What are the CT findings associated with pyelonephritis? Contrast-enhanced CT is less sensitive than renal cortical scintigraphy for the detection of acute infection. Acute infection is seen as wedge-shaped areas of decreased attenuation in the kidney. Areas of scar related to prior infection can also be identified. CT is particularly helpful when abscess formation is …
What are the findings on a renal cortical scintigraphic study in acute and chronic infection? A renal cortical scintigraphic study reveals parenchymal defects in children with acute infection secondary to focal areas of edema and inflammation. These defects revert to normal if the process completely resolves. In chronic infection or chronic pyelonephritis secondary to reflux …
What diagnostic tests are useful for the detection of acute and chronic pyelonephritis in children? Renal cortical scintigraphy, contrast-enhanced computed tomography (CT), and renal US are used to detect acute and chronic pyelonephritis in children. Pyelonephritis may be difficult to diagnose accurately, especially in infants and young children who cannot give a history. It may …
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What is dysfunctional voiding? Dysfunctional voiding may be due to a neurogenic bladder or the so-called pediatric unstable bladder. The bladder may show variable degrees of wall thickening, trabeculation, and alteration in contour and storage capacity. Bladder-sphincter dyssynergia may be indicated by the presence of a dilated posterior urethra caused by the external sphincter failing …
Vesicoureteral reflux What is primary Vesicoureteral reflux? VUR occurs either primarily or secondarily. Primary VUR is due to “immaturity” or abnormality of the ureterovesical junction (UVJ), which allows urine to ascend into the ureters during bladder filling or voiding. Generally, reflux is related to ureteral orifice size and the length of the ureter as it …
What is voiding urosonography? Pediatric imagers are currently looking to offer voiding urosonography as an alternative to fluoroscopic or radionuclide voiding cystography. With this technique, which avoids the use of ionizing radiation, fluid containing microbubbles is instilled into the urinary bladder; VUR reaching the kidneys can be readily detected utilizing US. What are the pros …
How is Voiding Cystourethrogram performed? The bladder is catheterized using sterile technique, and under fluoroscopy, the bladder is filled to capacity with iodinated contrast material. An approximation of the expected normal bladder capacity (mL) in a child is calculated by (age [in years] + 2) × 30. The catheter is removed, and the child voids …