The application of 3D Multislice Ultrasound in analysis of Fetal Urinary Tract Abnormalities

Abstract

Objectives : To evaluate 3D multislice ultrasound technology in detection of fetal urinary tract anomalies. Methods : Twentyfive patients with fetal urinary tract anomalies are included in this study. Fetuses were scanned in 2D, and 3D multislice technique prior to confirming the urinary tract abnormality. Fetal kidneys and bladder were analyzed in all 3 planes in 3D multislice mode in order to confirm urinary tract anomaly. Results : In one patient bilateral renal and bladder agenesis detected, associated with other severe anomalies as hydrocephalus, cleft lip, oligoamnion and single umbilical artery. Kariotyping confirmed triploidy. One fetus had marked megavesica. One fetus had multiple anomalies including microcystic kidneys associated with Trisomy 13. Another fetus had polycystic kidneys, and the third had polycystic kidney with contralateral renal and bladder agenesis. One fetus had microcystic kidneys and one had unilateral polycystic kidney. Two fetuses had ureteral stenosis and marked pyelectasia with contralateral normal kidney. 16 fetuses had marked pyelectasia. In one case there was progression from pyelectasia to unilateral hydronephrosis. Kariotyping in fetuses where pyelectasia occurred in second trimester showed no abnormality. Conclusions : 3D multislice ultrasound improve diagnostic capabilities in detection of fetal urinary tract anomalies. It improved discrimination of normal kidney from pathological types and 3D multislice allowed morphological analysis of fetal kidneys in various planes in order to obtain the best section for final diagnosis.