MULTISPIRAL COMPUTER TOMOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF CONGENITAL URETHEROIDHYDRONEFROSIS IN CHILDREN

Aim To identify the characteristic MSCT signs of pediatric ureterohydronephrosis allowing to assess the disease severity and differentiate between its various forms. Material and methods Sixty five children with III-IV grade ureterohydronephrosis underwent a comprehensive examination including MSCT urography. The study comprised 40 (61.5%) boys and 25 (38.5%) girls aged 3 months to 14 years (mean age 4.15±3.21 years). Results Obstructive disease was detected in 38 (58.5%) children, 27 (41.5%) patients had vesicoureteral reflux (VUR). Bilateral ureterohydronephrosis was found in 31 (47.7%) patients, unilateral - in 34 (52.3%). Twelve (35.3%) and twenty two (64.7%) patients had the rightsided and left-sided disease, respectively. Comparative analysis of MSCT signs of obstructive ureterohydronephrosis and VUR allowed for defining several distinctive symptoms which afford to accurately differentiate between the two pathological conditions. Conclusion Multispiral computed tomography has a high sensitivity and specificity in detecting malformations of the urinary tract, making it possible to accurately differentiate obstructive ureterohydronephrosis from the VUR which plays an important role in assessing the disease severity and selecting a surgical strategy.

ureterohydronephrosis, children, multispiral computed tomography