Research On The Results Of Ultrasound Examination Of Urinary Calculi In Children Caused By Melamine

Objective: To discuss the incidence of children with urinary tract stones due to melamine and understand their age, sex distribution characteristics, treatment and outcome measures though analyzing the screening results of 10,866 cases of melamine-contaminated milk consumption in children. To analyse of melamine stones ultrasound imaging features. At the same time, the use of ultrasound measurement of 1719 cases (0-14 years) of renal parameters of normal children, in order to provide children with kidney disease in healthy controls.Methods: The 10,866 cases of children from September 2008 to March 2009 in our hospital do routine ultrasound examination.Children get prone position, along the longitudinal axis of the kidney in the spine adjacent observing the various parts of the kidney echo.when the kidneys showed the largest long axis view ,stop frame to measuring the maximum length tracks, then rotate the probe 90°to take cross-section, measuring the largest width and thickness with a vertical diameter. All data provided by the operator repeated measurements three times averaged. Observation of renal morphology, internal structure, whether the expansion of ureter, bladder filling degree and the internal situation, determine the location of stones, number, size, structural characteristics, echo intensity, with or without hydronephrosis caused by kidney stones or ureter obstruction. In addition to review of the children to do a regular ultrasound checks, pay attention to stone location, size and number of changes, with the previous test results were compared.Results: The screening of 10,866 cases of children, the diagnosis of 270 cases of urinary tract stones, the positive detection rate was 2.48% (270/10866). Boys positive rate of 2.46% (151/6146), the girl positive rate of 2.52% (119/4720),χ~2 = 0.046, P = 0.831> 0.05, difference was not statistically significant.In the 270 cases of urinary calculi children,≤1-year-old 109 cases, accounted for 40.4%, ~ 2 years old in 70 cases, accounted for 26.0%, ~ 3 years old in 52 cases, accounted for 19.2%, ~ 6 years old in 29 cases, accounted for 10.7%, ~ 14 years old in 10 cases, accounted for 3.7%. Diagnosed with urinary tract stones in children accounted for the proportion of children with treatment were 4.71% (109/2313), 2.70% (70/2592), 2.26% (52/2301), 1.10% (29/2631), 0.97% ( 10/1029). Different age groups of urinary calculi comparison of detection rates,χ2= 78.827, P = 0.000 <0.05, differences were statistically significant. Comparing of detection rates of all age groups, except for ~ 2-year-old group and the ~ 3-year-old group (χ2 = 0.974, P = 0.324> 0.05), ~ 6-year-old group and the ~ 14-year-old group (χ2 = 0.119, P = 0.730> 0.05), the remaining difference between the groups were statistically significant.The urinary calculi predilection sites were mainly the kidneys, for 264 cases, accounting for 97.78%. Ureteral calculi in 4 cases, 2 cases of ureteral stone with kidney stones, bladder stones were not found. Stone sizes were small, the least of diameter 1mm, to those in greatest diameter of 30mm. Ultrasonic measurement of diameter of≤3mm stones were most common, accounting for 46.7%. Stone diameter> 10mm were only 24 cases, accounting for 8.9%.Ultrasonographic Features:Most of the stone shape was irregular, the majority showed accumulation of sediment or slag-like.They showed massive high points or strong echo,without acoustic shadow or accompanied by a weak acoustic shadow. Most of the stones could be detected the edge. Ureteral calculi showed patchy or small-group block strong echoes in the lumen, without obvious acoustic shadow. Parts of the ureter or kidney stones above could be seen to expand, showing no echo.As regards treatment, the majority of children through medical conservative treatment, urinary symptoms were improved significantly. Ultrasonic inspection found that urinary tract stones in varying degrees of decreases, until completely disappear.The analysis of children 0-14 years of age by normal renal ultrasound measurements showed that the same age group, generally the left kidney length and volume slightly larger than the right kidney. The size of the kidney increased with age and growth, infant and early childhood kidney increased rapidly and, thereafter, to slow down, to a teenager basically to stabilize.Conclusion: Melamine-contaminated infant milk powder led to the incidence of urinary calculi in children.The urinary stones caused by melamine occured mainly in infants and young children, and the younger the greater prevalence. They predilection sites were mainly the kidneys and sizes were small. Melamine stones showed massive high points or strong echo,without acoustic shadow or with a weak acoustic shadow,irregular shape,showing accumulation of sediment or slag-like. The ultrasound screening had played a significant role because of its high resolution, repeatable, high accuracy, no damage, etc. Ultrasonography was the preferred method of pediatric urinary calculi check.