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J Pediatr Infect Dis 2017; 12(01): 072-088
DOI: 10.1055/s-0037-1599121
DOI: 10.1055/s-0037-1599121
Review Article
Imaging in Pediatric Urinary Tract Infections
Further Information
Publication History
11 November 2016
22 November 2016
Publication Date:
23 March 2017 (online)
Abstract
Urinary tract infections (UTIs) commonly occur in children, and the clinical presentation varies depending on the child's age. The infection may affect only the bladder or may involve the kidneys and ureters. Multiple imaging modalities may be used to evaluate for underlying anomalies and complications of the infection. Here we discuss current imaging in pediatric UTI.
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References
- 1 Ladomenou F, Bitsori M, Galanakis E. Incidence and morbidity of urinary tract infection in a prospective cohort of children. Acta Paediatr 2015; 104 (7) e324-e329
- 2 Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J 2008; 27 (4) 302-308
- 3 Bulum B, Özçakar ZB, Kavaz A, Hüseynova M, Ekim M, Yalçinkaya F. Lower urinary tract dysfunction is frequently seen in urinary tract infections in children and is often associated with reduced quality of life. Acta Paediatr 2014; 103 (10) e454-e458
- 4 Keren R, Shaikh N, Pohl H , et al. Risk factors for recurrent urinary tract infection
and renal scarring. Pediatrics 2015; 136 (1) e13-e21
MissingFormLabel
- 5 Thakkar D, Deshpande AV, Kennedy SE. Epidemiology and demography of recently diagnosed cases of posterior urethral valves. Pediatr Res 2014; 76 (6) 560-563
- 6 Roth CC, Hubanks JM, Bright BC , et al. Occurrence of urinary tract infection in
children with significant upper urinary tract obstruction. Urology 2009; 73 (1) 74-78
MissingFormLabel
- 7 Hoberman A, Chao HP, Keller DM, Hickey R, Davis HW, Ellis D. Prevalence of urinary tract infection in febrile infants. J Pediatr 1993; 123 (1) 17-23
- 8 Zorc JJ, Levine DA, Platt SL , et al; Multicenter RSV-SBI Study Group of the Pediatric
Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics.
Clinical and demographic factors associated with urinary tract infection in young
febrile infants. Pediatrics 2005; 116 (3) 644-648
MissingFormLabel
- 9 Roberts KB ; Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 2011; 128 (3) 595-610
- 10 Shaikh N, Morone NE, Lopez J , et al. Does this child have a urinary tract infection?. JAMA 2007; 298 (24) 2895-2904
- 11 Stein R, Dogan HS, Hoebeke P , et al; European Association of Urology; European Society for Pediatric Urology. Urinary tract infections in children: EAU/ESPU guidelines. Eur Urol 2015; 67 (3) 546-558
- 12 McTaggart S, Danchin M, Ditchfield M , et al; Kidney Health Australia - Caring for Australasians with Renal Impairment. KHA-CARI guideline: diagnosis and treatment of urinary tract infection in children. Nephrology (Carlton) 2015; 20 (2) 55-60
- 13 Shaikh N, Craig JC, Rovers MM , et al. Identification of children and adolescents at risk for renal scarring after a first urinary tract infection: a meta-analysis with individual patient data. JAMA Pediatr 2014; 168 (10) 893-900
- 14 Riccabona M. Imaging in childhood urinary tract infection. Radiol Med (Torino) 2016; 121 (5) 391-401
- 15 Hoberman A, Greenfield SP, Mattoo TK , et al; RIVUR Trial Investigators. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med 2014; 370 (25) 2367-2376
- 16 Mattoo TK, Chesney RW, Greenfield SP , et al; RIVUR Trial Investigators. Renal scarring in the randomized intervention for children with vesicoureteral reflux (RIVUR) Trial. Clin J Am Soc Nephrol 2016; 11 (1) 54-61
- 17 National Institute for Health and Care Excellence (NICE). Urinary tract infection in under 16s: diagnosis and management. Available at https://www.nice.org.uk/guidance/cg54 . Published 2007 . Accessed September 22, 2016
- 18 Han BK, Babcock DS. Sonographic measurements and appearance of normal kidneys in children. AJR Am J Roentgenol 1985; 145 (3) 611-616
- 19 Siegel MJ. Urinary tract. In: Siegel MJ, , ed. Pediatric Sonography. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011: 384-460
- 20 Dinkel E, Ertel M, Dittrich M, Peters H, Berres M, Schulte-Wissermann H. Kidney size in childhood. Sonographical growth charts for kidney length and volume. Pediatr Radiol 1985; 15 (1) 38-43
- 21 Dinkel E, Orth S, Dittrich M, Schulte-Wissermann H. Renal sonography in the differentiation of upper from lower urinary tract infection. AJR Am J Roentgenol 1986; 146 (4) 775-780
- 22 Stull TL, LiPuma JJ. Epidemiology and natural history of urinary tract infections in children. Med Clin North Am 1991; 75 (2) 287-297
- 23 Roberts JA. Etiology and pathophysiology of pyelonephritis. Am J Kidney Dis 1991; 17 (1) 1-9
- 24 Craig WD, Wagner BJ, Travis MD. Pyelonephritis: radiologic-pathologic review. Radiographics 2008; 28 (1) 255-277 , quiz 327–328
- 25 Thornbury JR. Acute renal infections. Urol Radiol 1991; 12 (4) 209-213
- 26 Morello W, La Scola C, Alberici I, Montini G. Acute pyelonephritis in children. Pediatr Nephrol 2016; 31 (8) 1253-1265
- 27 Talner LB, Davidson AJ, Lebowitz RL, Dalla Palma L, Goldman SM. Acute pyelonephritis: can we agree on terminology?. Radiology 1994; 192 (2) 297-305
- 28 Avni EF, Van Gansbeke D, Thoua Y , et al. US demonstration of pyelitis and ureteritis in children. Pediatr Radiol 1988; 18 (2) 134-139
- 29 Fan NC, Tain YL. Sonographic finding of persistent renal pelvic wall thickening in children. Pediatr Neonatol 2014; 55 (4) 269-274
- 30 Robben SGF, Boesten M, Linmans J, Lequin MH, Nijman RM. Significance of thickening of the wall of the renal collecting system in children: an ultrasound study. Pediatr Radiol 1999; 29 (10) 736-740
- 31 Tain YL. Renal pelvic wall thickening in childhood urinary tract infections--evidence of acute pyelitis or vesicoureteral reflux?. Scand J Urol Nephrol 2003; 37 (1) 28-30
- 32 Gordon ZN, McLeod DJ, Becknell B, Bates DG, Alpert SA. Uroepithelial thickening on sonography improves detection of vesicoureteral reflux in children with first febrile urinary tract infection. J Urol 2015; 194 (4) 1074-1079
- 33 Fontanilla T, Minaya J, Cortés C , et al. Acute complicated pyelonephritis: contrast-enhanced ultrasound. Abdom Imaging 2012; 37 (4) 639-646
- 34 Cheng CH, Tsau YK, Hsu SY, Lee TL. Effective ultrasonographic predictor for the diagnosis of acute lobar nephronia. Pediatr Infect Dis J 2004; 23 (1) 11-14
- 35 Mitterberger M, Pinggera GM, Colleselli D , et al. Acute pyelonephritis: comparison of diagnosis with computed tomography and contrast-enhanced ultrasonography. BJU Int 2008; 101 (3) 341-344
- 36 Basiratnia M, Noohi AH, Lotfi M, Alavi MS. Power Doppler sonographic evaluation of acute childhood pyelonephritis. Pediatr Nephrol 2006; 21 (12) 1854-1857
- 37 Seguias L, Srinivasan K, Mehta A. Pediatric renal abscess: a 10-year single-center retrospective analysis. Hosp Pediatr 2012; 2 (3) 161-166
- 38 Paintsil E. Update on recent guidelines for the management of urinary tract infections in children: the shifting paradigm. Curr Opin Pediatr 2013; 25 (1) 88-94
- 39 Jequier S, Rousseau O. Sonographic measurements of the normal bladder wall in children. AJR Am J Roentgenol 1987; 149 (3) 563-566
- 40 Cheng SN, Phelps A. Correlating the sonographic finding of echogenic debris in the bladder lumen with urinalysis. J Ultrasound Med 2016; 35 (7) 1533-1540
- 41 Nørgaard JP, van Gool JD, Hjälmås K, Djurhuus JC, Hellström AL ; International Children's Continence Society. Standardization and definitions in lower urinary tract dysfunction in children. Br J Urol 1998; 81 (Suppl. 03) 1-16
- 42 Tsai JD, Chang SJ, Lin CC, Yang SS. Incomplete bladder emptying is associated with febrile urinary tract infections in infants. J Pediatr Urol 2014; 10 (6) 1222-1226
- 43 McArthur C, Baxter GM. Current and potential renal applications of contrast-enhanced ultrasound. Clin Radiol 2012; 67 (9) 909-922
- 44 Farhat W, Traubici J, Sherman C, Williams T, Babyn P, McLorie G. Reliability of contrast enhanced sonography with harmonic imaging for detecting early renal scarring in experimental pyelonephritis in a porcine model: preliminary results. J Urol 2002; 168 (3) 1114-1117
- 45 Majd M, Nussbaum Blask AR, Markle BM , et al. Acute pyelonephritis: comparison of diagnosis with 99mTc-DMSA, SPECT, spiral CT, MR imaging, and power Doppler US in an experimental pig model. Radiology 2001; 218 (1) 101-108
- 46 Kawashima A, Sandler CM, Ernst RD, Goldman SM, Raval B, Fishman EK. Renal inflammatory disease: the current role of CT. Crit Rev Diagn Imaging 1997; 38 (5) 369-415
- 47 Weiser AC, Amukele SA, Leonidas JC, Palmer LS. The role of gadolinium enhanced magnetic resonance imaging for children with suspected acute pyelonephritis. J Urol 2003; 169 (6) 2308-2311
- 48 Leonidas JC, Berdon WE. MR imaging of urinary tract infections in children. Radiology 1999; 210 (2) 582-584
- 49 Ifergan J, Pommier R, Brion MC, Glas L, Rocher L, Bellin MF. Imaging in upper urinary tract infections. Diagn Interv Imaging 2012; 93 (6) 509-519
- 50 Martina MC, Campanino PP, Caraffo F , et al. Dynamic magnetic resonance imaging in acute pyelonephritis. Radiol Med (Torino) 2010; 115 (2) 287-300
- 51 Angel C, Shu T, Green J, Orihuela E, Rodriquez G, Hendrick E. Renal and peri-renal abscesses in children: proposed physio-pathologic mechanisms and treatment algorithm. Pediatr Surg Int 2003; 19 (1-2): 35-39
- 52 Rinder MR. Renal abscess: an illustrative case and review of the literature. Md Med J 1996; 45 (10) 839-843
- 53 Pennington DJ, Lonergan GJ, Flack CE, Waguespack RL, Jackson CB. Experimental pyelonephritis in piglets: diagnosis with MR imaging. Radiology 1996; 201 (1) 199-205
- 54 Lonergan GJ, Pennington DJ, Morrison JC, Haws RM, Grimley MS, Kao TC. Childhood pyelonephritis: comparison of gadolinium-enhanced MR imaging and renal cortical scintigraphy for diagnosis. Radiology 1998; 207 (2) 377-384
- 55 Vivier PH, Sallem A, Beurdeley M , et al. MRI and suspected acute pyelonephritis in children: comparison of diffusion-weighted imaging with gadolinium-enhanced T1-weighted imaging. Eur Radiol 2014; 24 (1) 19-25
- 56 Bitsori M, Raissaki M, Maraki S, Galanakis E. Acute focal bacterial nephritis, pyonephrosis and renal abscess in children. Pediatr Nephrol 2015; 30 (11) 1987-1993
- 57 Geoghegan T, Govender P, Torreggiani WC. MR urography depiction of fluid-debris levels: a sign of pyonephrosis. AJR Am J Roentgenol 2005; 185 (2) 560
- 58 Cheng CH, Tsai MH, Su LH , et al. Renal abscess in children: a 10-year clinical and radiologic experience in a tertiary medical center. Pediatr Infect Dis J 2008; 27 (11) 1025-1027
- 59 Flood TF, Stence NV, Maloney JA, Mirsky DM. Pediatric brain: repeated exposure to linear gadolinium-based contrast material is associated with increased signal intensity at unenhanced T1-weighted MR imaging. Radiology 2017; 282 (1) 222-228
- 60 Darge K, Anupindi SA, Jaramillo D. MR imaging of the abdomen and pelvis in infants, children, and adolescents. Radiology 2011; 261 (1) 12-29
- 61 Darge K, Higgins M, Hwang TJ, Delgado J, Shukla A, Bellah R. Magnetic resonance and computed tomography in pediatric urology: an imaging overview for current and future daily practice. Radiol Clin North Am 2013; 51 (4) 583-598
- 62 Darge K, Grattan-Smith JD, Riccabona M. Pediatric uroradiology: state of the art. Pediatr Radiol 2011; 41 (1) 82-91
- 63 Jaimes C, Darge K, Khrichenko D, Carson RH, Berman JI. Diffusion tensor imaging and tractography of the kidney in children: feasibility and preliminary experience. Pediatr Radiol 2014; 44 (1) 30-41
- 64 Rathod SB, Kumbhar SS, Nanivadekar A, Aman K. Role of diffusion-weighted MRI in acute pyelonephritis: a prospective study. Acta Radiol 2015; 56 (2) 244-249
- 65 Aoyagi J, Odaka J, Kuroiwa Y , et al. Utility of non-enhanced magnetic resonance imaging to detect acute pyelonephritis. Pediatr Int 2014; 56 (3) e4-e6
- 66 De Pascale A, Piccoli GB, Priola SM , et al. Diffusion-weighted magnetic resonance imaging: new perspectives in the diagnostic pathway of non-complicated acute pyelonephritis. Eur Radiol 2013; 23 (11) 3077-3086
- 67 Gardiner RA, Gwynne RA, Roberts SA. Perinephric abscess. BJU Int 2011; 107 (Suppl. 03) 20-23
- 68 Dawson C, Aitken K, Ng K, Dolke G, Gadian D, Whitfield HN. Magnetic resonance imaging of urinary calculi. Urol Res 1994; 22 (4) 209-212
- 69 Kovanlikaya A, Okkay N, Cakmakci H, Ozdoğan O, Degirmenci B, Kavukcu S. Comparison of MRI and renal cortical scintigraphy findings in childhood acute pyelonephritis: preliminary experience. Eur J Radiol 2004; 49 (1) 76-80
- 70 Pennington DJ, Zerin JM. Imaging of the urinary tract in children. Pediatr Ann 1999; 28 (11) 678-686
- 71 Kardorff R, Traoré M, Doehring-Schwerdtfeger E, Vester U, Ehrich JH. Ultrasonography of ureteric abnormalities induced by Schistosoma haematobium infection before and after praziquantel treatment. Br J Urol 1994; 74 (6) 703-709
- 72 Ambaram PR, Kala UK, Petersen KL. Emphysematous pyelonephritis in children. Pediatr Infect Dis J 2016; 35 (10) 1159-1161
- 73 Kuo YT, Chen MT, Liu GC, Huang CN, Huang CL, Huang CH. Emphysematous pyelonephritis: imaging diagnosis and follow-up. Kaohsiung J Med Sci 1999; 15 (3) 159-170
- 74 Gupta S, Araya CE, Dharnidharka VR. Xanthogranulomatous pyelonephritis in pediatric patients: case report and review of literature. J Pediatr Urol 2010; 6 (4) 355-358
- 75 Zugor V, Schott GE, Labanaris AP. Xanthogranulomatous pyelonephritis in childhood: a critical analysis of 10 cases and of the literature. Urology 2007; 70 (1) 157-160
- 76 Cakmakci H, Tasdelen N, Obuz F, Yilmaz E, Kovanlikaya A. Pediatric focal xanthogranulomatous pyelonephritis: dynamic contrast-enhanced MRI findings. Clin Imaging 2002; 26 (3) 183-186
- 77 Hugosson C, Ahmed S, Sackey K, Akhtar M. Focal xanthogranulomatous pyelonephritis in a young child. Pediatr Radiol 1994; 24 (3) 213-215
- 78 Raut AA, Naphade PS, Ramakantan R. Imaging spectrum of extrathoracic tuberculosis. Radiol Clin North Am 2016; 54 (3) 475-501
- 79 Tonkin AK, Witten DM. Genitourinary tuberculosis. Semin Roentgenol 1979; 14 (4) 305-318
- 80 Roylance J, Penry JB, Davies ER, Roberts M. The radiology of tuberculosis of the urinary tract. Clin Radiol 1970; 21 (2) 163-170
- 81 Garcia-Roig ML, Kirsch AJ. Urinary tract infection in the setting of vesicoureteral reflux. F1000 Res 2016; 5: 51
- 82 Ward VL, Strauss KJ, Barnewolt CE , et al. Pediatric radiation exposure and effective dose reduction during voiding cystourethrography. Radiology 2008; 249 (3) 1002-1009
- 83 Haid B, Becker T, Koen M , et al. Lower radiation burden in state of the art fluoroscopic cystography compared to direct isotope cystography in children. J Pediatr Urol 2015; 11 (1) 35.e1-35.e6
- 84 Thacker PG, Collins HR, Hill J. Distress experienced during pediatric VCUGs - a granular, prospective assessment using the brief behavioral distress scale. Pediatr Radiol 2016; 46 (5) 660-665
- 85 Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen-Möbius TE ; International Reflux Study in Children. International system of radiographic grading of vesicoureteric reflux. Pediatr Radiol 1985; 15 (2) 105-109
- 86 Darge K, Papadopoulou F, Ntoulia A , et al. Safety of contrast-enhanced ultrasound in children for non-cardiac applications: a review by the Society for Pediatric Radiology (SPR) and the International Contrast Ultrasound Society (ICUS). Pediatr Radiol 2013; 43 (9) 1063-1073
- 87 Darge K. Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children. I. Procedure. Pediatr Radiol 2008; 38 (1) 40-53
- 88 Riccabona M, Vivier PH, Ntoulia A , et al; ESPR Uroradiology Task Force. ESPR uroradiology task force imaging recommendations in paediatric uroradiology, part VII: standardised terminology, impact of existing recommendations, and update on contrast-enhanced ultrasound of the paediatric urogenital tract. Pediatr Radiol 2014; 44 (11) 1478-1484
- 89 Colleran GC, Barnewolt CE, Chow JS, Paltiel HJ. Intrarenal reflux: diagnosis at contrast-enhanced voiding urosonography. J Ultrasound Med 2016; 35 (8) 1811-1819
- 90 Darge K, Troeger J. Vesicoureteral reflux grading in contrast-enhanced voiding urosonography. Eur J Radiol 2002; 43 (2) 122-128
- 91 Darge K. Voiding urosonography with US contrast agents for the diagnosis of vesicoureteric reflux in children. II. Comparison with radiological examinations. Pediatr Radiol 2008; 38 (1) 54-63 , quiz 126–127
- 92 Wong LS, Tse KS, Fan TW , et al. Voiding urosonography with second-generation ultrasound contrast versus micturating cystourethrography in the diagnosis of vesicoureteric reflux. Eur J Pediatr 2014; 173 (8) 1095-1101