Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia 30342, USA.
J Urol. 2011 Sep;186(3):1059-64. doi: 10.1016/j.juro.2011.04.105. Epub 2011 Jul 23.
The contralateral kidney is abnormal in up to 25% of patients with multicystic dysplastic kidney. Traditionally, anatomical and functional evaluation of the contralateral kidney has been performed with ultrasound and dimercapto-succinic acid renal scintigraphy, as indicated. Recently magnetic resonance urography has been used to evaluate renal anatomy and function in other urological abnormalities. We compared the results of magnetic resonance urography and ultrasound for evaluating the contralateral kidney in patients with multicystic dysplastic kidney and we describe the range of findings detected.
Patients with multicystic dysplastic kidney who underwent magnetic resonance urography were identified. Anatomical findings on magnetic resonance urography were analyzed and compared to those on renal ultrasound. Additional functional information derived from magnetic resonance urography was also recorded.
We retrospectively identified 58 patients with a unilateral multicystic dysplastic kidney who had undergone magnetic resonance urography, of whom 54 also underwent ultrasound. Of the patients 19 (32.8%) had a contralateral abnormality. A discrepancy between magnetic resonance urography and ultrasound was seen in 9 patients (16.7%). Of these patients only 1 had a completely normal contralateral kidney by ultrasound on retrospective review. The incidence and range of parenchymal abnormalities was wider than previously reported.
Contralateral abnormalities in children with multicystic dysplastic kidney are common and more definitively evaluated with magnetic resonance urography vs ultrasound. Renal ultrasound remains the most appropriate modality for the initial evaluation of children with multicystic dysplastic kidney, and magnetic resonance urography is recommended when a functional study is required either to confirm the diagnosis of multicystic dysplastic kidney or to evaluate suspected abnormalities of the contralateral kidney.
在多达 25%的多囊性发育不良肾患者中，对侧肾脏异常。传统上，对侧肾脏的解剖和功能评估是通过超声和二巯基琥珀酸肾闪烁显像术进行的，视情况而定。最近，磁共振尿路成像已用于评估其他泌尿科异常的肾脏解剖和功能。我们比较了磁共振尿路成像和超声在评估多囊性发育不良肾患者对侧肾脏中的结果，并描述了所检测到的发现范围。
确定了接受磁共振尿路成像检查的多囊性发育不良肾患者。分析磁共振尿路成像的解剖学发现，并与肾脏超声进行比较。还记录了磁共振尿路成像得出的其他功能信息。
我们回顾性地确定了 58 例单侧多囊性发育不良肾患者接受了磁共振尿路成像检查，其中 54 例也接受了超声检查。在这些患者中，有 19 例（32.8%）存在对侧异常。磁共振尿路成像与超声之间存在差异的患者有 9 例（16.7%）。在这些患者中，只有 1 例在回顾性检查时超声显示对侧肾脏完全正常。实质异常的发生率和范围比以前报道的更广泛。
在多囊性发育不良肾的儿童中，对侧异常很常见，磁共振尿路成像比超声更能明确评估。肾脏超声仍然是评估多囊性发育不良肾儿童的初始最适当的方法，当需要功能研究来确认多囊性发育不良肾的诊断或评估对侧肾脏的可疑异常时，建议使用磁共振尿路成像。
