How Reliable Are Imaging Study Reports in Assessing Pediatric Ureteropelvic Junction Obstruction? A Real-World Experience

Ali Sezer; Emre Kandemir; Bilge Türedi

doi:10.54233/endourolbull-1603830

How Reliable Are Imaging Study Reports in Assessing Pediatric Ureteropelvic Junction Obstruction? A Real-World Experience

Authors : Ali Sezer, Emre Kandemir, Bilge Türedi

Pages : 47-53

Doi:10.54233/endourolbull-1603830

View : 32 | Download : 33

Publication Date : 2025-05-30

Article Type : Research Paper

Abstract :Objective: Serial ultrasonography (US) and nuclear scintigraphy imaging are sufficient in the decision-making process in most ureteropelvic-juntion obstruction (UPJO) patients. Contrast-enhanced cross-sectional imaging (CE-CSI) can be used in uncertain indications or the presence of additional anatomical anomalies. We evaluate the effectiveness and reliability of pre-operative US and CE-CSI reports of UPJO patients who underwent pyeloplasty. Material and Methods: The data of pediatric patients under the age of 18 who underwent CE-CSI with suspicion of UPJO between March 2020-2024 and who subsequently underwent pyeloplasty were reviewed retrospectively. The patients were divided into two groups. Primarily, ultrasound and CE-CSI reports were compared, and secondarily, the initial and re-evaluated CE-CSI report findings were compared in terms of the reporting of crossing vessels (CV). Results: The data of 44 patients (23 boys and 21 girls) with a mean age of 8.1 years were reviewed. Ultrasound and CE-CSI reports were compared, and it was seen that significantly more parenchymal thickness information was reported in the CE-CSI group than in the US group (CE-CSI:31(70.5%), US:18(40.9%), p=0.007). Crossing vessels were reported in 10 patients (41.6%) in initial CE-CSI reports. After re-evaluation of images by a radiologist who cooperated with the pediatric urologist, CV was reported in 21 patients (87.5%), and the difference was statistically significant (p=0.003) Conclusion: Despite its disadvantages in the pediatric age group, the success of CE-CSI in revealing detailed anatomical information, particularly vascular anatomy, cannot be ignored. Our study demonstrated that investigating the presence of CV in pediatric patients with UPJO is crucial, particularly in older and symptomatic children. In CE-CSI, the results should be evaluated by an experienced uroradiologist.
Keywords : kesitsel görüntüleme, piyeloplasti, üreteropelvik bileşke darlığı, ultrason

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