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Cyclic cystography: diagnostic yield in selected pediatric populations

M J Gelfand1, B L Koch, A H Elgazzar

  • 1Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. gelfand.mj@chmcc.org

Radiology
|November 30, 1999
PubMed

Insights

A second cycle of cyclic cystography improves diagnosis of vesicoureteral reflux (VUR) in children. The diagnostic yield is higher in VUR follow-up cases than in severe urinary tract infection cases.

Area of Science:

  • Pediatric Urology
  • Diagnostic Imaging

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, often diagnosed via cystography.
  • The diagnostic yield of cyclic cystography may vary depending on the patient population.

Purpose of the Study:

  • To evaluate the diagnostic yield of cyclic cystography in relation to the prevalence of VUR.
  • To determine if a second cycle of cystography increases diagnostic yield in specific pediatric populations.

Main Methods:

  • Prospective study of 2 groups: 124 children with severe urinary tract infection and 135 with diagnosed VUR.
  • Cyclic cystography (nuclear or fluoroscopic) was performed, with a second cycle if VUR was not initially detected.

Main Results:

  • VUR was detected in cycle 1 in 32% of severe UTI cases and 67% of VUR follow-up cases.
  • A second cycle detected VUR in 9% of severe UTI cases and 24% of VUR follow-up cases.
  • Grade I-III VUR was identified in 15 patients during the second cycle.

Conclusions:

  • The second cycle of cyclic cystography offers a higher diagnostic yield in VUR follow-up patients compared to those with severe urinary tract infection.
  • Pretest probability of VUR should guide the decision to perform a second cystography cycle.
Abstract

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