THE POST-ANGIOCARDIOGRAPHY UROGRAM IN CHILDREN - SHOULD IT BE ABANDONED

This study examines the value of the urogram radiograph taken after an giocardiography, in children with suspected congenital heart disease, to screen for co-existent urinary tract abnormalities. A retrospective audit of post-angiocardiography urograms over a three year period 199 0 to 1993 is presented. 184 urograms obtained in 166 children were rev iewed (86 males; mean age 18.1 months). Twenty-five urograms (13.6%) w ere obtained in cases where the urinary tract had previously been inve stigated. These urograms contributed no additional information. Image quality was suboptimal in 62 examinations (33.7%), due to gas, faeces or poor opacification, and two lesions were undetected on suboptimal r adiographs. Urinary tract abnormalities were detected in 17 patients ( 10.2%). These lesions were also detectable at sonography. We suggest t hat routine post-angiocardiography urograms can be abandoned in favour of sonographic screening of the urinary tract in children with congen ital heart disease.