Pediatr Radiol (2006) 36: 470–471 DOI 10.1007/s00247-006-0158-6

PE DIATRI C RAD IOLOGY CME ACTIVI TY

Pediatric Radiology Continuing Medical Education Activity

Published online: 18 March 2006 # Springer-Verlag 2006

Physician needs statement Pediatric Radiology Continuing Medical Education (CME) activity is designed to provide educational information primarily related to technology, techniques, and applications of pediatric and fetal imaging for radiologists and those involved in allied sciences. This material includes information on imaging appearances of normal growth and development, as well as injury and illness that effect the pediatric population.

Accreditation statement This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The American College of Radiology and The Society for Pediatric Radiology. The American College of Radiology is accredited by the ACCME to provide continuing medical education for physicians. The American College of Radiology designates this educational activity for a maximum of 1 AMA PRA Category 1 credit™. Physicians should claim only credit commensurate with the extent of their participation in the activity. The American Medical Association has determined that physicians not licensed in the U.S. who participate in this CME Activity are eligible for AMA PRA category 1 credit.

Objectives: General educational objectives of Pediatric Radiology CME consist of the following: After reading the article and successfully completing the Pediatric Radiology CME activity, the participant will: – – – –

Understand the variety of normal variations and disorders that effect pediatric population Identify and apply appropriate imaging strategies for evaluation of normal variations and disorders Recognize risks and benefits of imaging modalities Recognize the features and understand the basic anatomic, physiologic, and cellular basis for normal growth and development as well as illness and injury

Instructions Participants 1. must access website (http://www.cme.pedrad.org) 2. must answer at least 70% of the questions correctly Completion of each test results in 1 hour of category 1 credit. This evaluation is an online activity. Only examinations completed on the website will be valid for CME credit. Please do not mail or FAX in responses to the questions for the CME article. Access to articles for CME credit will be up to one calendar year. In addition, participants will be provided immediate feedback through e-mail notification. Documentation of credits earned for the year 2006 CME tests will be available to SPR members on the CME Gateway. More information on this service is forthcoming. Participation is free for members of the SPR.

Learning goals and objectives Goals: To increase knowledge and understanding of both appropriate use and features of pediatric imaging evaluation including basic anatomy, physiology, and growth and development, in both healthy and disease states.

For questions regarding the CME activity, contact: Donald P. Frush, M.D. Phone: +1-919-684-7293 Fax: +1-919-684-7151 E-mail: [email protected]

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Perinatal assessment of hereditary cystic renal diseases: the contribution of sonography Fred E. Avni, Laurent Garel, Marie Cassart, Anne Massez, Daniele Eurin, François Didier, Michelle Hall, Rita L . Teele (Please see article in this issue. Dr. Didier has not disclosed his relevant financial relationships or potential conflicts of interest. The remaining author(s) have no financial interest, arrangement, or affiliation to disclose in the context of this CME activity. There is no investigational or “off-label” use of medical devices or other products, or pharmaceutical agents to disclose.)

Learning objectives 1. To learn the spectrum of hereditary renal cystic disease, 2. To understand a proposed classification system for cystic renal disease in children, 3. To be familiar with perinatal sonographic patterns in the variety of renal cystic diseases, 4. To be able to discuss the differential considerations.

Questions 1. The diagnosis of fetal nephropathy is based on which one of the following? a. Absence of a kidney b. Abnormal parenchymal echotexture c. Hydronephrosis d. Asymmetric renal involvement 2. Which one of the following is the most common nongenetic type of cystic disease encountered by fetal ultrasound? a. Renal dysplasia b. Glomerulocystic disease c. Medullary sponge kidney d. Multilocular cyst 3. During fetal sonographic assessment for cystic renal disease, renal echogenicity is determined by comparing the fetal kidney to which one of the following? a. Lung b. Liver c. Extremity soft tissues d. Placenta 4. Which one of the following is true regarding autosomal recessive polycystic kidney disease? a. 1 in 200,000 births b. Rarely causes fetal death c. Cystic dilation of tubules predominates in the medulla. d. Hepatic fibrosis has not been described in the fetus.

5. Which one of the following is the typical sonographic appearance of autosomal recessive polycystic kidney disease? a. Normal size, hyperechoic, good corticomedullary differentiation b. Normal size, hyperechoic, poor corticomedullary differentiation c. Enlarged, hyperechoic, poor corticomedullary differentiation d. Enlarged, hyperechoic, good corticomedullary differentiation 6. Which one of the following is true regarding autosomal dominant polycystic kidney disease? a. Less common than autosomal recessive polycystic kidney disease b. Though hereditary, 75% of cases arise from spontaneous mutation. c. Cysts arise in the cortex, sparing the medulla. d. Cysts develop on walls of collecting tubules. 7. Which one of the following is true regarding glomerulocystic renal disease? a. Glomerular cysts are not specific for a single disorder. b. >50% of spaces have to be affected to establish the diagnosis. c. Presents with normal size but hyperechoic kidneys. d. Typically, cysts are medullary. 8. Medullary cystic dysplasia is associated with which one of the following? a. Cysts limited to the medullary region b. Meckel Gruber c. Beckwith–Wiedemann d. Usually normal size kidneys 9. Regarding simple renal cysts seen in fetal ultrasound, which one of the following is true? a. Most common non-hereditary cystic renal disorder b. Simple cyst may disappear. c. A single simple cyst seen on fetal ultrasound does not warrant follow-up. d. None of the above 10. Of hereditary cystic disease, which one of the following is associated with either normal or reversed corticomedullary echotexture? a. Autosomal dominant polycystic kidney disease b. Automosal recessive polycystic kidney disease c. Glomerulocystic disease d. Medullary cystic dysplasia