Department of Neonatology, Sir Ganga Ram Hospital, New Delhi. E-mail:
In neonates the most common indication for an imaging procedure is the follow-up of an abnormality detected during antenatal sonography. With its noninvasiveness, wide availability, and ease of use without the risks associated with ionizing radiation exposure, ultrasound is an excellent imaging modality for initial evaluation of a suspected neonatal abdominal mass. When a mass is present, the sonographic features and the clinical presentation along with the age of the patient can help pursue a focused differential diagnosis in most cases. In some cases, ultrasound may even facilitate a definitive diagnosis without the necessity of additional imaging studies. VCUG, the second most common neonatal urinary tract imaging procedure, is used to evaluate lower urinary tract anatomy. It can be used to distinguish obstructive from nonobstructive hydronephrosis, vesicoureteral reflux, bladder tumors, and ureteroceles.
Diagnostic genitourinary evaluation with nuclear medicine techniques remains an area of untapped potential. Appropriate radionuclide imaging techniques provide useful and often invaluable functional information. They also offer the advantages of a low absorbed radiation dose and a significantly lower morbidity. Antenatally detected renal abnormalities are frequently encountered. Recommended postnatal evaluation of these infants has evolved to minimize invasive testing while maximizing detection of significant abnormalities.
