The use of ultrasound screening for the detection of urinary tract abnormalities in apparently healthy four-month-old infants in Chiba city

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  • 千葉市４カ月健診腎エコーにおけるスクリーニング基準の設定―乳児腎エコーの普及に向けて―
  • ―乳児腎エコーの普及に向けて―

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Abstract

Ultrasound screening was performed in 2806 apparently healthy four-month-old infants in Chiba city (males 1435, females 1371). Seventy-seven infants (2.7%) underwent a further ultrasound examination following the initial screening assessment.<br>Of these, 49 infants (1.7%) exhibited 6 mm or more splitting of the renal central echo complex (CEC) with 24 infants (0.86%) exhibiting greater than grade II hydronephrosis as defined by the Society for Fetal Urology (SFU). In these 24 infants, 6 had ureteropelvic junction stenosis, 2 had megaureter (ureterovesical junction stenosis), and 2 had vesicoureteral reflux (VUR). Of the 77 infants, 21 infants (0.75%) had a renal length less than 3 standard deviations and/or a difference in renal length of more than 1 centimeter. In these 21 infants, 3 had unilateral renal hypoplasia (1 case associated with bilateral VUR), and 1 had a double pelvis and ureter. Four infants exhibited a solitary kidney in the first examination, but subsequently 1 case was found to have an ectopic hypoplastic kidney accompanied by bilateral grade IV VUR.<br>Finally 18 infants (0.64%) exhibited urinary tract abnormalities. Three infants underwent surgical correction, 1 of them having the possibility of future deterioration of renal function (bilateral ureterovesical junction stenosis).<br>In conclusion, a significant level of urinary tract abnormalities was detected following ultrasound screening of four-month-old infants. The useful findings of ultrasound screening included hydronephrosis greater than SFU grade II (or 7-8 mm or more splitting of the CEC), renal length less than 3 standard deviations, and a difference in renal length of more than 3 standard deviations (9 mm).

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