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儿童主要肾脏和泌尿系统疾病的影像学诊断

Imaging Diagnosis of Major Kidney and Urinary Tract Disorders in Children.

作者信息

Aldughiem Ahmad

机构信息

Department of Nephrology, Wright State University, Dayton Children's Hospital, One Children's Plaza, Dayton, OH 45404, USA.

出版信息

Medicina (Kaunas). 2025 Apr 10;61(4):696. doi: 10.3390/medicina61040696.

Abstract

: Diagnostic imaging is essential for evaluating urinary tract disorders, offering critical insights into renal pathology. This review examines the strengths, limitations, and clinical applications of various imaging modalities, with a focus on pediatric populations. : A narrative review was conducted, synthesizing current literature on ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, and voiding cystourethrography (VCUG). Relevant studies were selected based on diagnostic accuracy, clinical utility, and safety considerations. : US is the preferred first-line imaging due to its safety, accessibility, and cost-effectiveness. CT excels in detecting renal calculi, trauma, and malignancies but is limited by radiation exposure. MRI offers superior soft tissue contrast without radiation but is costly and often requires sedation. Nuclear medicine evaluates renal function and scarring, while VCUG remains the gold standard for diagnosing vesicoureteral reflux and posterior urethral valves. : Imaging modalities are vital for diagnosing and managing urinary tract disorders, with selection based on clinical needs, patient age, and safety. Ultrasound is the primary choice for its non-invasiveness and cost-effectiveness, while CT, MRI, nuclear medicine, and VCUG provide essential structural and functional insights. A balanced approach ensures accuracy while minimizing patient risk, especially in pediatrics.

摘要

诊断成像对于评估泌尿系统疾病至关重要,能提供有关肾脏病理学的关键见解。本综述探讨了各种成像方式的优势、局限性及临床应用,重点关注儿科人群。进行了一项叙述性综述,综合了有关超声(US)、计算机断层扫描(CT)、磁共振成像(MRI)、核医学及排尿性膀胱尿道造影(VCUG)的当前文献。基于诊断准确性、临床实用性和安全性考虑选择相关研究。超声因其安全性、可及性和成本效益而成为首选的一线成像方法。CT在检测肾结石、创伤和恶性肿瘤方面表现出色,但受辐射暴露限制。MRI提供出色的软组织对比度且无辐射,但成本高昂且通常需要镇静。核医学评估肾功能和瘢痕形成,而VCUG仍是诊断膀胱输尿管反流和后尿道瓣膜的金标准。成像方式对于诊断和管理泌尿系统疾病至关重要,其选择基于临床需求、患者年龄和安全性。超声因其非侵入性和成本效益而成为主要选择,而CT、MRI、核医学和VCUG提供重要的结构和功能见解。一种平衡的方法可确保准确性,同时将患者风险降至最低,尤其是在儿科患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ed0/12028883/bcfc4e01e1b1/medicina-61-00696-g014.jpg

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