Imaging of the Urinary Tract

Abstract

Accurate imaging of the urinary tract is essential in assessing potential urinary tract abnormalities, and in planning any treatment, whether surgical or conservative. Imaging in the context of the urinary tract is not just a depiction of the anatomy, but also an assessment of function in the broadest sense so this will include not only the function of the kidneys, but also of the ureters and the bladder. It is only when all this information is known that an informed diagnosis can be made and an intelligent management plan constructed. As such, the management of urinary tract conditions requires the collaborative effort of pediatric urologists, nephrologists, and radiologists, and pediatricians, usually in the form of a multidisciplinary meeting. The importance of this joined up approach cannot be overemphasized. The imaging provided by the radiologist may include plain abdominal radiographs, ultrasound (US), micturating cystograms (MCUGs), and other fluoroscopic and angiographic studies, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine (NM) studies. The intravenous urogram (IVU) is essentially obsolete in any modern center, and positron emission tomography (PET) is rarely used in children in the urinary tract. Angiography and angioplasty are key in the assessment of the vasculature and for therapeutic angioplasty. These will be discussed in turn, and their various applications, merits, and drawbacks highlighted.