Clinic of Pediatric Surgery and Oncology, Medical University of Lodz Tutors: Zbigniew Jankowski M.D., Ph.D., Janusz Jabłoński M.D., Ph.D., Małgorzata Lewandowska M.D Clinic Manager: Andrzejewska Ewa, Prof. PhD Barbara Popek, Joanna Pietrzyk

Uro CT Investigation of:  Pathological changes in urinay tract  Progression of changes  Evaluation of other organs 3D reconstructions

 Children are not small adults.  A debate about use of uro CT in children is still current.

Limitations:  Greater harmfulness of X-ray in children  The need for general anesthesia in babies  Intravenously administred contrast

1) M. Riccabona, F. E. Avni and co-authors Pediatr Radiol (2010) 40:1315–1320 ESPR uroradiology task force and ESUR paediatric working group: imaging and procedural recommendations in paediatric uroradiology, part III. Minutes of the ESPR uroradiology task force minisymposium on intravenous urography, uro-CT and MR-urography in childhood 2) M. Riccabona, F. E. Avni, M.B. Damasioand with co-authors Pediatr Radiol (2012) 42:1275–1283 ESPR Uroradiology Task Force and ESUR Paediatric Working Group—Imaging recommendations in paediatric uroradiology, Part V: childhood cystic kidney disease, childhood renal transplantation and contrast-enhanced ultrasonography in children 3) M.B. Damasio, K. Darge, M. Riccabona European Journal of Radiology (2012) Multi-detector CT in the paediatric urinary tract 4) M.P.Hiorns Urol Clin North Am May; 37(2): Imaging of the urinary tract: the role of CT and MRI 5 ) E. Sorantin, S. Weissensteiner, G. Hasenburger, M. Riccabona European Journal of Radiology(2012) CT in children – dose protection and general considerations when planning a CT in a child

Aim  Analysis of cases difficult in terms of the diagnostic, in which uro- CT was used

Case 1  9-year old boy  Polytrauma  USG → subcapsular hematoma of spleen?

Case 1, Uro CT

Case 1, uro CT

Case 2  14-year old girl  Nocturnal and daytime enuresis  USG → right kidney: normal calices and renal pelvis, blurred shape of upper polar

Case 2, uro CT

Case 3  15-year old boy  Right-side hydronephrosis and subpelvical obstruction of the ureter (diagnosis by USG, cystography, urography, renoscyntygraphy)  Postponed operation → other imaging studies

Case 3, uro CT

Conclusions  CT urography is useful method for evaluation of the urinary tract  The necessity of reducing radiation exposure from medical imaging is to determine the role of uro-CT in the diagnosis of pediatric patients.

Wiem – obrazek (znajdzie się)