What's new in pediatric uroradiology.

The diagnosis and treatment of infants and children with urinary tract abnormalities have recently been affected by three developments. First, hydronephrosis can be detected in the fetus on obstetrical ultrasonography. Prenatal detection has resulted in a marked increase in the number of neonates referred for uroradiologic evaluation. Ureteropelvic junction (UPJ) obstruction, ureterovesical junction obstruction (UVJ), and reflux have been found to be the most common causes of hydronephrosis. Prophylactic antibiotics begun soon after delivery can prevent infection and its sequelae. Second, multicystic dysplastic kidney can now be accurately diagnosed preoperatively by a combination of ultrasonography and renal scintigraphy. This diagnostic certainty makes the decision to remove such a kidney a philosophical one. Third, it has been learned that reflux is sometimes familial. Nuclear cystography is an accurate and efficient method for screening asymptomatic family members.