Imaging assessment of renal injuries in children and adolescents: CT or ultrasound?

Abstract

BACKGROUND:

Since the introduction of the ALARA ("as low as reasonably achievable") concept, ultrasound (US) has been progressively advocated for paediatric diagnostic imaging. This study aimed to analyse the role and accuracy of US in paediatric renal trauma.

METHODS:

From 1999 to 2009, the tertiary-care-hospital database was retrospectively evaluated for renal trauma with regards to aetiology, type of injury, diagnostics, management and outcome.

RESULTS:

Forty-seven patients (29 males, 18 females; median age=14years, range 1-17 years) were identified. US was initially applied in 45 patients with correct results in 86.6%. Computed tomography (CT) was performed in 16 patients in the acute trauma setting - complementary to US in 14 cases, with a diagnostic accuracy of 93%. Most renal injuries were grade I° (n=30), followed by grade III° (n=8), IV° (n=5), and II°/V° (n=2 each). All patients were initially managed conservatively and followed by US. Clinical deterioration necessitated surgery in four patients (2 nephrectomies, 1 partial nephrectomy, 1 urinoma drainage). The outcome was generally favourable with a renal preservation rate of 95%.

CONCLUSION:

With respect to the ALARA principle, US can be safely and reliably applied as the first-line diagnostic imaging technique and for follow-up for suspected traumatic paediatric renal injuries.

• Authors: Eva Elisa Amerstorfer, Axel Haberlik, Michael Riccabona
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 50 Issue 3 Pg. 448-55 (Mar 2015) ISSN: 1531-5037 [Electronic] United States
• PMID: 25746706 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Age Factors
• Child
• Child, Preschool
• Drainage
• Female
• Humans
• Infant
• Kidney (diagnostic imaging, injuries, surgery)
• Male
• Nephrectomy
• Retrospective Studies
• Time Factors
• Tomography, X-Ray Computed
• Ultrasonography
• Urinoma (therapy)