Division of Paediatric Urology, Department of Surgery, Children's Hospital of Eastern Ontario , Ottawa , Ontario , Canada.
Department of Medical Imaging, Children's Hospital of Eastern Ontario , Ottawa , Ontario , Canada.
J Urol. 2019 Aug;202(2):394-399. doi: 10.1097/JU.0000000000000264. Epub 2019 Jul 8.
The growing availability of modern-day imaging has resulted in an increase in the number of renal cysts detected in the pediatric population. Few publications have reported outcomes of these childhood cysts. In this study we assessed the prevalence and evolution of renal cysts in children, and described clinical characteristics, mode of presentation and ultimate outcomes.
Our institutional ultrasound database was searched for all abdominal ultrasound reports from 2006 to 2017. These reports were then cross-referenced with a manual retrospective chart review. Clinical characteristics including mode of presentation, cyst characteristics, and outcomes were analyzed using descriptive and nonparametric statistical methods.
Of 70,500 abdominal ultrasound scans during the study period 1,531 (2.2%) met the study inclusion criteria. Overall 26% of cysts were complex and 10.1% of cases were associated with hydronephrosis. Echogenic kidneys were more likely to be associated with simple cysts (p=0.0001). There was no difference between cyst diameter and symptomatology (p=0.82). The conversion of simple to complex renal cysts was less than 1% and 1.8% of complex cysts developed renal cell carcinoma.
In a large cohort of children who underwent abdominal imaging we found a 10-year renal cyst prevalence of 2.2%. Given that nearly all cysts follow a benign course and that simple cysts will invariably grow within 2 years, we believe that these cases could be safely discharged after that point. We continue to recommend surveillance for patients with cysts larger than 15 mm, complex cysts, family history of adult polycystic kidney disease or those with concomitant genitourinary anomalies requiring ongoing followup.
现代成像技术的日益普及导致儿童人群中检测到的肾囊肿数量增加。很少有文献报道这些儿童囊肿的结果。在这项研究中，我们评估了儿童肾囊肿的患病率和演变，并描述了临床特征、表现方式和最终结果。
我们的机构超声数据库搜索了 2006 年至 2017 年所有的腹部超声报告。然后，这些报告与手动回顾性图表审查进行交叉参考。使用描述性和非参数统计方法分析临床特征，包括表现方式、囊肿特征和结果。
在研究期间的 70500 次腹部超声扫描中，有 1531 次（2.2%）符合研究纳入标准。总体而言，26%的囊肿为复杂性，10.1%的病例与肾积水有关。回声增强的肾脏更可能与单纯性囊肿有关（p=0.0001）。囊肿直径与症状之间无差异（p=0.82）。单纯性肾囊肿向复杂性肾囊肿的转化不到 1%，1.8%的复杂性囊肿发展为肾细胞癌。
在接受腹部成像的一大群儿童中，我们发现 10 年肾囊肿患病率为 2.2%。鉴于几乎所有的囊肿都遵循良性过程，而且单纯性囊肿在 2 年内肯定会增大，我们认为这些病例在这之后可以安全出院。我们继续建议对囊肿大于 15 毫米、复杂性囊肿、成人多囊肾病家族史或伴有需要持续随访的泌尿生殖系统异常的患者进行监测。
