Survey of pediatric physicians to determine preferences for terms to describe variable degrees of distension of the urinary collecting system.

1. Defining urinary collecting system distension
in ultrasound reports: A survey of referring
physicians
Crapp SJ, Spottswood SE, Hernanz-Schulman M, Jabs K, Thomas J, Yu C, Kan JH
Department of Diagnostic Imaging, Monroe Carell Jr Children's Hospital, Vanderbilt
University Medical Center, Nashville, TN 37232, USA
Dr. Seth J. Crapp, Pediatric Imaging

2. BACKGROUND:
The terms employed by radiologists to describe
and report the degree of urinary collecting
system distension identified on renal sonography
can be variable, and the meaning intended by the
radiologist may not coincide with that
understood by referring physicians to whom that
report is directed.
Dr. Seth J. Crapp, Pediatric Imaging

3. OBJECTIVE:
The purpose of this study is to determine how
referring physicians interpret a variety of terms
commonly used by radiologists to describe
distension of the renal collecting system.
Dr. Seth J. Crapp, Pediatric Imaging

4. MATERIALS AND METHODS:
After IRB approval, an online survey was
distributed to 393 pediatric practitioners. The
survey asked their interpretation of the terms:
hydronephrosis, hydroureter, megaureter, and
pelvocaliectasis; and preferred terms to describe
distension of the urinary collecting system.
Dr. Seth J. Crapp, Pediatric Imaging

5. 1. Please indicate your specialty:
0%
2%
2% Pediatrics
Pediatric
nephrology
General/family
practice
Pediatric urology
96%
Dr. Seth J. Crapp, Pediatric Imaging

6. 2. What is your level of training?
0% 1% Attending physician
Resident
41%
Fellow
58%
Nurse practicioner/
physician assistant
Dr. Seth J. Crapp, Pediatric Imaging

7. 3. What does the term hydronephrosis imply
in a renal ultrasound report?
1% 2%
A. vesicoureteral
reflux
B. obstruction
24% 19%
C. extra-renal pelvis
5%
D. other pathology
7%
E. A or B
F. A, B, C or D
42%
G. No pathology
Dr. Seth J. Crapp, Pediatric Imaging

8. 5. What does the term pelvocaliectasis imply
in a renal ultrasound report?
3% 1% 8% A. vesicoureteral
reflux
B. obstruction
7%
C. extra-renal pelvis
27%
D. minimal
hydronephrosis
E other pathology
33%
F. A, B, C, D or E
21%
G. No pathology
Dr. Seth J. Crapp, Pediatric Imaging

9. What does the term hydroureter imply in a
renal ultrasound report?
0% 1% 5% A. vesicoureteral
reflux
B. obstruction
30%
C. dilatation of
ureter, non-specific
D. A, B or C
65%
E. No pathology
Dr. Seth J. Crapp, Pediatric Imaging

10. What does the term megaureter imply in a renal ultrasound report?
A. vesicoureteral reflux
B. obstruction
C. same as hydroureter
D. A, B or C
E. No pathology
Dr. Seth J. Crapp, Pediatric Imaging

11. What terms do you prefer radiologists use to describe relative distension of the urinary
collecting system in a renal ultrasound report?
A. Hydronephrosis/ hydroureter
B. Pelvocaliectasis/ ureterectasis
Dr. Seth J. Crapp, Pediatric Imaging