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产前和产后泌尿道扩张:标准化超声定义和分类的优势

Prenatal and postnatal urinary tract dilation: advantages of a standardized ultrasound definition and classification.

作者信息

Pelliccia Piernicola, Sferrazza Papa Simone, Cavallo Federica, Tagi Veronica Maria, Di Serafino Marco, Esposito Francesco, Persico Antonello, Vezzali Norberto, Vallone Gianfranco

机构信息

Department of Pediatrics, University of Chieti-Pescara, Chieti, Italy.

Department of Emergency Radiology, Antonio Caldarelli Hospital, Naples, Italy.

出版信息

J Ultrasound. 2019 Mar;22(1):5-12. doi: 10.1007/s40477-018-0340-3. Epub 2018 Nov 27.

Abstract

Urinary tract dilatation is identified sonographically in 1-2% of fetuses and reflects a spectrum of possible nephro-uropathies. There is significant variability in the clinical management of individuals with prenatal urinary tract dilatation to postnatal urinary pathologies, because of a lack of consensus and uniformity in defining and classifying urinary tract dilation. Ultrasonography is the first step to screen and diagnose kidneys and the urinary tract diseases of the children. The need for a correct ultrasound approach led to the realization of algorithms aimed at standardizing the procedures, the parameters and the classifications. Our objective was to highlight the strengths of the Classification of Urinary Tract Dilation (UTD) suggested by the Consensus Conference which took place in 2014 with the participation of eight Scientific Societies and was subsequently published on the Journal of Pediatric Urology. Before its spread out, the definition of UTD was not uniform and the ultrasonographic measurements were not clearly defined, leading to misunderstandings between physicians. The Classification by the Consensus Conference of 2014 represents a revolutionary tool for the diagnosis and management of UTD. Furthermore, the parameters suggested by the classification proposed are applicable for both prenatal and postnatal classification, ensuring a correct follow-up in children with UTD whose diagnosis had been already made during pregnancy.

摘要

超声检查发现1%-2%的胎儿存在泌尿道扩张,这反映了一系列可能的肾-尿路疾病。由于在产前泌尿道扩张至产后尿路疾病的个体临床管理方面缺乏共识和统一标准,导致其临床管理存在显著差异。超声检查是筛查和诊断儿童肾脏及尿路疾病的第一步。为了正确进行超声检查,人们开发了旨在规范检查程序、参数和分类的算法。我们的目的是强调2014年由八个科学学会参与的共识会议提出的泌尿道扩张(UTD)分类的优势,该分类随后发表在《小儿泌尿外科杂志》上。在其推广之前,UTD的定义并不统一,超声测量也没有明确界定,导致医生之间产生误解。2014年共识会议的分类是诊断和管理UTD的革命性工具。此外,该分类提出的参数适用于产前和产后分类,确保对孕期已确诊UTD的儿童进行正确的随访。

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