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Standardization of Pediatric Uroradiological Terms: a Multidisciplinary European Glossary

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Pediatr Radiol (2018) 48:291–303 https://doi.org/10.1007/s00247-017-4006-7 ESPR Standardization of pediatric uroradiological terms: a multidisciplinary European glossary Pierre-Hugues Vivier1,2 & Thomas A. Augdal3 & Fred E. Avni4 & Justine Bacchetta5 & Rolf Beetz6 & Anna K. Bjerre7 & Johan Blickman8 & Pierre Cochat5 & Rosana Coppo9 & Beatrice Damasio10 & Kassa Darge11 & Alaa El-Ghoneimi12 & Piet Hoebeke13 & Göran Läckgren14 & Marc-David Leclair15 & Maria-Luisa Lobo16 & Gianantonio Manzoni17 & Stephen D. Marks 18 & Girolamo Mattioli19 & Hans-Joachim Mentzel20 & Pierre Mouriquand21 & Tryggve Nevéus 22 & Aikaterini Ntoulia11,23 & Lil-Sofie Ording-Muller24 & Josef Oswald25 & Frederica Papadopoulou26 & Gabriella Porcellini9 & Ekkehard Ring27 & Wolfgang Rösch28 & Ana F. Teixeira29 & Michael Riccabona30 Received: 25 September 2017 /Accepted: 27 September 2017 /Published online: 15 November 2017 # The Author(s) 2017. This article is an open access publication Abstract To promote the standardization of nephro- ical reports and communication between different clinicians uroradiological terms used in children, the European Society involved in pediatric urology and nephrology. of Paediatric Radiology uroradiology taskforce wrote a de- tailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for Keywords Imaging . Nephrology . Pediatrics . Radiology . discussion and acceptance to improve the quality of radiolog- Glossary . Urology . Standardization This article is co-published by the Journal of Pediatric Urology (https:// doi.org/10.1016/j.jpurol.2017.05.026) and Pediatric Radiology (https:// doi.org/10.1007/s00247-017-4006-7) * Pierre-Hugues Vivier University Medical Clinic, [email protected] Mainz, Germany 7 Pediatric Nephrology, 1 Oslo University Hospital, Rikshospitalet, Radiology, Ramsay - Générale de Santé, service de Radiologie, Oslo, Norway Hôpital Privé de l’Estuaire, 505 rue Irène Joliot Curie, 76620 Le Havre, France 8 Pediatric Radiology, 2 Golisano Childrens Hospital, Pediatric Radiology, Rochester, NY, USA University Hospital Charles Nicolle, Rouen, France 9 Pediatric nephrology, 3 Regina Margherita Hospital, Pediatric Radiology, Turin, Italy University Hospital of North Norway, Tromsø, Norway 10 Pediatric Radiology, 4 Istituto G. Gaslini, Pediatric Radiology, Jeanne de Flandre Hospital, Genoa, Italy Lille University hospitals, Lille, France 11 Pediatric Radiology, Children’sHospitalofPhiladelphia, 5 Perelman School of Medicine, Pediatric nephrology, University of Pennsylvania, Hôpital Femme Mère Enfant, Philadelphia, PA, USA Bron, France 12 6 Pediatric Surgery and Urology, Pediatric Nephrology, University Hospital Robert Debré, APHP, Center for Paediatric and Adolescent Medicine, 292 Pediatr Radiol (2018) 48:291–303 Introduction clinicians. We hope this work will be helpful for a better de- scription of pathology and for facilitation of the communica- Based on the experience of the members of the European tion between radiologists, urologists and nephrologists. Society of Paediatric Radiology (ESPR) uroradiology Initially, our group faced disagreements about terms used taskforce, terms commonly usedinpediatricnephro- to describe chronic urinary tract dilatation. Some members of uroradiology have been (re)defined to standardize and specify the group added an “obstruction” value to some terms which terms to avoid potential misunderstandings. This work has were not considered pathological by other members. The cur- been submitted subsequently to representatives of European rent definition of chronic obstruction (see the detailed defini- Pediatric Urologists and Nephrologists for discussion and tion below) in practice is the one described by Koff [5]andis acceptance. based on functional deterioration rather than morphologic The purpose was not to provide in-depth explanations for changes. Based on this definition, we decided that none of all terms but effort has been made to emphasize pathophysi- the terms describing an upper urinary tract dilatation should ology illustrating the conditions when necessary. Readers have an “obstruction” connotation. should refer to textbooks or reviews for further details. We This glossary is not intended to serve as a guideline for suggest no longer using some terms, which may be considered clinical management. Other recommendations have been pre- as “overused” with subsequent confusing perceptions of their viously published on the management of various urological actual meaning. and renal disorders [6–13]. Other publications have previously defined some terms, This work has been conducted in several phases. At first, particularly for duplex kidneys [1] and lower urinary tract some members of the ESPR uroradiology taskforce and function [2–4]. We chose to include most of these terms to European Society of Urogenital Radiology (ESUR) pediatric provide a detailed, standardized glossary. A few terms in our working group have searched preexisting publications about glossary are not radiological terms, such as those pertaining to definitions of uro-radiological terms used in the pediatric field. lower urinary tract function disorders, but have to be well These terms have been cited and others (re)defined. The draft known and understood by pediatric radiologists for better has been subsequently submitted to all the members of the management of patients who are cared for by multiple ESPR uroradiology taskforce for comments and editing. University of Paris-Diderot, Sorbonne, 22 Department of Women’s and Children’sHealth, Paris, France Uppsala University, Uppsala, Sweden 13 Urology, Ghent University Hospital, 23 Paediatric Radiology, Ghent, Belgium King’s College Hospital, London, UK 14 Pediatric Urology, University Children’s Hospital, 24 Paediatric Radiology, Uppsala, Sweden Oslo University Hospital, Oslo, Norway 15 Pediatric Surgery and Urology, Children University Hospital, 25 Pediatric Urology, Nantes, France Hospital of the Sisters of Charity, Linz, Austria 16 Radiology, Hospital de Santa Maria, University Hospital, 26 Radiology, Lisbon, Portugal Ioannina University, Ioannina, Greece 17 Pediatric Urology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 27 Department of Pediatrics, Milan, Italy University Hospital LKH Graz, Graz, Austria 18 Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, 28 Pediatric Urology, London, UK University Medical Center Regensburg, Regensburg, Germany 19 Dinogmi University of Genova, Pediatric Surgery and Urology, Gaslini Institute, 29 Pediatric Nephrology, Genoa, Italy Centro Hospitalar São João, Porto, Portugal 20 Pediatric Radiology, Diagnostic and Interventional Radiology, University Hospital Jena, 30 Pediatric Radiology, Jena, Germany University Hospital LKH Graz, Graz, Austria 21 Pediatric Urology, Hôpital Mère-Enfant, Hospices Civils de Lyon and Claude Bernard University, Lyon 1, France Pediatr Radiol (2018) 48:291–303 293 Thereafter, for broader comments, public presentations of this Bladder exstrophy-epispadias complex (BEEC) Complex work have been performed in 2013 both at the ESPR congress congenital abdominal midline malformation which can in- (Budapest, Hungary) and at the ESUR congress (Istanbul, volve the urethra, the bladder, the pelvis, the pelvic floor, the Turkey). abdominal wall, the genitalia (with frequent duplication in After having gathered the multiple comments and ideas in females), and sometimes the spine and the anus. BEEC covers this fashion, this work has been edited and then sent to a wide spectrum of anomalies of different severity levels, European pediatric nephrologists and urologists, who were ranging from epispadias representing the mildest form, includ- invited based on skill set and interest to contribute to devel- ing proximal and distal epispadias, to the classical bladder opment of this glossary. After integrating their new comments exstrophy, and exstrophy of the cloaca, the most severe form. and discussion of this draft among the members of the ESPR This latter malformation is frequently referred to as OEIS uroradiology taskforce, a new public presentations were per- (omphalocele, cloacal exstrophy, imperforate anus and spinal formed at the 2015 ESPR congress (Graz, Austria) and 2015 dysraphism). Unlike the classical cloacal malformation which ESUR congress (Copenhagen, Denmark) for audience input occurs almost exclusively in phenotypical girls, cloacal from the audience. Finally, the glossary was sent to all co- exstrophy is seen in both boys and girls [14, 15]. authors for final discussion and agreement before submission for publication. Bladder instability This is an old cystomanometric term which should be replaced by “detrusor overactivity” [2, 4]. Glossary Bladder overactivity See “overactive bladder”. Acute urinary obstruction Acute impairment to the flow of Bolande’stumourSee “mesoblastic nephroma”. urine in the urinary tract resulting in a sudden increase in intraluminal pressure. It is often painful and is usually but Cacchi Ricci’s disease See “medullary sponge kidney”. not always associated with urinary tract distension. Calicectasis See “caliectasis”. Adult (simple) ureterocele The “adult” (and “simple”)partof this term should not be used any longer. It refers to a single Caliectasis (= calicectasis) Dilatation of one calyx or several system ureterocele which was thought to be more frequently calyces of the kidney. This term is descriptive and does not encountered in adults and often discovered
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    ORIGINAL ARTICLE Clinical Course and Effective Factors of Primary Vesicoureteral Reflux Azar Nickavar1, Niloofar Hajizadeh2, and Arash Lahouti Harahdashti3 1 Department of Pediatric Nephrology, Aliasghar Childrens’ Hospital, Iran University of Medical Sciences, Tehran, Iran 2 Department of Pediatric Nephrology, Childrens’ Medical Center, Tehran University of Medical Sciences, Tehran, Iran 3 Department of Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Received: 5 Sep. 2013; Received in revised form: 6 Aug. 2014; Accepted: 22 Oct. 2014 Abstract- Vesicoureteral reflux (VUR) is one of the most important causes of urinary tract infection and renal failure in children. It is a potentially self-limited disease. The aim of this study was to evaluate the clinical course and significant factors in children with primary VUR. The medical charts of 125 infants and children (27.2 % males, 72.8% females) with all grades of primary VUR were retrospectively reviewed. Mean age at diagnosis was 22.3±22.9 months. 52% of patients had bilateral VUR. Mild reflux (Grade I, II) was the most common initial grade. 53.6% of patients achieved spontaneous resolution. 30.1% of patients had decreased renal function on initial DMSA renal scan, significantly in males and severe VUR. Reflux nephropathy occurred in 17.6% of patients, especially in renal damage and male sex. No significant association was observed between recurrent urinary tract infection with the severity of VUR, and the presence of renal damage at admission. Age at diagnosis, gender, grade, laterality, the absence of recurrent urinary tract infection and renal damage had a significant correlation between spontaneous VUR resolution.
  • Effects of Ramipril in Nondiabetic Nephropathy: Improved Parameters of Oxidatives Stress and Potential Modulation of Advanced Glycation End Products

    Effects of Ramipril in Nondiabetic Nephropathy: Improved Parameters of Oxidatives Stress and Potential Modulation of Advanced Glycation End Products

    Journal of Human Hypertension (2003) 17, 265–270 & 2003 Nature Publishing Group All rights reserved 0950-9240/03 $25.00 www.nature.com/jhh ORIGINAL ARITICLE Effects of ramipril in nondiabetic nephropathy: improved parameters of oxidatives stress and potential modulation of advanced glycation end products KSˇ ebekova´1, K Gazdı´kova´1, D Syrova´2, P Blazˇı´cˇek2, R Schinzel3, A Heidland3, V Spustova´1 and R Dzu´ rik 1Institute of Preventive and Clinical Medicine, Bratislava, Slovakia; 2Military Hospital, Bratislava, Slovakia; 3University Wuerzburg, Germany Enhanced oxidative stress is involved in the progres- patients on conventional therapy did not differ signifi- sion of renal disease. Since angiotensin converting cantly from the ramipril group, except for higher Hcy enzyme inhibitors (ACEI) have been shown to improve levels in the latter. Administration of ramipril resulted in the antioxidative defence, we investigated, in patients a drop in blood pressure and proteinuria, while creati- with nondiabetic nephropathy, the short-term effect of nine clearance remained the same. The fluorescent the ACEI ramipril on parameters of oxidative stress, AGEs exhibited a mild but significant decline, yet CML such as advanced glycation end products (AGEs), concentration was unchanged. The AOPP and malon- advanced oxidation protein products (AOPPs), homo- dialdehyde concentrations decreased, while a small rise cysteine (Hcy), and lipid peroxidation products. Ramipril in neopterin levels was evident after treatment. The (2.5–5.0 mg/day) was administered to 12 newly diag- mentioned parameters were not affected significantly in nosed patients for 2 months and data compared with a the conventionally treated patients. Evidence that rami- patient group under conventional therapy (diuretic/ pril administration results in a mild decline of fluores- b-blockers) and with age- and sex-matched healthy cent AGEs is herein presented for the first time.