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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
Summary
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.