Is intravenous urography necessary in the assessment of renal duplex system in children?

OBJECTIVE

Partial or complete duplication of the renal tract may be an incidental finding or may be associated with significant pathology. Accurate assessment is not always easy. This retrospective review was undertaken to determine whether intravenous urography (IVU) in combination with a DMSA renal scan provides significant additional information.

PATIENTS AND

METHODS

Eighteen patients referred to our imaging department with a provisional diagnosis on ultrasound of renal tract duplication during a three year period were identified by searching the radiological computer files. The presenting features were urinary infection (13), abdominal pain (3) and abnormal antenatal sonography (2).

RESULTS

Four patients were found not to have renal duplication. There was concordance between the IVU and DMSA scan in seven. Additional clinically relevant information was obtained in three cases. A false negative result from the DMSA scan was found in four children and a false positive result in three.

CONCLUSION

In a significant number of cases of possible renal tract duplication, additional relevant information can be obtained from an IVU. Patient distress is minimised by combining the IVU and DMSA in one single episode of venous access. Review of the radiological images during the investigation allows minimisation of radiation dosage.