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Pediatric Nephrology
Published in: Pediatric Nephrology 3/2021

01-03-2021 | Magnetic Resonance Imaging | Educational Review

The old becomes new: advances in imaging techniques to assess nephron mass in children

Authors: Marissa J. DeFreitas, Chryso P. Katsoufis, Juan C. Infante, Michael L. Granda, Carolyn L. Abitbol, Alessia Fornoni

Published in: Pediatric Nephrology | Issue 3/2021

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Abstract

Renal imaging is widely used in the assessment of surrogate markers of nephron mass correlated to renal function. Autopsy studies have tested the validity of various imaging modalities in accurately estimating “true” nephron mass. However, in vivo assessment of nephron mass has been largely limited to kidney volume determination by ultrasonography (US) in pediatric populations. Practical limitations and risks create challenges in incorporating more precise 3D volumetric imaging, like magnetic resonance imaging (MRI), and computed tomography (CT) technologies, compared to US for routine kidney volume assessment in children. Additionally, accounting for structural anomalies such as hydronephrosis when estimating renal parenchymal area in congenital anomalies of the kidney and urinary tract (CAKUT) is important, as it correlates with chronic kidney disease (CKD) progression. 3D imaging using CT and MRI has been shown to be superior to US, which has traditionally relied on 2D measurements to estimate kidney volume using the ellipsoid calculation. Recent innovations using 3D and contrast-enhanced US (CEUS) provide improved accuracy with low risk. Indexing kidney volume to body surface area in children is an important standard that may allow early detection of CKD progression in high-risk populations. This review highlights current understanding of various imaging modalities in assessing nephron mass, discusses applications and limitations, and describes recent advances in the field of imaging and kidney disease. Although renal imaging has been a long-standing, essential tool in assessing kidney disease, innovation and new applications of established technologies provide important tools in the study and management of kidney disease in children.
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Metadata
Title
The old becomes new: advances in imaging techniques to assess nephron mass in children
Authors
Marissa J. DeFreitas
Chryso P. Katsoufis
Juan C. Infante
Michael L. Granda
Carolyn L. Abitbol
Alessia Fornoni
Publication date
01-03-2021
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 3/2021
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-020-04477-8

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