Sonographic Evaluation of Hydronephrosis in Pediatric Patients and Correlation with Intravenous Urography

Abstract

Introduction: This cross sectional study was carried out with an aim to evaluate the accuracy of ultrasonography (USG) in the evaluation of hydronephrosis (HDN) in pediatric age group. Methodology: The study was carried out from January 2017 to November 2017 in the Department of Radiology and Imaging, Sir Salimullah Medical Collage and Mitford Hospital, Dhaka. Eighty two patients aged from 1-18 years, admitted as suspected HDN were included as study subject. Result: In this study, the mean age of the patients was 6.31 (±3.34) years and 46.3% belonged to 5 years age group. Male and female ratio was approximately 2:1, 55 (67.1%) were male. Regarding the presenting complains, loin pain was most common (81.7%) feature. Recurrent urinary tract infection (URI) was observed in 52.4%, hematuria in 29.3%, flank mass in 18.3%, vomiting in 2.4% of the study patients. In every patient, with proper clinical evaluation, renal function test was done. After admission, in every patient USG and IVU was done in every patient. In IVU, it was found that 25.6% of cases had left sided HDN, 24.4% right sided HDN and 31.7% both sided HDN. In USG, out of 93 HDN cases in IVU, 85 were correctly diagnosed. The sensitivity was 91.4%. Out of 71 non-obstructed kidneys on USG, 68 were correctly assigned as non HDN, the specificity was 95.8%. Conclusion: This study findings showed USG to be a sensitive screening technique for excluding urinary tract obstruction.