THE urinary tract infection it is often seen in children, even at a very young age. The question that arises is whether any imaging test should be done in a baby or child with a UTI. In consultation with the pediatrician or pediatric nephrologist / pediatric urologist, depending on the severity of the UTI and the age of the child, there are specific imaging tests that can be performed on babies and children with UTI.

The first and basic examination is the kidney-ureter-bladder ultrasound. This ultrasound can be performed from the first day of the child’s life, it does not burden him at all and it is a quick examination that gives very important information about the position, texture and morphology of the kidneys as well as about possible abnormalities in their formation or findings urinary tract obstruction. It is done very easily and quickly.

However, if there are specific findings that give rise to the suspicion of vesicoureteral reflux, i.e. a paradoxical movement of urine from the bladder up to the kidneys, which may endanger the normal morphology and function of the kidneys, a special study with ascending cystourethrography is requested .

This examination is the ideal method for regression control, is performed with fluoroscopy and should be performed in special pediatric radiology centers, which have special pulsed radiation machines and apply special pediatric protocols of low radiation burden.

It must also be carried out by specialized pediatric radiologists, who are familiar with performing the examination: under aseptic conditions, a very thin catheter is placed in the child’s urethra, a contrast agent is injected, the course of which is fluoroscopically captured and evaluated if it is as expected or if there is reflux.

Also, this specific examination outlines the urethra in detail, which is very important to do especially in little boys since sometimes there are strictures that prevent the normal flow of urine and predispose to urinary infections or burdening the kidney function. Cystography can also be performed sonographically, however this is usually done in follow-up cases where the anatomy has first been investigated by digital examination or in girls where a study of the urethra is not necessary.

Finally, if the UTI has been caused because there is an underlying abnormality in the kidneys with a complex morphology, in the last decade a new, special MRI has been applied, the magnetic urography. This examination should also be performed in special pediatric radiology departments where there is a special protocol and software for the study of renal function.

It ensures the detailed study of the anatomy and morphology of the kidneys, which is necessary if the correction of the abnormality requires surgical intervention. It provides 3D images that surgeons need to plan the operating room as well as functional information that replaces the functional scintigraphy study.

Thus, with this examination, which has no radiation at all, a detailed study of the anatomy and function of complex renal abnormalities is ensured at the same time and the surgery is properly planned in cases where it is needed. This examination, due to the length and detail required, is performed on babies and young children under sedation (mild anesthesia) with the help of pediatric anesthesiologists.