Aims and objectives
VUR is a common disorder in children that leads to ascending infection,
renal growth impairment and parenchymal scarring; the reflux nephropathy is responsible for 30-50% of renal failure in children.
[1-4]
Primary VUR is the most common congenital anomaly and it is seen in 0.5-1.5% of children.
The prevalence for vesicoureteral reflux (VUR) in young children (< 4 years) is 25% which is higher than its prevalence (12%) in 4-12 years children.
VUR might occur in an otherwise normally functioning bladder or might be secondary...
Methods and materials
Patients selecion
This retrospective study included VUS using SonoVue® and VCUG examinations performed between June 2011 and December 2015.
The total number of patients was 133,
with 263 pelvi-ureter units in children of mean age 21 months (range 29 days – 12 years).
There were 63 girls and 70 boys.
We included all children who suffered from recurrent urinary tract infections (UTI) with a proven positive urine culture or pelvicalyceal dilatation or in follow-up of VUR.
We excluded children who were incapable of voiding spontaneously...
Results
Vesicoureteral reflux was detected in 69 KUUs by VUS (26,2 %) and in 67 KUUs by VCUG (25,5 %).
Of these,
12 patients had bilateral VUR.
VCUG missed VUR in 5 cases and reflux was detected only by VUS (3 patients had grade 3 reflux and 2 patients had grade 4 reflux).
In 3 cases reflux was detected only by VCGU and VUS missed reflux (2 patients had grade 1 reflux and one patient had grade 2 reflux).
The inter-rater agreement between VUS and VCUG,...
Conclusion
Voiding urosonography (VUS) is a technique for diagnosing vesicoureteral reflux (VUR).
Its main advantage is that it does not entail ionising radiation.
Although voiding cystourethrography (VCUG) remains the test most commonly used because of high availability and low cost,
its radiation dose,
even when pulsed fluoroscopy is used,
cannot be ignored.
[5]
VCUG delivers significant ionizing radiation,
despite the use of digital and pulsed fluoroscopy (0,39 +/- 0,17 mSv).
[2-3]
Our findings suggest that VUS is a safe,
no-ionizing radiation,
technique with similar diagnostic results...
Personal information
Dr.
Vincenzo Costanzo,
Dipartimento di Scienze Radiologiche,
Di.Bi.Med.,
Università di Palermo,
Via del Vespro 127,
90100,
Palermo,
Italia; Phone: +393498189666; Mail:
[email protected]
References
1.
Maciej Piskunowicz1,
Dominik Świętoń1,
Dorota Rybczyńska,
Piotr Czarniak,
Arkadiusz Szarmach,
Mariusz Kaszubowski,
Edyta Szurowska; Comparison of voiding cystourethrography and urosonography with second-generation contrast agents in simultaneous prospective study; J Ultrason 2016: 16: 339-347.
2.
Ward et al; Pediatric Radiation Exposure and Effective Dose Reduction during Voiding Cystourethrography; Radiology: Volume 249: Number 3: December 2008.
3.
L.
Mariotti,
M.
E.
Latini,
S.
Riccioni,
M.
Scialpi; Cistouretrografia minzionale con fluoroscopia nello studio del reflusso vescico-ureterale: protocollo di esame e dose radiante in età pediatrica; Il giornale...