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American Family Physician Sep 2020Urinary tract infections (UTIs) are common in children and are associated with significant short- and long-term morbidity. They have a high recurrence rate and are... (Review)
Review
Urinary tract infections (UTIs) are common in children and are associated with significant short- and long-term morbidity. They have a high recurrence rate and are associated with anatomic and functional abnormalities. The decision to test for UTI is based on risk factors and the child's age. Urinalysis is valuable to rule out UTI and to help decide when to start antibiotics; however, urine culture is needed for definitive diagnosis. Urine specimens collected via perineal bagging should not be used for culture because of high false-positive rates. Diagnosis of UTI requires pyuria and bacterial growth in the urine culture. Prompt treatment of UTIs reduces renal scarring. Antibiotic selection should be based on local sensitivity patterns and adjusted once culture results are available. In most cases, oral antibiotics are as effective as intravenous agents. When intravenous antibiotics are used, early transition to an oral regimen is as effective as longer intravenous courses. Kidney and bladder ultrasonography is helpful to identify acute complications and anatomic abnormalities. Voiding cystourethrography is indicated when ultrasound findings are abnormal and in cases of recurrent febrile UTIs. The use of antibiotic prophylaxis for recurrent UTIs is controversial. Identification and treatment of bowel and bladder dysfunction can prevent UTI recurrence.
Topics: Anti-Bacterial Agents; Child, Preschool; Culture Techniques; Female; Humans; Infant; Kidney; Male; Patient Selection; Recurrence; Ultrasonography; Urinalysis; Urinary Bladder; Urinary Tract Infections; Urography
PubMed: 32866365
DOI: No ID Found -
Annals of the Royal College of Surgeons... Sep 1977It is essential to distinguish between an obstructed and an unobstructed hydronephrosis as the management of the two types is quite different. Some of the radiographic...
It is essential to distinguish between an obstructed and an unobstructed hydronephrosis as the management of the two types is quite different. Some of the radiographic and isotopic methods of distinguishing these two leave much to be desired and the place of dynamic studies is discussed. The aetiology of pelviureteric junction obstruction remains uncertain, but it is probable that one or more of several factors may be involved and these are discussed. The types of hydroenphrosis are classified as chronic, intermittent, unsuspected, equivocal, and reflux-induced.
Topics: Adolescent; Adult; Chronic Disease; Female; Humans; Hydronephrosis; Male; Ureteral Obstruction; Urography
PubMed: 900795
DOI: No ID Found -
Journal of the Royal Society of Medicine Jul 1979
Topics: Diagnosis, Differential; Humans; Hypertension; Retroperitoneal Fibrosis; Retroperitoneal Neoplasms; Steroids; Urography
PubMed: 552544
DOI: 10.1177/014107687907200703 -
European Radiology Nov 2005With the advent of multi-detector row CT scanners, evaluation of the urothelium of the entire urinary tract with high-resolution thin sections during a single...
With the advent of multi-detector row CT scanners, evaluation of the urothelium of the entire urinary tract with high-resolution thin sections during a single breath-hold has become a reality. Multidetector CT urography (MDCTU) is a single examination that allows evaluation of potential urinary tract calculi, renal parenchymal masses, and both benign and malignant urothelial lesions. Initial results with this new technique are encouraging. Current investigations of MDCTU focus on methods to improve opacification and distension of the upper urinary tract-the collecting systems, pelvis, and ureters. The role of abdominal compression, infusion of saline and/or furosemide, and optimal time delay of excretory phase imaging is being explored. Upper tract urothelial malignancies, including small lesions less the 5 mm in diameter, can be detected with high sensitivity. Methods to reduce radiation exposure are being explored, including split-bolus contrast injection techniques that combine nephrographic and excretory phases into a single phase. It is likely that in the near future, radiological evaluation of significant unexplained hematuria or of known or prior urothelial malignancy will consist of a single examination--MDCTU.
Topics: Contrast Media; Humans; Radiation Dosage; Sensitivity and Specificity; Tomography, X-Ray Computed; Urography; Urologic Diseases
PubMed: 16479653
DOI: 10.1007/s10406-005-0114-9 -
Kidney International Aug 2016
Topics: Adult; Creatinine; Cystography; Cystoscopy; Edema; Foot; Glomerular Filtration Rate; Hemoglobins; Humans; Hypertension; Lipomatosis; Magnetic Resonance Imaging; Male; Rare Diseases; Tomography, X-Ray Computed; Ultrasonography; Urethra; Urinary Bladder; Urinary Bladder Diseases; Urography
PubMed: 27418096
DOI: 10.1016/j.kint.2016.05.009 -
Pediatric Radiology Feb 2022The goal of functional renal imaging is to identify and quantitate irreversible renal damage and nephron loss, as well as potentially reversible hemodynamic changes. MR... (Review)
Review
The goal of functional renal imaging is to identify and quantitate irreversible renal damage and nephron loss, as well as potentially reversible hemodynamic changes. MR urography has evolved into a comprehensive evaluation of the urinary tract that combines anatomical imaging with functional evaluation in a single test without ionizing radiation. Quantitative functional MR imaging is based on dynamic contrast-enhanced MR acquisitions that provide progressive, visible enhancement of the renal parenchyma and urinary tract. The signal changes related to perfusion, concentration and excretion of the contrast agent can be evaluated using both quantitative and qualitative measures. Functional evaluation with MR has continued to improve as a result of significant technical advances allowing for faster image acquisition as well as the development of new tracer kinetic models of renal function. The most common indications for MR urography in children are the evaluation of congenital anomalies of the kidney and urinary tract including hydronephrosis and renal malformations, and the identification of ectopic ureters in children with incontinence. In this paper, we review the underlying acquisition schemes and techniques used to generate quantitative functional parameters including the differential renal function (DRF), asymmetry index, mean transit time (MTT), signal intensity versus time curves as well as the calculation of individual kidney glomerular filtration rate (GFR). Visual inspection and semi-quantitative assessment using the renal transit time (RTT) and calyceal transit times (CTT) are fundamental to accurate diagnosis and are used as a basis for the interpretation of the quantitative data. The importance of visual assessment of the images cannot be overstated when analyzing the quantitative measures of renal function.
Topics: Child; Humans; Kidney; Kidney Pelvis; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Urography
PubMed: 35022851
DOI: 10.1007/s00247-021-05264-9 -
The British Journal of Radiology Apr 2022Excretory urography (EU) had been the most frequently performed imaging modality for uroradiology in the past. With the advances in ultrasonography, and development of... (Review)
Review
Excretory urography (EU) had been the most frequently performed imaging modality for uroradiology in the past. With the advances in ultrasonography, and development of cross-sectional urography with CT and MRI, EU is now seldom performed. Consequently, there has been a decline of expertise in this technique. However, EU has multiple advantages such as dynamic nature, easy availability, low cost and radiation burden. These render it potentially very valuable in specific indications like congenital anomalies, urothelial lesions and urinary leaks. This review intends to emphasize the current day relevance of excretory urography, outline the key points of the technique, and describe the pearls and pitfalls of interpretation.
Topics: Cross-Sectional Studies; Humans; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Ultrasonography; Urography
PubMed: 34990261
DOI: 10.1259/bjr.20210949 -
Journal of Postgraduate Medicine 1998We report a case of circumcaval ureter diagnosed preoperatively by 'fish-hook' appearance on intravenous pyelogram. At surgery, patient was treated by 'Anderson Hones'...
We report a case of circumcaval ureter diagnosed preoperatively by 'fish-hook' appearance on intravenous pyelogram. At surgery, patient was treated by 'Anderson Hones' pyeloplasty leaving the retrocaval segment in-situ.
Topics: Adult; Humans; Male; Ureter; Urography; Urologic Surgical Procedures
PubMed: 10703562
DOI: No ID Found -
Proceedings of the Royal Society of... Jun 1956
Topics: Motion Pictures; Urography
PubMed: 13336046
DOI: No ID Found -
British Medical Journal Aug 1977
Topics: Cystoscopy; Hematuria; Humans; Urine; Urography
PubMed: 890334
DOI: 10.1136/bmj.2.6084.445