Primarily affecting males, LUTO has been classified into several different types and often proves difficult to diagnose. Currently, researchers are working on better ways to detect LUTO in utero and gain a clearer understanding of its causes.
The article “Microtomographic Analysis of Lower Urinary Tract Obstruction,” in Pediatric and Developmental Pathology, describes the use of two forms of imaging scanners, optical projection tomography and contrast-enhanced microCT scanning, to study 10 specimens collected at autopsy from male fetuses with lower urinary tract obstructions. Optical projection tomography uses visible, infrared, and ultraviolet light to image small, transparent specimens, and microCT scanning is x-ray–based CT scanning of small specimens made up of soft tissue or bone.
Conventional light microscopy was used to verify the findings of each scan. The results were then compared with 9 age-matched controls (with no obstructions). The scans showed more of the lower urinary tract and urethra than previous techniques, and the blockages that caused fetal mortality were clearer than on a regular fetal ultrasound performed in utero.
Microtomography performed at autopsy was able to capture 360º, three-dimensional images that are not available with the current ultrasound technology used while the fetus is in utero. Optical projection tomography and microCT scanning did, however, give clear pictures of the anatomy of the lower urinary tract and urethra that will be invaluable when diagnosing LUTO. They offered a clearer, more complete image of the condition in intact organs. This technology is currently available for use in a research setting. Hopefully, this approach may in the future by moved to the clinical arena and aid physicians to more quickly identify LUTO in the future.
The use of both optical projection scanning and microCT scanning allowed researchers to gain a clear image of the obstructions without dissecting the organs. Now there are lasting scans of the organs fully intact that can be used to gain a better understanding of the anatomy of both normal and obstructed urinary tracts. It is also the researchers’ hope that as technology evolves, so will higher resolution ultrasounds for detection of LUTO, and as more is learned about the disorder, in utero therapies and family counseling will continue to develop, eventually contributing to the prevention of this disease.
Full text of the article, “Microtomographic Analysis of Lower Urinary Tract Obstruction,” Pediatric and Developmental Pathology, Vol. 16, No. 6, 2013, is available.
About Pediatric and Developmental Pathology’
Pediatric and Developmental Pathology is the premier journal dealing with the pathology of disease from conception through adolescence. It covers the spectrum of disorders developing in-utero (including embryology, placentology, and teratology), gestational and perinatal diseases, and all diseases of childhood. For more information about the journal or society, please visit: http://www.pedpath.org
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