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Introduction
In recent years, with the improvement of imaging techniques and prenatal care systems, a growing number of cases of pediatric hydronephrosis have been detected in the early prenatal period and followed up (1,2). In addition, an increasing number of cases of pediatric ampullary renal pelvis (ARP), which is challenging to distinguish from hydronephrosis, have been diagnosed in postnatal follow-up observations (3). To improve the diagnostic accuracy of this type of pelvis and to reduce misdiagnosis, the present study reports the findings in the clinical follow-up of 65 cases of ARP from 1,167 pediatric patients who were prenatally suspected to have hydronephrosis.
Patients and methods
Patient characteristics
This study retrospectively analyzed 1,167 cases of prenatally suspected hydronephrosis, who were referred to comprehensive pediatric surgery, obstetrics, ultrasound and other related departments in the Qilu Hospital of Shandong University (Jinan, China) between January 2003 and December 2011. For the purpose of this study, different levels of postnatal follow-up program were performed for these cases according to the grade of hydronephrosis. A total of 65 cases were diagnosed with pediatric ARP by complete physical examination by ultrasound, computed tomography urography (CTU) and magnetic resonance imaging of the urinary system (MRU). Of these cases of ARP, 37 were males and 28 were females. The average age of the cases ranged from 2 to 8 years (mean age, 3.9 years). Unilateral and bilateral ARP were diagnosed in 54 (left in 31 and right in 23 cases) and 11 cases, respectively.
Follow-up surveillance
In the large-scale prenatal screening and follow-up of postnatal hydronephrosis, ARP initially did not show any difference from hydronephrosis by sonographic examination. Ultrasonic examination reported a volatile separation of the renal pelvis collection system by 2–3 cm, with or without mild renal calyx dilatation. Such cases were closely followed up according to the grade of hydronephrosis and ultrasound tests were performed once every one to three months. Compared with cases of...