Evaluation of differential renal function in children - a comparative study between magnetic resonance urography and dynamic renal scintigraphy.

BACKGROUND: Urinary system anomalies, both congenital and acquired, constitute a relatively common clinical problem in children. The main role of diagnostic imaging is to determine early diagnosis and support therapeutic decisions to prevent the development of chronic renal disease. The aim of this study was to evaluate the utility of magnetic resonance urography (MRU) in assessment of urinary system in children, by comparing differential renal function calculated using MRU with dynamic renal scintigraphy (DRS). MATERIALS AND METHODS: The study group consisted of 46 patients aged 1 week to 17 years (median 7 (0.5; 13) years, 17 (37%) girls, 29 (63%) boys), who underwent dynamic renal scintigraphy due to various clinical reasons. All participants underwent MRU, which was used to measure differential renal function. Functional analysis was performed using dedicated external software (CHOP-fMRU and pMRI without prior knowledge of DRS results. MRU results acquired using pMRI were assessed for inter and intraobserver agreement. RESULTS: Statistical analysis of the results showed excellent agreement between MRU and DRS in measuring differential renal function with Pearson correlation coefficient 0.987 for CHOP-fMRU and 0.971 for pMRI, p < 0.001. Interclass correlation coefficient (ICC) for these programs was 0.987 (95% CI 0.976-0.993) and 0.969 (95% CI 0.945-0.983) respectively, p < 0.001. The Bland-Altman 95% limits of agreement for CHOP-fMRU results vs. DRS was - 6.29-5.50 p.p. and for pMRI results vs. DRS - 9.15-9.63 p.p. The differential renal function measurements calculated in pMRI showed excellent intraobserver and interobserver agreement with ICC 0.996 (95% CI 0.994-0.998) and 0.992 (95% CI 0.986-0.996) respectively, p < 0.001. CONCLUSIONS: The study showed no significant differences between magnetic resonance urography and dynamic renal scintigraphy in calculating differential renal function. It indicates high utility of MRU in the evaluation of urinary system in children.

Volume of the normal prostate gland in polish boys, aged 1-17 years: Based on transabdominal ultrasound - Prospective study.

BACKGROUND: Until now, there are no established norms for prostate size in children. Prostate volume during development has been analyzed in small study groups. In diagnostic imaging, transabdominal ultrasound and magnetic resonance imaging are used. AIMS: To establish prostate volume norms for individuals aged 1-17 years using transabdominal ultrasound. STUDY DESIGN: Between 2021 and 2023, transabdominal prostate ultrasound was performed on 482 Caucasian boys, aged 1-17 years, who were patients of the urology clinic. Normative data were based on results of 345 boys with normal lower urinary tract, urethral and penile structures. Patients with abnormal external genitalia, Prune Belly Syndrome, Myelomeningocele, chromosomal disorders, or prostate abnormalities found in ultrasound were excluded from the study. Patient eligibility was determined based on medical records and physical examinations. During ultrasound, height, anterior-posterior dimension, and width of prostate were assessed. Prostate volume was calculated using the ellipsoid formula VH x L(AP) x W x 0.523. Measurements were correlated with age, weight, and height. Results were analyzed using descriptive statistics, statistical significance tests for means, and correlation methods. After estimating preliminary results, taking into account the development periods, patients were divided into age groups: 1-4 years (n = 70), 5-10 years (n = 124), 11-12 years (n = 43), 13-15 years (n = 65), and 16-17 years (n = 43). RESULTS: The table and nomogram shows prostate volumes based on age. Prostate size remains stable up to the age of 8. We noticed a transitional phase at the age of 8-11 years. A significant increase in volume occurs over 11 years of age. There was a statistically significant relationship between prostate size, age, height, and weight. DISCUSION: Established norms can serve as a reference for prostate analysis in patients with defects of the genitourinary system. An interesting analysis would be a prostate size assessment in relation to stage of development on Tanner scale. CONCLUSION: Transabdominal ultrasound, being a non-invasive, painless, and readily accessible examination, allows assessment of prostate size even in boys aged 1 year old. A statistically significant relationship was found between prostate size, weight, and height. Norms for prostate size in boys were established according to age.