Pelvic Dilatation Research Articles

Are DMSA Scans Reliable for Diagnosing Vesicoureteral Reflux in Infants and Children?

A retrospective study for data record of 106 patients subjected to voiding cystourethrogram test (VCUG), sonography test, and dimercaptosuccinic acid (DMSA) scintigraphy take place at King Abdulaziz University, radiology department to find out the possibilities of detecting vesicoureteral reflux (VUR) in infants and children. Hydronephrosis & Renal pelvis dilatation were the highest frequency reason for VUR scan study and represent 36% of the overall cases with 53% positive finding, while Recurrent UTI frequency was 22.6% with 83% positive finding, and patients who had history of VUR come at the third place with 15% frequency and 81% positive finding. VUR was found in 65 of 106 children representing 61%. Male children are more likely to diagnostic with VUR than female and they represented 69% while 31% for female. Among the children with VUR, 39 had high-grade reflux (grade IV or V), while 26 had low-grade reflux (grades I, II or III). When we classified VUR into low-grade and high-grade, we found the majority of children with high-grade VUR had an abnormal DMSA and represented 77.4%, while 13 children with low-grade VUR had normal study. These studies are agreed with the present study; most children with normal DMSA scan finding had low grade reflux. In this study, 48 of 65 children (74%) the DMSA scintigraphy shows abnormal findings during the period of UTI while the VCUG scan study shows VUR in 75% of the children during the period of UTI. Comparing results of ultrasound and VCUG scan, 59% of the ultrasound findings gave the same result as VCUG in detecting the VUR in children. Then we confirm it all with the urine culture results of the same children. We found the majority of children with VUR had abnormal US finding during the period of UTI and represented 83%.

Conservative management of obstructive uropathy secondary to stones

Obstructive uropathy is defined as structural obstruction to urine flow along the urinary tract. It can lead to dilatation of renal pelvis and calyces. (1). However renal pelvis can be dilated without obstruction. Therefore hydronephrosis and dilated renal pelvis are not synonymous terms. The damage to renal tissue caused by these conditions often leads to obstructive nephropathy contributing to renal failure (2) and if treated early is a potentially reversible form of kidney disease. (3).The most common cause for obstructive uropathy is renal stones. Obstructive uropathy can be unilateral, bilateral or can be classified as acute or chronic.

Right renal pelvic calculus mimicking an extrarenal pelvis

A 57-year-old man presented with recurrent intermittent colicky right flank pain of 1-year duration. Intravenous urogram (IVU) on two separate occasions suggested a right-sided, extrarenal pelvis. However, when pain became recurrent and persistent, he had a non-contrast computed tomography (CT) examination, which revealed a calculus in the renal pelvis. Diagnosis was missed in the initial imaging modalities because apart from the dilated pelvis, there was no evidence of hydronephrosis or calculus seen, hence a diagnosis of extrarenal pelvis. This case report highlights the superior utility of CT in imaging of suspected urolithiasis, especially when the patient remains symptomatic. Radiologists should be wary, especially in symptomatic patients with features of extrarenal pelvis on IVU.

Revisiting Imaging and Pathology of Malignant Appearing Uterine Smooth Muscle Tumors: A Mistaken Identity of Leiomyosarcoma on MRI

Uterine leiomyoma is a relatively common condition occurring in a majority of African American and Caucasian women by age 50. Magnetic resonance imaging of the pelvis with contrast is the modality of choice when evaluating uterine tumors. We report a case of a patient with a four-day history of intra-menstrual vaginal bleeding who underwent magnetic resonance imaging of the pelvis that suggested the tumor was a leiomyosarcoma, the malignant counterpart of leiomyoma. Therefore, the patient underwent pre-operative uterine artery embolization to decrease blood loss with exploratory laparotomy, resection of pelvic mass and dilation and curettage. Pathologic evaluation of the mass returned a diagnosis of leiomyoma. Magnetic resonance imaging evaluation of leiomyomata remains difficult. Further development of imaging parameters could improve diagnosis of benign uterine fibroids.

Investigation and identification of etiologies involved in the development of acquired hydronephrosis in aged laboratory mice with the use of high-frequency ultrasound imaging.

Laboratory mice develop naturally occurring lesions that affect biomedical research. Hydronephrosis is a recognized pathologic abnormality of the mouse kidney. Acquired hydronephrosis can affect any mouse, as it is caused by any naturally occurring disease that impairs free urine flow. Many etiologies leading to this condition are of particular significance to aging mice. Non-invasive ultrasound imaging detects renal pelvic dilation, renal enlargement, and parenchymal loss for pre-mortem identification of this condition. High-frequency ultrasound transducers produce high-resolution images of small structures, ideal for detecting organ pathology in mice. Using a 40 MHz linear array transducer, we obtained high-resolution images of a diversity of pathologic lesions occurring within the abdomen of seven geriatric mice with acquired hydronephrosis that enabled a determination of the underlying etiology. Etiologies diagnosed from the imaging results include pyelonephritis, neoplasia, urolithiasis, mouse urologic syndrome, and spontaneous hydronephrosis, and were confirmed at necropsy. A retrospective review of abdominal scans from an additional 149 aging mice shows that the most common etiologies associated with acquired hydronephrosis are mouse urologic syndrome and abdominal neoplasia. This report highlights the utility of high-frequency ultrasound for surveying research mice for age-related pathology, and is the first comprehensive report of multiple cases of acquired hydronephrosis in mice.

Prenatal Diagnosis of Severe Fetal Renal Pelvic Dilatation and Treatment with Double Pig Tail Catheter

Introduction: Fetal urinary tract obstructions require feto-amniotic shunting with percutaneous vesico centesis or Double Pig Tail Catheter (DPTC) draining fetal urine to the amnion, mainly used to treat low urinary tract obstructions and though is associated to high morbidity; if it is early applied maintains permeable the urinary tract, prolongs fetal life and prevents maternal complications. There are few fetal patients with upper urinary tract obstructions treated by DPTC reported. We report a fetal patient with severe upper urinary obstruction due to ureteric-pelvic stenosis, derived to amnion with a DPTC. Case: A 19 years old women with 30 weeks of gestation was sent with diagnosis of an abdominal giant cystic in the fetus. The Ultrasound (US) confirmed the presence of a cystic abdominal mass of 10 cm by 10 cm, associated to left renal dilatation, the right kidney was ectopic and dilated forming the cystic mass secondary to an upper urinary tract obstruction, the bladder was normal displaced to the left. An US guided insertion of a DPTC was successfully done at 32 weeks of gestation. The pregnancy ended at 37 weeks with a 2,600 g female newborn, without abdominal cyst and normal creatinine. A follow up by the Pediatric Surgical Department until 18 months old observed normal serum creatinine levels. Conclusion: A successful installation of a DPTC in a 32 weeks of gestation fetus released a severe upper urinary tract obstruction maintaining permeable after borne.

Clinical characteristics and outcomes of antenatal fetal intra-abdominal umbilical vein varix detection.

ObjectiveThis study reviewed clinical characteristics of fetal intra-abdominal umbilical vein (FIUV) varices that were detected during antenatal ultrasound examinations.MethodsBetween January 2006 and January 2012, 121 cases of FIUV varices were detected and 7 cases were lost to follow-up. We retrospectively reviewed the medical records of 114 patients and neonates.ResultsFrom a total 96,553 ultrasound examinations in 43,995 pregnancies, 121 cases of FIUV varices were identified (2.8 per 1,000 pregnancies). Gestational age at diagnosis was 32.0 ± 2.9 weeks (range, 20.1-36.3 weeks), the mean diameter of the FIUV varix was 12.6 ± 2.1 mm (range, 8.0-21.0 mm) at initial diagnosis and the mean maximal diameter was 13.1 ± 2.3 mm (range, 8.0-21.0 mm) during follow-up. The most severe pregnancy complications included one case of intrauterine fetal death and another case of fetal hydrops. Associated fetal anomalies (n = 11, 9.6%) detected by ultrasonography included bilateral renal pelvis dilatation, ventriculomegaly, cryptorchidism, incomplete renal duplication and pulmonary sequestration. A total of 104 cases (91.2%) were delivered at term and 10 cases (8.8%) were preterm deliveries before 37 weeks of gestation.ConclusionFIUV varices that are not associated with fetal anomalies based on ultrasound examination during prenatal care have favorable pregnancy outcomes. Nevertheless, close fetal monitoring is recommended to decrease perinatal complications.

Comment to “Urinary tract disease in dogs: US findings. A mini-pictorial essay”

Comment to “Urinary tract disease in dogs: US findings. A mini-pictorial essay”

Comparison of the reliability of two hydronephrosis grading systems: The Society for Foetal Urology grading system vs. the Onen grading system

To compare the reliability of the conventional ultrasonography grading system for hydronephrosis as suggested by the Society for Fetal Urology (SFU) in 1993 and that developed by Onen in 2007. One hundred and eighty kidneys in 90 paediatric patients were assessed by four radiologists using each of the two grading systems twice. The SFU system was graded 0-4 (0=no hydronephrosis; 1=visualized only renal pelvis; 2=plus a few caliceal dilatation; 3=all calyceal dilatation; 4=plus parenchymal thinning). The Onen system was graded 0-4 (0=no hydronephrosis; 1=only renal pelvic dilatation; 2=plus caliceal dilatation; 3=plus <50% renal parenchymal loss; 4=plus >50% renal parenchymal loss). Cohen's kappa statistic was used to estimate intra- and interobserver agreement. The weighted least-squares approach was used to compare the intra-observer agreement, and bootstrapping was used to compare the interobserver agreement between the two systems. Intra-observer agreement was substantial to almost perfect in both the SFU (κ0.79-0.95) and the Onen (κ 0.66-0.97) grading system without difference. The overall interobserver agreement was substantial in both the SFU (κ 0.61-0.68) and the Onen (κ0.66-0.76) grading system. However, interobserver agreement was fair to moderate for SFU grades 1 and 2 and Onen grades 2 and 3. Both the SFU and Onen grading system are reliable with good intra- and interobserver agreement. However, decreased interobserver agreement was demonstrated for SFU grades 1 and 2 and Onen grades 2 and 3.

Ultrassonografia Doppler na avaliação renal de cadelas diagnosticadas com piometra antes e após tratamento com ovariosalpingohisterectomia

O objetivo do presente estudo foi avaliar a hemodinâmica renal de cadelas com piometra por meio de exames laboratoriais, ultrassonografia Modo B e Doppler, antes e após o tratamento cirúrgico com ovariosanpigohisterectomia (OSH). Foram utilizadas 30 cadelas com diagnóstico de piometra, todas foram submetidas a OSH (momento 1) e 20 foram reavaliadas sete dias após a cirurgia (momento 2). A perfusão renal, o índice de resistividade da artéria renal principal e de cada artéria interlobar (cranial, média e caudal) foi estatisticamente diferente entre os momentos 1 e 2 (p&lt;0,05). Não foi observada diferença estatística para a perfusão renal entre o rim direito e esquerdo no momento 1 e 2. As correlações entre o índice de resistividade da artéria renal principal e as variáveis utilizadas para verificar a função renal foram estabelecidas no momento 1. Para as variáveis correlacionadas ureia, creatinina, proteinúria, relação GGT/creatinina e proteína/creatinina ocorreram associações curvilíneas e positivas com o índice de resistividade da artéria renal principal (p&lt;0,05), no entanto essas correlações foram consideradas de média e fracas. Ao comparar o IR da artéria renal principal com diferentes escores de desidratação e perfusão renal, este foi estatisticamente diferente, e demonstrou aumento da resistência renal em cadelas com moderada redução da perfusão renal, assim como em cadelas desidratadas. Foram avaliadas diversas características de morfologia renal na ultrassonografia Modo B, no entanto, somente as variáveis presença de dilatação de pelve, sinal da medular e outras alterações como áreas de infartos e pontos hiperecogênicos difusos na cortical e medular renal foram estatisticamente distintas de um momento para o outro, com maior frequência no momento 2. Os resultados do presente trabalho demonstram que a ultrassonografia Doppler pode identificar alterações de redução na perfusão renal, por meio do Doppler colorido e o aumento do índice de resistividade das artérias renais em cadelas com piometra. Assim como, a ultrassonografia modo B, embora apresente alterações inespecíficas, pode detectar alterações renais progressivas em cadelas com piometra.

This Month in Pediatric Urology

No AccessJournal of UrologyThis Month in Pediatric Urology1 Aug 2013This Month in Pediatric Urology Michael L. Ritchey Michael L. RitcheyMichael L. Ritchey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.04.080AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "This Month in Pediatric Urology." The Journal of Urology, 190(2), pp. 375–376 References 1 : Effect of preoperative hormonal stimulation on postoperative complication rates after proximal hypospadias repair: a systematic review. J Urol2013; 190: 652. Link, Google Scholar 2 : Renal transplantation into a diverted urinary system—is it safe in children?. J Urol2013; 190: 678. Abstract, Google Scholar 3 : Diagnostic accuracy of renal pelvic dilatation for detecting surgically managed ureteropelvic junction obstruction. J Urol2013; 190: 661. Link, Google Scholar 4 : Incidence, significance and natural history of persistent retrograde venous flow after varicocelectomy in children and adolescents: correlation with catch-up growth. J Urol2013; 190: 689. Link, Google Scholar 5 : Reproducibility and reliability of semen analyses in youths at risk for infertility. J Urol2013; 190: 683. Link, Google Scholar © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 190Issue 2August 2013Page: 375-376 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael L. Ritchey More articles by this author Expand All Advertisement Loading ...

Postnatal Assessment of the Infants with Antenally Detected Renal Pelvic Dilation

Of the 280 patients, 70 (25 %) were female and 210 (75 %) were male. Mean follow up duration was 16.3±18.6 months (6-127 months). Of the 350 renal units with RPD in postnatal USG, 197 (56.3 %) were mild, 84 (24 %) were moderate and 69 (19.7 %) were severe . Among the infants with mild dilation non-obstructive pelvic dilation (n= 95: 70.4 %), vesicoureteral reflux (VUR) (n= 14: 10.4 %), ureteropelvic junction obstruction (UPJO) (n= 12: 8.9 %), ureterovesical junction obstruction (UVJO) (n= 3: 2.2 %), and posterior ureteral valve (PUV) (n=1: 0.7 %) were detected. In the moderate dilation group, non-obstructive pelvic dilation (n=29:44.7 %), VUR (n=15: 23%), UPJO (n=12: 18.5 %), UVJO (n=1:1.5 %), and PUV (n=3: 4.7 %) were encountered. In the severe dilation group, were non-obstructive pelvic dilation (n=10:13.2 %), VUR (n=5 :9.6 %), UPJO (n= 18: 34.6 %), UVJO (1:1.9 %), and PUV (n= 5: 9.6 %) were observed. RPD disappeared in 34.9 % of renal units with mild dilation on follow up and pd decreased in 26.4 %, was increased in 9% and remained stable in 29.7 % of the cases, respectively. The rate of spontaneous resolution of VUR was 34 %. Renal function deteriorated in 1 patient with PUV. Conclusion: Majority of mild or moderate antenatal RPD is due to non-obstructive pelvic dilation and VUR. Antenatal US is a sensitive method to detect urinary tract abnormalities with only 10 % false positive results.

Obstetric Ultrasound: Errors and Pitfalls in the Second Trimester of Pregnancy

The majority of fetal malformations has confirmed his diagnosis in routine obstetric ultrasound examination or during the morphological examination of the second trimester of pregnancy. The aim of this essay is demonstrate the possible errors and pitfalls in ultrasound diagnosis in the second trimester of pregnancy with emphasis on fetal malformations. The cases were selected retrospectively from the personal archive of the authors, cases and situations experienced that can lead to misinterpretation by the sonographer to illustrate and discuss the sonographic diagnostic criteria defined in the literature. Some variations of normal in the second trimester of pregnancy, birth and choroid plexus cysts, cystic adenomatoid malformation, cystic hygroma, pelvic dilatation, changes in amniotic fluid can be resolved and lead to misinterpretation. Knowledge of this variability is crucial for the correct diagnosis. Ultrasonography is the most appropriate method of screening for abnormalities in the second trimester of pregnancy with high specificity in diagnosing malformations. However, the lack of care and embryological landmarks and sonographic aspects usual for their gestational age may lead to misinterpretation.

Pielonefrite Bilateral Crônica Em Um Porquinho Da Índia - Aspecto Ultrassonográfico

The purpose of this report is the description of the sonographic appearance of chronic pyelonephritis in a guinea pig, not previously reported, and important by the growing presence of these animals in the clinical routine. A 2-year-old female animal of the specie Cavia porcellus with a history of recurrent cystitis was referred for ultrasound due to suspicion of pyelonephritis. Ultrasonography revealed kidneys with preserved dimensions and well-defined and regular borders, when compared to exams of healthy animals of the same specie. During the examination, there were marked increase in echogenicity of the medullar region and bilateral renal pelvis dilation, which measured 0.38 and 0.41 cm in diameter in the left and right kidney, respectively. Patients affected by acute pyelonephritis may present hyperechogenic focal areas in medullar region or irregular hypoechoic and/or hyperechoic areas in renal cortex. In the animal of this report, however, a generalized increase in echogenicity of the medullar region was identified, possible due to the chronicity of pyelonephritis. The dilation of the renal pelvis observed on the ultrasound of this patient also contributed to the diagnosis of chronic pyelonephritis since in most acute cases, this alteration is not detected.

Educational Exhibit Abstract No. 381 - Magnetic resonance (MR) evaluation of dilated pelvic veins: what the vascular and interventional radiologist needs to know

Learning Objectives 1. Identify various clinical conditions which cause pelvic venous dilatation and/or obstruction. 2. Describe the anatomic abnormality associated with each clinical condition and provide MR and correlative conventional angiographic examples of each abnormality. 3. Discuss the utility of MR angiography in planning potential endovascular interventions for such venous abnormalities, with a specific focus on the use of blood pool contrast agents in MR angiography. Background Recently developed MR blood pool contrast agents, such as gadofoscecet (Ablavar™), have markedly less extracellular distribution than their predecessors, a property that allows for steady-state high-resolution imaging of veins and complex venous lesions. In this presentation, we will illustrate how gadofoscecet use enhances the MR characterization of venous anomalies and abnormalities. Improved MR characterization facilitates not only proper diagnosis of but also the appropriate planning for endovascular interventions which treat pelvic vein obstruction. Clinical Findings/Procedure Details We will present MR and correlative conventional angiography examples of venous anomalies and abnormalities resulting in pelvic venous dilatation and/or obstruction, including: congenital caval anomalies, inferior vena cava stenosis stenosis from chronic iliocaval thrombosis, May-Thurner (Cockett) syndrome, nutcracker syndrome, gonadal vein reflux, venous obstruction secondary to mass effect from extrinsic anatomic structures. Conclusion and/or Teaching Points (1) Pelvic venous dilation is commonly caused by venous anomalies or abnormalities which can be diagnosed noninvasively using MR angiography. (2) MR blood pool contrast agents, such as gadofoscecet (Ablavar™), enhance MR characterization of venous anomalies and abnormalities by opacifying their full geographic extent as well as providing information regarding directionality of venous flow. (3) MR angiography is a useful, if not critical, tool in pre-procedure planning of endovascular treatment of pelvic vein obstruction.

Effects of Tolterodine and Trospium Chloride on Renal Damage Induced by Partial Upper Urinary Tract Obstruction

To examine the efficacy of trospium chloride and tolterodine on the renal parenchymal inflammatory process and upper urinary dilation in rats with chronic partial upper urinary tract obstruction. A total of 32 rats were divided into 4 groups: group 1, control; group 2, obstruction; group 3, obstruction plus tolterodine; and group 4, obstruction plus trospium chloride. In all groups, except for group 1, partial upper urinary tract obstruction was induced by embedding the upper quarter of the right ureter into the psoas muscle for 14 days. At the end of the experiment, the rats were killed. The catalase, malondialdehyde, and protein carbonyl levels were determined in renal tissue. Tubular dilation and parenchymal inflammation were evaluated using hematoxylin-eosin staining. Smooth muscle actin and cytoglobin were examined with immunohistochemical staining. The obstruction group demonstrated severe pelvic dilation and parenchymal inflammation and increased smooth muscle actin staining in the wall of upper urinary tract (P<.05). The treatment of the rats with tolterodine and trospium chloride markedly attenuated the inflammatory alterations and reduced tubular dilation. This treatment also reduced elevated oxidative stress product levels and restored the depleted renal antioxidant enzyme. These findings imply that increased renal pelvic pressure can contribute to renal parenchymal injury in chronic pelvic upper urinary tract obstruction. Antimuscarinic medications such as tolterodine and trospium chloride exert renoprotective effects, probably by prevention of pelvic pressure increases.

Gross anatomical study of bilateral megaureters associated with renal pelvis dilatation and a giant urinary bladder: an adult cadaver with a brief review of the literature

Although bilateral megaureters are not an infrequent occurrence in the urinary tract, bilateral megaureters associated with bilateral renal pelvis dilatation and a giant urinary bladder appear to be rare. In this paper, a cadaver case of an adult Japanese male with bilateral megaureters is described. In addition to describing and illustrating this case, the anatomy and etiology of these anomalous structures is discussed with a brief review of the literature.

Renal pelvis rupture in a kidney with ureteropelvic junction obstruction and extrarenal calyces

The extrarenal calyx (ERC) is a rare congenital anomaly, associated with various other abnormalities of the urogenital system. We report a unique case of ERC in a solitary functioning kidney with a massively dilated pelvis that developed spontaneous rupture. A dismembered pyeloplasty was performed at the time of rupture. The patient did well post-operatively with a stable creatinine and stable SFU grade 2 hydronephrosis.

Diagnostic Accuracy of Renal Pelvic Dilatation for Detecting Surgically Managed Ureteropelvic Junction Obstruction

In this study we evaluate the diagnostic accuracy of renal pelvic dilatation for detecting infants with prenatal hydronephrosis who will need surgical intervention for ureteropelvic junction obstruction during followup. Between 1999 and 2010, 371 newborns diagnosed with isolated prenatal hydronephrosis were prospectively followed. The main event of interest was the need for pyeloplasty. Diagnostic odds ratio, sensitivity, specificity and diagnostic accuracy (assessed by AUC) of fetal renal pelvic dilatation and postnatal renal pelvic dilatation were evaluated. A total of 312 patients were included in the analysis and 25 (7.5%) infants underwent pyeloplasty. The diagnostic performance for detecting the need for pyeloplasty was excellent for all ultrasonography measurements. The AUC was 0.96 (95% CI 0.92-0.98) for fetal renal pelvic dilatation, 0.97 (95% CI 0.95-0.98) for postnatal renal pelvic dilatation and 0.95 (95% CI 0.92-0.97) for the Society for Fetal Urology grading system. A cutoff of 18 mm for fetal renal pelvic dilatation and a cutoff of 16 mm for postnatal renal pelvic dilatation had the best diagnostic odds ratio to identify infants who needed pyeloplasty. Considering a diagnosis to be positive only if fetal renal pelvic dilatation was greater than 18 mm and postnatal dilatation was greater than 16 mm, sensitivity was 100% and specificity was 86% (95% CI 80.7-89.9). Our findings suggest that the combination of fetal and postnatal renal pelvic dilatation is able to increase the diagnostic accuracy for detecting infants who need a more comprehensive postnatal investigation for upper urinary tract obstruction.

Reproducibility of fetal renal pelvis volume assessed by three‐dimensional ultrasonography with two different measurement techniques

To evaluate reproducibility of fetal renal pelvis volume as assessed by the Virtual Organ Computer Aided AnaLysis (VOCAL) imaging program and by Automatic Volume Calculation (SonoAVC). In addition, the intra- and interobserver reliability of fetal renal pelvis volume measurements with SonoAVC were established. In this study, the fetal renal pelvis volume was measured using 3D ultrasonography in 76 kidneys of 66 fetuses with renal pelvis dilatation in the second or third trimester of pregnancy. After volume acquisition by one observer, the reproducibility of volume calculation was assessed using VOCAL imaging program and SonoAVC by two observers. Intra- and interobserver reproducibility was evaluated by calculating intraclass correlation coefficients (ICC), coefficient of variation (CV) and repeatability coefficient (r). Bland-Altman plots were generated to explore agreement. A high degree of reproducibility was observed between VOCAL and SonoAVC, ICC of 0.989; 95% CI 0.983-0.993, respectively. Intraobserver reproducibility of volume measurements performed by SonoAVC demonstrated a high degree of reliability with ICC of 0.995 (95% CI 0.993-0.997), CV 6.05% and r of 0.75. The interobserver reproducibility with ICC of 0.995 (95% CI 0.992-0.997), CV 10.14% and r 1.21 was also indicative of good reliability. Volume measurements of fetal renal pelvis performed by SonoAVC renders reproducible measurements in comparison with the VOCAL imaging program. There is no significant difference between VOCAL imaging program and SonoAVC. The intra- and interobserver reliability of the fetal renal pelvis measurements made by SonoAVC were considered to be very good. SonoAVC, however, needs post processing in the majority of cases but is less time consuming than VOCAL.