Parenchyma-to-hydronephrosis Area Ratio Is a Promising Outcome Measure to Quantify Upper Tract Changes in Infants With High-grade Prenatal Hydronephrosis.
Objective: To explore the value of renal parenchyma-to-hydronephrosis area ratio (PHAR) in detecting trends of hydronephrosis (HN) improvement or worsening and response to surgical intervention.Methods: Initial and follow-up sagittal renal ultrasound images of patients entered into a prenatal HN dat...
| Publicado en: | Urology Vol. 104; no. 1; pp. 166 - 172 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Elsevier B.V.
Jun2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=123255800&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 123255800 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00904295 1YG jtl: Urology issn: 00904295 maglogo: N pubinfo: dt: Jun2017 vid: 104 iid: 1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 123255800 123255800 NLM28111223 10.1016/j.urology.2017.01.015 NLM28111223 123255800 ppf: 166 ppct: 6 formats: tig: atl: Parenchyma-to-hydronephrosis Area Ratio Is a Promising Outcome Measure to Quantify Upper Tract Changes in Infants With High-grade Prenatal Hydronephrosis. aug: au: Rickard, Mandy Lorenzo, Armando J. Braga, Luis H. Munoz, Caroline affil: Department of Surgery and McMaster Pediatric Surgery Research Collaborative, McMaster University, Canada sug: subj: Hydronephrosis Diagnosis Kidney Anatomy and Histology Prospective Studies Ultrasonography, Prenatal Ureteral Obstruction Diagnosis Male Retrospective Design Hydronephrosis Therapy Urology Kidney Infant Kidney Pelvis Treatment Outcomes Pregnancy Ureteral Obstruction Therapy Software Infant, Newborn Female Infant: 1-23 months Infant, Newborn: birth-1 month Male Female ab: Objective: To explore the value of renal parenchyma-to-hydronephrosis area ratio (PHAR) in detecting trends of hydronephrosis (HN) improvement or worsening and response to surgical intervention.Methods: Initial and follow-up sagittal renal ultrasound images of patients entered into a prenatal HN database from 2008 to 2016, with baseline Society for Fetal Urology (SFU) grades III and IV HN and without vesicoureteral reflux, were evaluated using National Institutes of Health-sponsored image-processing software. Renal parenchymal area, hydronephrosis area (HA), PHAR, anteroposterior diameter (APd), and SFU grade were captured at baseline and most recent visit. Data were analyzed based on the need for surgical intervention to address obstruction.Results: Out of 193 infants (159 boys; 135 left side), 58 (30%) underwent surgery. Patients managed surgically compared with those managed nonsurgically had worse baseline HN severity markers: SFU grade (3.6 ± 0.5 vs 3.1 ± 0.4; P <.001), urinary tract dilation classification (2.7 ± 0.5 vs 2.2 ± 0.4; P <.001), APd (20.3 ± 10.1 vs 12.8 ± 8.0; P <.001), HA (10.0 ± 6.6 vs 4.7 ± 2.8; P <.001), and PHAR (1.3 ± 1.0 vs 3.0 ± 2.9; P <.001); but both patient groups had similar renal parenchymal area (9.4 ± 3.5 vs 9.7 ± 2.8; P = .5). At last follow-up, the following discrepancies persisted: SFU grade (2.3 ± 1.0 vs 1.7 ± 1.0; P <.001), urinary tract dilation classification (1.5 ± 0.7 vs 1.0 ± 0.7; P <.001), APd (11.7 ± 8.0 vs 7.7 ± 5.7; P <.001), and HA (6.4 ± 5.1 vs 3.6 ± 2.7; P <.001); however, PHAR was equalized for both groups (7.2 ± 14.0 vs 7.1 ± 6.1; P = .9).Conclusion: By concurrently considering changes in renal parenchyma and degree of HN, we found that PHAR appears to be a promising parameter that reflects similarities between patients managed surgically and those managed nonsurgically, despite initial discrepancies. Our data suggest that this variable may provide reassurance and a more objective assessment of improvement after surgery compared with other traditional ultrasound outcome measures. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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