.To identify typical sonographic semiotics of ureterohydronephrosis in children having importance in determining the severity of disease and the choice of treatment strategy in this category of patients. Material and methods. Sonographic images of the kidneys and urinary tract of 158 children with ureterohydronephrosis were examined. Unilateral and bilateral ureterohydronephrosis was found in 75 and 83 children, respectively. There were 100 (63.3%) boys and 58 (36.7%) girls. The age of patients ranged from 3 months to 14 years (mean 4.15+3.21). Results. Ultrasound examination enables the upper 193 (80.1%) and lower 167 (69.3%) third of ureters to be visualized. At the same time more than half of the visualized ureters had a diameter greater than 1 cm, and one-tenth of the affected ureters had diameters greater than 2 cm. If direct visualization of the ureters was impossible, pelvicalyceal system was evaluated, which was expanded on the affected side in all examined children. The morpho-sonographic changes of renal parenchymal in children with III-IV degree ureterohydronephrosis are described in details. Conclusion. Ultrasound examination can be regarded as a screening method for initial evaluation of patients with ureterohydronephrosis. It provides a rough estimation of the extent, level and nature of disturbances of urinary excretion, a preliminary assessment of the renal parenchyma and identification of anomalies of the urinary tract. These findings can be useful in choosing an optimal algorithm of diagnosis and surgical treatment of the disease.

ureterohydronephrosis, children, ultrasound, kidneys, urinary tract