ACR Appropriateness Criteria® Antenatal Hydronephrosis–Infant

Abstract

Antenatal hydronephrosis is the most frequent urinary tract anomaly detected on prenatal ultrasonography. It occurs approximately twice as often in males as in females. Most antenatal hydronephrosis is transient with little long-term significance, and few children with antenatal hydronephrosis will have significant obstruction, develop symptoms or complications, and require surgery. Some children will be diagnosed with more serious conditions, such as posterior urethral valves. Early detection of obstructive uropathy is necessary to mitigate the potential morbidity from loss of renal function. Imaging is an integral part of screening, diagnosis, and monitoring of children with antenatal hydronephrosis. Optimal timing and appropriate use of imaging can reduce the incidence of late diagnoses and prevent renal scarring and other complications. In general, follow-up neonatal ultrasound is recommended for all cases of antenatal hydronephrosis, while further imaging, including voiding cystourethrography and nuclear scintigraphy, is recommended for moderate or severe cases, or when renal parenchymal or bladder wall abnormalities are suspected.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current

The Role of Varied Sonographic Criteria for Predicting Treatment and Prognosis of Antenatal Hydronephrosis: A Retrospective Cohort Study

“…7 Conversely, some critical entities, such as severe UPJO, VUR, and posterior urethral valve (PUV) require early diagnosis and treatment to prevent severe patient complications. 8,9 It is yet to be established as to which of these classification systems (e.g., SFU, APD, or UTD) or a combination could provide improved pathologic detection. Hence, this study aimed to determine the value of the data generated using these criteria in detecting the cause and prognosis of AH and assess and compare the SFU guidelines, APD, and UTD classification criteria for predicting the long-term prognosis of AH.…”