Sutherland R W, Wiener J S, Roth D R, Gonzales E T
Scott Department of Urology, Texas Children's Hospital, Baylor College of Medicine, Houston.
J Urol. 1997 Sep;158(3 Pt 2):1265-7. doi: 10.1097/00005392-199709000-00158.
Renal anatomy and function are usually monitored in the myelomeningocele population using routine ultrasound as the child grows. Clinical questions arise when a renal unit is of marginal size when evaluated with nomograms derived from normal patient populations. Our goal was to construct a renal size nomogram using ultrasound for the myelomeningocele population to help the clinician identify abnormal growth.
We reviewed the charts and radiological files of 96 patients with myelomeningocele followed at our institution. Images of 930 renal units were included to construct the nomogram. Patients were excluded from study due to hydronephrosis or hydroureter, solitary kidney, recurrent symptomatic urinary tract infection, vesicoureteral reflux, reconstructive surgery or known high bladder storage pressure.
A renal size nomogram was constructed by plotting patient age against maximal renal length on real-time ultrasound. Expected mean and standard deviations were calculated for each age group.
Previous studies using excretory urography have shown that kidneys in the myelomeningocele population are smaller than in a healthy control population. Ultrasound is now the modality most commonly used to monitor renal anatomy. The creation of a renal nomogram based on ultrasound should help the clinician identify abnormal renal growth more accurately.
随着患有脊髓脊膜膨出的儿童成长，通常采用常规超声对其肾脏解剖结构和功能进行监测。当使用源自正常患者群体的列线图评估时，若肾单位大小处于临界值，就会出现临床问题。我们的目标是利用超声为脊髓脊膜膨出患者群体构建一个肾脏大小列线图，以帮助临床医生识别异常生长情况。
我们回顾了在本机构接受随访的96例脊髓脊膜膨出患者的病历和放射学档案。纳入了930个肾单位的图像以构建列线图。因肾盂积水或输尿管积水、单肾、复发性有症状尿路感染、膀胱输尿管反流、重建手术或已知膀胱高储尿压力而被排除在研究之外。
通过将患者年龄与实时超声下的最大肾脏长度进行绘图，构建了肾脏大小列线图。计算了每个年龄组的预期均值和标准差。
以往使用排泄性尿路造影的研究表明，脊髓脊膜膨出患者群体的肾脏比健康对照群体的肾脏小。超声现在是最常用于监测肾脏解剖结构的检查方式。基于超声创建的肾脏列线图应有助于临床医生更准确地识别肾脏异常生长情况。
