Siemens D R, Prouse K A, MacNeily A E, Sauerbrei E E
Department of Urology, Queen's University, Kingston, Ontario, Canada.
Tech Urol. 1998 Dec;4(4):198-201.
We tested the parameters of gestational age and renal pelvic anteroposterior (AP) diameter of antenatally detected pelvicaliectasis for their ability to determine insignificant postnatal renal pelvic dilatation. A retrospective analysis of 10,365 antenatal sonograms revealed 121 kidneys with pelvicaliectasis, from which 99 sonograms with sufficient postnatal follow-up were reviewed. Gestational ages were classified as <20, 20-30, or >30 weeks. Thresholds of renal pelvic AP diameter in each gestational period that were predictive of postnatal insignificance were determined to be <6, <8, and <10 mm, respectively. Insignificance postnatally was defined as no or minimal renal pelvic splitting (Society for Fetal Urology grade <II/IV). By categorizing the antenatal sonograms into gestational periods and varying the threshold of AP diameter in each period, the overall sensitivity, specificity, positive predictive value, and negative predictive value of these parameters were 89%, 96%, 95%, and 91%, respectively. We conclude that applying these parameters to antenatal pelvicaliectasis could ultimately provide a clinical management strategy that would aid in the prediction of an insignificant postnatal outcome and obviate unnecessary investigations, anxiety, and cost.
我们测试了产前检测到的肾盂扩张的胎龄和肾盂前后径参数，以确定其判断产后肾盂扩张无临床意义的能力。对10365份产前超声检查进行回顾性分析，发现121例肾脏存在肾盂扩张，其中99份超声检查有足够的产后随访资料并进行了复查。胎龄分为<20周、20 - 30周或>30周。各孕周预测产后无临床意义的肾盂前后径阈值分别确定为<6 mm、<8 mm和<10 mm。产后无临床意义定义为无或仅有轻微肾盂分离（胎儿泌尿外科学会分级<II/IV）。通过将产前超声检查按孕周分类并改变各孕周的前后径阈值，这些参数的总体敏感性、特异性、阳性预测值和阴性预测值分别为89%、96%、95%和91%。我们得出结论，将这些参数应用于产前肾盂扩张最终可提供一种临床管理策略，有助于预测产后无临床意义的结局，避免不必要的检查、焦虑和费用。
