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Urinary Tract Dilation
Roya Sohaey, MD
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KEY FACTS

  • Imaging

    • Clinical Issues

      • Diagnostic Checklist

        TERMINOLOGY

        • Abbreviations

          • Urinary tract dilation (UTD)
        • Synonyms

          • Pelviectasis, pyelectasis, fetal hydronephrosis
        • Definitions

          • Renal collecting system distended with urine from variety of causes
            • Mild UTD is often isolated transient finding
            • Renal pelvis is often first structure that is dilated

        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. 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
                              2. American Institute of Ultrasound in Medicine: AIUM practice guideline for the performance of obstetric ultrasound examinations. J Ultrasound Med. 32(6):1083-101, 2013
                              3. Hadar E et al: Sonographic evaluation of kidney parenchymal growth in the fetus. Arch Gynecol Obstet. 286(4):867-72, 2012
                              4. 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
                              5. Lidefelt KJ et al: Antenatal renal pelvis dilatation: 2-year follow-up with DMSA scintigraphy. Pediatr Nephrol. 24(3):533-6, 2009
                              6. Thornburg LL et al: Third trimester ultrasound of fetal pyelectasis: predictor for postnatal surgery. J Pediatr Urol. 4(1):51-4, 2008
                              7. Duncan KA: Antenatal renal pelvic dilatation; the long-term outlook. Clin Radiol. 62(2):134-9, 2007
                              8. Coplen DE et al: The magnitude of fetal renal pelvic dilatation can identify obstructive postnatal hydronephrosis, and direct postnatal evaluation and management. J Urol. 176(2):724-7; discussion 727, 2006
                              9. Sidhu G et al: Outcome of isolated antenatal hydronephrosis: a systematic review and meta-analysis. Pediatr Nephrol. 21(2):218-24, 2006
                              10. Signorelli M et al: Prenatal diagnosis and management of mild fetal pyelectasis: implications for neonatal outcome and follow-up. Eur J Obstet Gynecol Reprod Biol. 118(2):154-9, 2005
                              11. Damen-Elias HA et al: Variability in dilatation of the fetal renal pelvis during a bladder filling cycle. Ultrasound Obstet Gynecol. 24(7):750-5, 2004
                              12. John U et al: The impact of fetal renal pelvic diameter on postnatal outcome. Prenat Diagn. 24(8):591-5, 2004
                              13. Odibo AO et al: Prenatal mild pyelectasis: evaluating the thresholds of renal pelvic diameter associated with normal postnatal renal function. J Ultrasound Med. 23(4):513-7, 2004
                              14. Chitty LS et al: Charts of fetal size: kidney and renal pelvis measurements. Prenat Diagn. 23(11):891-7, 2003
                              15. Chudleigh PM et al: The association of aneuploidy and mild fetal pyelectasis in an unselected population: the results of a multicenter study. Ultrasound Obstet Gynecol. 17(3):197-202, 2001
                              16. Chudleigh T: Mild pyelectasis. Prenat Diagn. 21(11):936-41, 2001
                              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, fetal hydronephrosis
                                    • Definitions

                                      • Renal collecting system distended with urine from variety of causes
                                        • Mild UTD is often isolated transient finding
                                        • Renal pelvis is often first structure that is dilated

                                    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. 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
                                                          2. American Institute of Ultrasound in Medicine: AIUM practice guideline for the performance of obstetric ultrasound examinations. J Ultrasound Med. 32(6):1083-101, 2013
                                                          3. Hadar E et al: Sonographic evaluation of kidney parenchymal growth in the fetus. Arch Gynecol Obstet. 286(4):867-72, 2012
                                                          4. 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
                                                          5. Lidefelt KJ et al: Antenatal renal pelvis dilatation: 2-year follow-up with DMSA scintigraphy. Pediatr Nephrol. 24(3):533-6, 2009
                                                          6. Thornburg LL et al: Third trimester ultrasound of fetal pyelectasis: predictor for postnatal surgery. J Pediatr Urol. 4(1):51-4, 2008
                                                          7. Duncan KA: Antenatal renal pelvic dilatation; the long-term outlook. Clin Radiol. 62(2):134-9, 2007
                                                          8. Coplen DE et al: The magnitude of fetal renal pelvic dilatation can identify obstructive postnatal hydronephrosis, and direct postnatal evaluation and management. J Urol. 176(2):724-7; discussion 727, 2006
                                                          9. Sidhu G et al: Outcome of isolated antenatal hydronephrosis: a systematic review and meta-analysis. Pediatr Nephrol. 21(2):218-24, 2006
                                                          10. Signorelli M et al: Prenatal diagnosis and management of mild fetal pyelectasis: implications for neonatal outcome and follow-up. Eur J Obstet Gynecol Reprod Biol. 118(2):154-9, 2005
                                                          11. Damen-Elias HA et al: Variability in dilatation of the fetal renal pelvis during a bladder filling cycle. Ultrasound Obstet Gynecol. 24(7):750-5, 2004
                                                          12. John U et al: The impact of fetal renal pelvic diameter on postnatal outcome. Prenat Diagn. 24(8):591-5, 2004
                                                          13. Odibo AO et al: Prenatal mild pyelectasis: evaluating the thresholds of renal pelvic diameter associated with normal postnatal renal function. J Ultrasound Med. 23(4):513-7, 2004
                                                          14. Chitty LS et al: Charts of fetal size: kidney and renal pelvis measurements. Prenat Diagn. 23(11):891-7, 2003
                                                          15. Chudleigh PM et al: The association of aneuploidy and mild fetal pyelectasis in an unselected population: the results of a multicenter study. Ultrasound Obstet Gynecol. 17(3):197-202, 2001
                                                          16. Chudleigh T: Mild pyelectasis. Prenat Diagn. 21(11):936-41, 2001