Current Treatment Options in Pediatrics

, Volume 4, Issue 1, pp 1–13 | Cite as

Update on Pediatric Kidney and Urinary Tract Imaging

  • Jonathan R. Dillman
  • Andrew T. Trout
Urology (P Reddy and B Vanderbrink, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Urology



This paper will review the current roles of imaging for assessing the pediatric kidneys and urinary tract, while emphasizing recent trends and advances in imaging techniques.

Recent findings

Imaging aids in the diagnosis, assessment, and follow-up of the spectrum of congenital and developmental, infectious and inflammatory, traumatic, neoplastic, vascular, and acquired renal and urinary tract conditions. While ultrasound is the workhorse imaging modality for evaluating the kidneys and urinary tract in the pediatric population, magnetic resonance imaging, computed tomography, nuclear scintigraphy, and abdominal radiography also play particular roles. Numerous recent advances have improved the diagnostic capabilities of these modalities.


Imaging plays an important role in the management of children and young adults with suspected and known renal and urologic abnormalities.


Children Kidneys Urinary tract Imaging Ultrasound 


Compliance with Ethical Standards

Conflict of Interest

Jonathan R. Dillman declares that he has no conflict of interest. Andrew T. Trout declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    American College of Radiology (ACR) Appropriateness criteria—hematuria—child: American College of Radiology; [Available from:].
  2. 2.
    Combs AJ, Van Batavia JP, Chan J, Glassberg KI. Dysfunctional elimination syndromes--how closely linked are constipation and encopresis with specific lower urinary tract conditions? J Urol. 2013;190(3):1015–20. Scholar
  3. 3.
    Dillman JR, Kappil M, Weadock WJ, Rubin JM, Platt JF, DiPietro MA, et al. Sonographic twinkling artifact for renal calculus detection: correlation with CT. Radiology. 2011;259(3):911–6. Scholar
  4. 4.
    Kim HK, O'Hara S, Je BK, Kraus SJ, Horn P. Feasibility of superb microvascular imaging to detect high-grade vesicoureteral reflux in children with urinary tract infection. Eur Radiol. 2018;28(1):66–73.
  5. 5.
    Palmeri ML, Nightingale KR. Acoustic radiation force-based elasticity imaging methods. Interface Focus. 2011;1(4):553–64. Scholar
  6. 6.
    Dillman JR, Smith EA, Davenport MS, DiPietro MA, Sanchez R, Kraft KH, et al. Can shear-wave elastography be used to discriminate obstructive hydronephrosis from nonobstructive hydronephrosis in children? Radiology. 2015;277(1):259–67. Scholar
  7. 7.
    Sağlam D, Bilgici MC, Kara C, Yılmaz GC, Çamlıdağ İ. Acoustic radiation force impulse elastography in determining the effects of type 1 diabetes on pancreas and kidney elasticity in children. AJR Am J Roentgenol. 2017;209(5):1143–49.
  8. 8.
    Bekci T, Ceyhan Bilgici M, Genc G, Tekcan D, Veysel Polat A, Tomak L. Evaluation of renal parenchyma elasticity with acoustic radiation force impulse quantification in nutcracker syndrome and comparisons with grayscale Doppler sonography and laboratory findings. J Ultrasound Med. 2017;36(1):61–7. Scholar
  9. 9.
    • Piskunowicz M, Swieton D, Rybczynska D, Czarniak P, Szarmach A, Kaszubowski M, et al. Comparison of voiding cystourethrography and urosonography with second-generation contrast agents in simultaneous prospective study. J Ultrason. 2016;16(67):339–47. This article shows that voiding urosonography using micrubble contrast material instilled into the bladder has similar diagnostic perforamnce to voiding cystourethrography, but without ionizing radiation. .
  10. 10.
    •• Nguyen HT, Benson CB, Bromley B, Campbell JB, Chow J, Coleman B, et al. Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system). J Pediatr Urol. 2014;10(6):982–98. This manuscript presents a newly developed classification system for describing and following prenatal and postnatal urinary tract dilation. .
  11. 11.
    Myers MT, Elder JS, Sivit CJ, Applegate KE. Unenhanced helical CT in the evaluation of the urinary tract in children and young adults following urinary tract reconstruction: comparison with sonography. Pediatr Radiol. 2001;31(3):135–9. Scholar
  12. 12.
    Sade R, Ogul H, Eren S, Levent A, Kantarci M. Comparison of ultrasonography and low-dose computed tomography for the diagnosis of pediatric urolithiasis in the emergency department. Eurasian J Med. 2017;49(2):128–31. Scholar
  13. 13.
    Zhang GM, Sun H, Xue HD, Xiao H, Zhang XB, Jin ZY. Prospective prediction of the major component of urinary stone composition with dual-source dual-energy CT in vivo. Clin Radiol. 2016;71(11):1178–83. Scholar
  14. 14.
    Chow LC, Kwan SW, Olcott EW, Sommer G. Split-bolus MDCT urography with synchronous nephrographic and excretory phase enhancement. AJR Am J Roentgenol. 2007;189(2):314–22. Scholar
  15. 15.
    Dillman JR, Caoili EM, Cohan RH, Ellis JH, Francis IR, Nan B, et al. Comparison of urinary tract distension and opacification using single-bolus 3-phase vs split-bolus 2-phase multidetector row CT urography. J Comput Assist Tomogr. 2007;31(5):750–7. Scholar
  16. 16.
    Chan DP, Abujudeh HH, Cushing GL Jr, Novelline RA. CT cystography with multiplanar reformation for suspected bladder rupture: experience in 234 cases. AJR Am J Roentgenol. 2006;187(5):1296–302. Scholar
  17. 17.
    Karmazyn B, Gurram S, Marine MB, Mathew WR, Cain MP, Rink RC, et al. Is CT cystography an accurate study in the evaluation of spontaneous perforation of augmented bladder in children and adolescents? J Pediatr Urol. 2015;11(5):267.e1-6CrossRefPubMedGoogle Scholar
  18. 18.
    Glockner JF, Takahashi N, Kawashima A, Woodrum DA, Stanley DW, Takei N, et al. Non-contrast renal artery MRA using an inflow inversion recovery steady state free precession technique (Inhance): comparison with 3D contrast-enhanced MRA. J Magn Reson Imaging. 2010;31(6):1411–8. Scholar
  19. 19.
    Angeretti MG, Lumia D, Cani A, Barresi M, Nocchi Cardim L, Piacentino F, et al. Non-enhanced MR angiography of renal arteries: comparison with contrast-enhanced MR angiography. Acta Radiol. 2013;54(7):749–56. Scholar
  20. 20.
    Ananthan K, Onida S, Davies AH. Nutcracker syndrome: an update on current diagnostic criteria and management guidelines. Eur J Vasc Endovasc Surg. 2017;53(6):886–94. Scholar
  21. 21.
    Zucker EJ, Ganguli S, Ghoshhajra BB, Gupta R, Prabhakar AM. Imaging of venous compression syndromes. Cardiovasc Diagn Ther. 2016;6(6):519–32. Scholar
  22. 22.
    Liang KW, Chen JW, Huang HH, Su CH, Tyan YS, Tsao TF. The performance of noncontrast magnetic resonance angiography in detecting renal artery stenosis as compared with contrast enhanced magnetic resonance angiography using conventional angiography as a reference. J Comput Assist Tomogr. 2017;41(4):619–27. Scholar
  23. 23.
    • Dickerson EC, Dillman JR, Smith EA, DiPietro MA, Lebowitz RL, Darge K. Pediatric MR urography: indications, techniques, and approach to review. Radiographics. 2015;35(4):1208–30. This review article presents state-of-the-art MRI techniques for assessing the pediatric kidneys and urianry tract, including common indications for MR imaging. .CrossRefPubMedGoogle Scholar
  24. 24.
    Khrichenko D, Darge K. Functional analysis in MR urography—made simple. Pediatr Radiol. 2010;40(2):182–99. Scholar
  25. 25.
    Figueroa VH, Chavhan GB, Oudjhane K, Farhat W. Utility of MR urography in children suspected of having ectopic ureter. Pediatr Radiol. 2014;44(8):956–62. Scholar
  26. 26.
    Treves ST, Gelfand MJ, Fahey FH, Parisi MT. 2016 update of the North American consensus guidelines for pediatric administered radiopharmaceutical activities. J Nucl Med. 2016;57(12):15N–8N.PubMedGoogle Scholar
  27. 27.
    Subcommittee on Urinary Tract Infection SCoQI, Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128(3):595–610. Scholar
  28. 28.
    Gordon I, Piepsz A, Sixt R. Auspices of Paediatric Committee of European Association of Nuclear M. Guidelines for standard and diuretic renogram in children. Eur J Nucl Med Mol Imaging. 2011;38(6):1175–88. Scholar
  29. 29.
    Faure A, London K, Smith GH. Early mercaptoacetyltriglycine(MAG-3) diuretic renography results after pyeloplasty. BJU Int. 2016;118(5):790–6. Scholar
  30. 30.
    Jaksic E, Bogdanovic R, Artiko V, Saranovic DS, Petrasinovic Z, Petrovic M, et al. Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis. Ann Nucl Med. 2011;25(1):37–43. Scholar
  31. 31.
    Hardy RD, Austin JC. DMSA renal scans and the top-down approach to urinary tract infection. Pediatr Infect Dis J. 2008;27(5):476–7. Scholar
  32. 32.
    Bernhardt MB, Moffett BS, Johnson M, Tam VH, Thompson P, Garey KW. Agreement among measurements and estimations of glomerular filtration in children with cancer. Pediatr Blood Cancer. 2015;62(1):80–4. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA

Personalised recommendations