The Value of Ultrasound in Diagnosing Vesicoureteral Reflux in Young Children with Urinary Tract Infection
Urinary tract infection is a common pediatric problem and vesicoureteral reflux is its most common complication. Detection of this reflux has classically been achieved by voiding cystouretrography (VCUG). Ultrasonography for evaluation of vesicoureteral reflux is shown to be feasible but is not widely accepted. Our aim was to assess the value of routine sonography in detecting vesicoureteral reflux is young children with urinary tract infection. This study was carried out in 105 patients suffering from urinary tract infection admitted to Shahid Sadughi Hospital in Yazd, Iran. These patients were evaluated by two methods (sonography and VCUG). Overall sensitivity and specificity value of sonography in suggesting vesicoureteral reflux were 63% and 95% respectively. The most accurate results were obtained with high grades reflux (75% and 955). The results reconfirmed that sonography is reliable in the exclusion or verification of high grade reflux and it has a low sensitivity in low grade vesicoureteral reflux.
Moorthy I, Easty M, McHugh K, Ridout D, Biassoni L, Gordon I. The presence of vesicoureteric reflux does not identify a population at risk for renal scarring following a first urinary tract infection. Arch Dis Child 2005;90(7):733-6.
Berrocal T, Gayá F, Arjonilla A. Vesicoureteral reflux: can the urethra be adequately assessed by using contrastenhanced voiding US of the bladder? Radiology 2005;234(1):235-41.
Giordano M, Marzolla R, Puteo F, Scianaro L, Caringella DA, Depalo T. Voiding urosonography as first step in thediagnosis of vesicoureteral reflux in children: a clinical experience. Pediatr Radiol 2007;37(7):674-7.
Piscitelli A, Galiano R, Serrao F, Concolino D, Vitale R, D'Ambrosio G, Pascale V, Strisciuglio P. Which cystography in the diagnosis and grading of vesicoureteral reflux? Pediatr Nephrol 2008;23(1):107-10.
Sulieman A, Theodorou K, Vlychou M, Topaltzikis T, Kanavou D, Fezoulidis I, Kappas C. Radiation dose measurement and risk estimation for paediatric patients undergoing micturating cystourethrography. Br J Radiol 2007;80(957):731-7.
Darge K, Trusen A, Troeger J. Diagnostic imaging of vesicoureteral reflux. Rays 2002;27(2):99-106.
Xhepa R, Bosio M, Manzoni G. Voiding cystourethrosonography for the diagnosis of vesicoureteral reflux in a developing country. Pediatr Nephrol 2004;19(6):638-43.
Escape I, Martínez J, Bastart F, Solduga C, Sala P. Usefulness of echocystography in the study of vesicoureteral reflux. J Ultrasound Med 2001;20(2):145-9.
Alshamsam L, Al Harbi A, Fakeeh K, Al Banyan E. The value of renal ultrasound in children with a first episode of urinary tract infection. Ann Saudi Med 2009;29(1):46-9.
Tsai YC, Hsu CY, Lin GJ, Wang CJ, Cheng CH, Huang YH, Yen MH, Hsia SH, Yan DC. Vesicoureteral reflux in hospitalized children with urinary tract infection: the clinical value of pelvic ectasia on renal ultrasound, inflammatory responses and demographic data. Chang Gung Med J 2004;27(6):436-42.
Sjöström S, Jodal U, Sixt R, Bachelard M, Sillén U. Longitudinal development of renal damage and renal function in infants with high grade vesicoureteral reflux. J Urol 2009;181(5):2277-83.
Uhl M, Kromeier J, Zimmerhackl LB, Darge K. Simultaneous voiding cystourethrography and voiding urosonography. Acta Radiol 2003;44(3):265-8.
Duran C, Valera A, Alguersuari A, Ballesteros E, Riera L, Martin C, Puig J. Voiding urosonography: the study of the urethra is no longer a limitation of the technique. Pediatr Radiol 2009;39(2):124-31.
Novljan G, Kenig A, Rus R, Kenda RB. Cyclic voiding urosonography in detecting vesicoureteral reflux in children. Pediatr Nephrol 2003;18(10):992-5.
Kopac M, Kenig A, Kljucevsek D, Kenda RB. Indirect voiding urosonography for detecting vesicoureteral reflux in children. Pediatr Nephrol 2005;20(9):1285-7.
Kenney IJ, Negus AS, Miller FN. Is sonographically demonstrated mild distal ureteric dilatation predictive of vesicoureteric reflux as seen on micturating cystourethrography? Pediatr Radiol 2002;32(3):175-8.
Müller L, Preda I, Jacobsson B, Sixt R, Jodal U, Hansson S, Hellström M. Ultrasonography as predictor of permanent renal damage in infants with urinary tract infection. Acta Paediatr 2009;98(7):1156-61.
Piaggio G, Degl' Innocenti ML, Tomà P, Calevo MG,= Perfumo F. Cystosonography and voiding cystourethrography in the diagnosis of vesicoureteral reflux. Pediatr Nephrol 2003;18(1):18-22.
Zamir G, Sakran W, Horowitz Y, Koren A, Miron D.Urinary tract infection: is there a need for routine renal ultrasonography? Arch Dis Child 2004;89(5):466-8.
Lee MD, Lin CC, Huang FY, Tsai TC, Huang CT, Tsai JD. Screening young children with a first febrile urinary tract infection for high-grade vesicoureteral reflux with renal ultrasound scanning and technetium-99m-labeled dimercaptosuccinic acid scanning. J Pediatr 2009;154(6):797-802.
Mahant S, Friedman J, MacArthur C. Renal ultrasound findings and vesicoureteral reflux in children hospitalised with urinary tract infection. Arch Dis Child 2002;86(6):419-20.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.