Learning objectives
To illustrate ce-VUS imaging findings in the evaluation of vesicoureteral reflux (VUR) associated with urinary pathology in paediatric patients.
To highlight the importance of the method based on its radiation-free,
highly efficient,
reliable and safe characteristics.
Background
VUR represents an abnormal retrograde flow of urine towards the ureter or even the kidneys.
This condition is associated with an increased risk of recurrent urinary tract infection (UTI) and renal scarring1.
The prevalence of VUR in children is between 0.4% and 1.8%.
It is found in 25% to 50% of children presenting with urinary tract infection,
in 27.4% of siblings of patients with
diagnosed VUR and in 3% to 19% of infants with documented prenatal urinary tract anomalies 2,3,4.
According to Darge,
the reflux...
Findings and procedure details
We retrospectively reviewed cases of paediatric patients investigated for VUR at our institution from January 2013 to December 2017.
122 patients (64 males and 58 females) underwent ce-VUS with intravesical administration of SonoVue®for the indication of "antenatal diagnosed urinary pathology and/or UTIs".
Their age ranged from 4 days to 26 years (mean age: 3 years and 7 months).
We found 64 patients with VUR,
73 patients had urinary pathology and 43 presented VUR associated with urinary pathology (26 males,
17 females).
For those who presented...
Conclusion
ce-VUS is currently regarded as a valid,
highly efficient,
reliable and safe imaging modality for examining VUR.
Regarding infants and children,
radiologists should continually think about using appropriate,
optimized,
justified and as safe as possible imaging modalities.
Personal information
Dr.
Ioana Boca
Medical Resident - Department of Radiology,
Emergency County Hospital,Cluj-Napoca/RO.
Dr.
Otilia Fufezan
Consultant Physician -Department of Radiology,
Children Emergency Hospital,
Cluj-Napoca/RO.
References
1.
R.
Keren,
N.
Shaikh,
H.
Pohl,
L.
Gravens-Mueller,
A.
Ivanova et al.
Risk Factors for Recurrent Urinary Tract Infection and Renal Scarring.
Pediatrics 2015 July; 136 (1): 1-9.
2.
Michael A.
Sargent.
Opinion
What is the normal prevalence of vesicoureteral reflux? Pediatr Radiol 2000,
March; 30: 587-93.
3.
Salvatore Arena,
Roberta Iacona,
Pietro Impellizzeri,
Tiziana Russo,
Lucia Marseglia et al.
Physiopathology of vesico-ureteral reflux.
Italian Journal of Pediatrics 2016; 42: 1-5.
4.
D.
Kuzmanovska,
A.
Risteski,
M.
Kambovska,
T.
Trpcevski,
E.
Sahpazova et al....