OBJECTIVE: Early diagnosis of voiding dysfunction can minimize social and psychological repercussions and avoid renal lesions. The ureteric jet can be evaluated by color Doppler, and a good correlation has been observed between this method and patients' clinical data in the diagnosis of voiding dysfunction. This study was aimed at evaluating the interobserver agreement in the assessment of the ureteral jet in asymptomatic children. MATERIALS AND METHODS: Interobserver agreement was prospectively evaluated. A total of 41 patients were sequentially evaluated by two medical sonographers. For each patient, three consecutive Doppler waveforms were obtained from each of the two ureteral jets. The number of peaks on each wave was observed and classified. The maximum velocity of the highest peak of each waveform was also observed. Kappa coefficients (κ) were calculated. RESULTS: Moderate interobserver agreement was observed (κ = 0.48; 95% confidence interval: 0.36-0.60). Most frequently a plateau pattern was observed for the ureteric jet. Maximum velocities measured by the two observers were respectively 32.37 cm/s and 35.63 cm/s. CONCLUSION: Moderate interobserver agreement was observed in the evaluation of the ureteric jet by means of color Doppler.

Keywords: Ureter, Urination, Children

OBJECTIVE: The present study is aimed at comparing the quality of sonographic abdominal images obtained in fasting and non fasting children. MATERIALS AND METHODS: This is a prospective study including children aged up to 12 years sequentially evaluated by two sonographers. The images were classified according to a score as follows: 1 (non-visualized or partially visualized, inappropriate for diagnosis); 2 (sufficient for diagnosis); or 3 (excellent). Images were also classified into "diagnostic" or "non diagnostic". RESULTS: Seventy-seven patients (47 boys and 30 girls) with ages ranging between 0 and 12 years (median = 1 year) were evaluated. Fasting proved a statistically significant advantage only for evaluating the gallbladder by only one of the observers (p = 0.032). Once the images were classified into either "diagnostic" or "non diagnostic" no difference was observed between the two groups. CONCLUSION: The authors conclude that fasting did not affect significantly the quality of abdominal sonographic images in children.

Keywords: Ultrasonography, Children, Abdominal, Fasting

OBJECTIVE: To evaluate the accuracy of computed tomography for local and lymph node staging of Wilms' tumor. MATERIALS AND METHODS: Each case of Wilms' tumor was evaluated for the presence of abdominal lymph nodes by a radiologist. Signs of capsule and adjacent organ invasion were analyzed. Surgical and histopathological results were taken as the gold standard. RESULTS: Sensitivity was 100% for both mesenteric and retroperitoneal lymph nodes detection, and specificity was, respectively, 12% and 33%, with positive predictive value of 8% and 11% and negative predictive value of 100%. Signs of capsular invasion presented sensitivity of 87%, specificity of 77%, positive predictive value of 63% and negative predictive value of 93%. Signs of adjacent organ invasion presented sensitivity of 100%, specificity of 78%, positive predictive value of 37% and negative predictive value of 100%. CONCLUSION: Computed tomography tumor showed low specificity and low positive predictive value in the detection of lymph node dissemination. The absence of detectable lymph nodes makes their presence unlikely, and likewise regarding the evaluation of local behavior of tumors.

Keywords: Computed tomography; Wilms' tumor; Staging.

Adnexal torsion is characterized by partial or complete rotation of the suspensory ligament of the ovary and its corresponding vascular pedicle, resulting in vascular impairment that can culminate in hemorrhagic infarction, as well as necrosis of the ovary and fallopian tube. Because there are myriad causes of acute pelvic pain, the differential diagnosis of ovarian torsion is often challenging. Consequently, radiologists should be familiar with the main imaging findings. In this regard, there are typical signs of ovarian torsion on magnetic resonance imaging, including increased ovarian volume with stromal edema and peripheral distribution of the ovarian follicles, as well as thickening of the fallopian tube, an adnexal mass (causal factor) that shifts toward the midline, and the classic, pathognomonic “whirlpool sign”. The objective of this essay was to review and illustrate the various magnetic resonance imaging findings in ovarian torsion.

Keywords: Magnetic resonance imaging; Ovary; Torsion abnormality; Ovarian neoplasms; Ovarian cysts.

Pancreas transplantation is a well-established treatment for patients with complicated diabetes mellitus and advanced renal failure. The most common procedure is simultaneous pancreas-kidney transplantation, in which the pancreas graft is positioned in the right pelvic region and the kidney graft is positioned in the left iliac fossa. Various imaging methods are used for the post-transplantation evaluation of the graft parenchyma and vascular anatomy, as well as for the identification of possible complications. As the number of cases increases, it is fundamental that radiologists understand the surgical procedure and the postoperative anatomy, as well as to recognize the possible postoperative complications and their imaging aspects, with the aim of providing the best guidance in the postoperative management of transplant recipients.

Keywords: Pancreas transplantation; Kidney transplantation; Organ transplantation; Diabetes mellitus; Postoperative complications.