泌尿器科画像診断の工夫と進歩 出生前超音波診断

Abstract

The frequent discovery of fetal congenital abnormalities has led to a better understanding of pediatric urological disorders. On the other hand, new questions on clinical examinations and management of the children have given rise to much controversy. We reviewed the difficulties and pitfalls surrounding the urological prenatal diagnosis. Accuracy of ultrasonography is operator-dependent, and main factors leading misdiagnosis include oligohydramnios and rare incidence of the abnormalities. Underlying disorders of prenatal hydronephrosis are multifactorial. Efforts to obtain co-existing findings, such as ureteral dilatation or bladder abnormalities, are essential to make accurate diagnosis. Evaluation of fetal renal function is mandatory in critical cases with decreased amniotic fluid volume. Biochemical analysis of fetal urine may be most reliable in differentiating fetuses with a good prognosis from those with a poor prognosis.