Antenatal hydronephrosis is the most frequent urinary tract anomaly detected on prenatal ultrasonography. It occurs approximately twice as often in males as in females. Most antenatal hydronephrosis is transient with little long-term significance, and few children with antenatal hydronephrosis will have significant obstruction, develop symptoms or complications, and require surgery. Some children will be diagnosed with more serious conditions, such as posterior urethral valves. Early detection of obstructive uropathy is necessary to mitigate the potential morbidity from loss of renal function. Imaging is an integral part of screening, diagnosis, and monitoring of children with antenatal hydronephrosis. Optimal timing and appropriate use of imaging can reduce the incidence of late diagnoses and prevent renal scarring and other complications. In general, follow-up neonatal ultrasound is recommended for all cases of antenatal hydronephrosis, while further imaging, including voiding cystourethrography and nuclear scintigraphy, is recommended for moderate or severe cases, or when renal parenchymal or bladder wall abnormalities are suspected. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

中文翻译：

---

ACR适当性Criteria®产前肾积水婴儿。

产前肾积水是产前超声检查中最常见的尿路异常。它在男性中的发病率大约是女性的两倍。大多数产前肾积水是一过性的，长期意义不大，很少有产前肾积水的儿童会出现明显的阻塞，出现症状或并发症并需要手术。一些孩子将被诊断出患有更严重的疾病，例如后尿道瓣膜。尽早发现阻塞性尿毒症对于减轻肾功能丧失的潜在发病率是必要的。影像检查是筛查，诊断和监测患有产前肾积水的儿童的重要组成部分。最佳时机和适当使用影像可以减少后期诊断的发生率，并防止肾脏瘢痕形成和其他并发症。一般而言，对于所有产前肾积水病例，建议进行随访新生儿超声检查，对于中度或重度病例，或怀疑有肾实质或膀胱壁异常时，建议进一步影像学检查，包括排空膀胱尿道造影和核闪烁显像。美国放射学院适当性标准是针对特定临床状况的循证指南，每年由多学科专家小组进行审查。指南的制定和修订包括对来自同行评审期刊的最新医学文献进行广泛分析，并应用公认的方法（兰德/加州大学洛杉矶分校的适当方法和建议评估的等级，制定，和评估（GRADE），以评估特定临床情况下成像和治疗程序的适当性。在证据不足或模棱两可的情况下，专家意见可能会补充现有证据以推荐影像学或治疗方法。