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Urinary Tract Dilation
Emily Edwards, MD
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KEY FACTS

  • Imaging

    • Clinical Issues

      • Diagnostic Checklist

        TERMINOLOGY

        • Abbreviations

          • Urinary tract dilation (UTD)
        • Synonyms

          • Pelviectasis, pyelectasis, hydronephrosis
        • Definitions

          • Renal collecting system distended with urine
            • Mild UTD may be isolated transient finding
            • Renal pelvis often 1st structure to dilate
            • Variety of causes

        IMAGING

        • General Features

          • Ultrasonographic Findings

            • Imaging Recommendations

              DIFFERENTIAL DIAGNOSIS

                PATHOLOGY

                • General Features

                  CLINICAL ISSUES

                  • Presentation

                    • Demographics

                      • Natural History & Prognosis

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            • Image Interpretation Pearls

                              Selected References

                              1. Gray MC et al: Assessment of urinary tract dilation grading amongst pediatric urologists. J Pediatr Urol. 16(4):457.e1-6, 2020
                              2. Nelson CP et al: Interobserver reliability of the antenatal consensus classification system for urinary tract dilatation. J Ultrasound Med. 39(3):551-7, 2020
                              3. Braga LH et al: Society for Fetal Urology classification vs urinary tract dilation grading system for prognostication in prenatal hydronephrosis: a time to resolution analysis. J Urol. 199(6):1615-21, 2018
                              4. Mileto A et al: Fetal urinary tract anomalies: review of pathophysiology, imaging, and management. AJR Am J Roentgenol. 210(5):1010-21, 2018
                              5. Braga LH et al: Associations of initial Society for Fetal Urology grades and urinary tract dilatation risk groups with clinical outcomes in patients with isolated prenatal hydronephrosis. J Urol. 197(3 Pt 2):831-7, 2017
                              6. Chow JS et al: Classification of pediatric urinary tract dilation: the new language. Pediatr Radiol. 47(9):1109-15, 2017
                              7. Kaspar CDW et al: The antenatal urinary tract dilation classification system accurately predicts severity of kidney and urinary tract abnormalities. J Pediatr Urol. 13(5):485.e1-7, 2017
                              8. Chalmers DJ et al: Inter-rater reliability of the APD, SFU and UTD grading systems in fetal sonography and MRI. J Pediatr Urol. 12(5):305.e1-5, 2016
                              9. Nguyen HT et al: Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system). J Pediatr Urol. 10(6):982-98, 2014
                              10. American Institute of Ultrasound in Medicine: AIUM practice guideline for the performance of obstetric ultrasound examinations. J Ultrasound Med. 32(6):1083-101, 2013
                              11. Hadar E et al: Sonographic evaluation of kidney parenchymal growth in the fetus. Arch Gynecol Obstet. 286(4):867-72, 2012
                              12. Keays MA et al: Reliability assessment of Society for Fetal Urology ultrasound grading system for hydronephrosis. J Urol. 180(4 Suppl):1680-2; discussion1682-3, 2008
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Imaging

                                • Clinical Issues

                                  • Diagnostic Checklist

                                    TERMINOLOGY

                                    • Abbreviations

                                      • Urinary tract dilation (UTD)
                                    • Synonyms

                                      • Pelviectasis, pyelectasis, hydronephrosis
                                    • Definitions

                                      • Renal collecting system distended with urine
                                        • Mild UTD may be isolated transient finding
                                        • Renal pelvis often 1st structure to dilate
                                        • Variety of causes

                                    IMAGING

                                    • General Features

                                      • Ultrasonographic Findings

                                        • Imaging Recommendations

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      DIAGNOSTIC CHECKLIST

                                                      • Consider

                                                        • Image Interpretation Pearls

                                                          Selected References

                                                          1. Gray MC et al: Assessment of urinary tract dilation grading amongst pediatric urologists. J Pediatr Urol. 16(4):457.e1-6, 2020
                                                          2. Nelson CP et al: Interobserver reliability of the antenatal consensus classification system for urinary tract dilatation. J Ultrasound Med. 39(3):551-7, 2020
                                                          3. Braga LH et al: Society for Fetal Urology classification vs urinary tract dilation grading system for prognostication in prenatal hydronephrosis: a time to resolution analysis. J Urol. 199(6):1615-21, 2018
                                                          4. Mileto A et al: Fetal urinary tract anomalies: review of pathophysiology, imaging, and management. AJR Am J Roentgenol. 210(5):1010-21, 2018
                                                          5. Braga LH et al: Associations of initial Society for Fetal Urology grades and urinary tract dilatation risk groups with clinical outcomes in patients with isolated prenatal hydronephrosis. J Urol. 197(3 Pt 2):831-7, 2017
                                                          6. Chow JS et al: Classification of pediatric urinary tract dilation: the new language. Pediatr Radiol. 47(9):1109-15, 2017
                                                          7. Kaspar CDW et al: The antenatal urinary tract dilation classification system accurately predicts severity of kidney and urinary tract abnormalities. J Pediatr Urol. 13(5):485.e1-7, 2017
                                                          8. Chalmers DJ et al: Inter-rater reliability of the APD, SFU and UTD grading systems in fetal sonography and MRI. J Pediatr Urol. 12(5):305.e1-5, 2016
                                                          9. Nguyen HT et al: Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system). J Pediatr Urol. 10(6):982-98, 2014
                                                          10. American Institute of Ultrasound in Medicine: AIUM practice guideline for the performance of obstetric ultrasound examinations. J Ultrasound Med. 32(6):1083-101, 2013
                                                          11. Hadar E et al: Sonographic evaluation of kidney parenchymal growth in the fetus. Arch Gynecol Obstet. 286(4):867-72, 2012
                                                          12. Keays MA et al: Reliability assessment of Society for Fetal Urology ultrasound grading system for hydronephrosis. J Urol. 180(4 Suppl):1680-2; discussion1682-3, 2008