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Voiding urosonography with ultrasonography contrast medium in children
Hans-Joachim Mentzel1, Susanna Vogt, Ulrike John
1Institute for Diagnostic and Interventional Radiology, University of Jena, Bachstrasse 18, 07740 Jena, Germany. hans-joachim.mentzel@med.uni-jena.de
Pediatric Nephrology (Berlin, Germany)
|April 17, 2002
Summary
Voiding urosonography (VUS) is a reliable new method for detecting vesicoureteral reflux (VUR) in children. This study found VUS highly accurate when compared to traditional voiding cystourethrography (VCUG).
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
- Nephrology
Background:
- Vesicoureteral reflux (VUR) is a common condition in children, often diagnosed via voiding cystourethrography (VCUG).
- Newer imaging techniques are being explored to improve diagnostic accuracy and patient comfort.
Purpose of the Study:
- To evaluate the diagnostic accuracy of voiding urosonography (VUS) using ultrasonography contrast medium.
- To compare VUS performance against the gold standard, radiographic voiding cystourethrography (VCUG), for VUR detection in pediatric patients.
Main Methods:
- A prospective study involving 118 children (3 weeks to 16 years) with 234 ureterorenal units.
- Patients underwent both VUS with ultrasonography contrast medium (Levovist) and conventional VCUG during the same session.
- VUS involved filling the bladder with saline and contrast, with reflux identified by echogenic bubbles in the ureter or renal pelvis.
Main Results:
- Voiding urosonography (VUS) demonstrated high diagnostic accuracy, with an overall concordance rate of 93.7% compared to voiding cystourethrography (VCUG).
- VUS achieved a sensitivity of 90%, specificity of 94.6%, and a negative predictive value of 97.8% for detecting VUR.
- Both methods excluded reflux in 77.7% of ureterorenal units, highlighting VUS's reliability in ruling out the condition.
Conclusions:
- Voiding urosonography (VUS) with ultrasonography contrast medium is a reliable and accurate diagnostic tool for detecting vesicoureteral reflux (VUR) in children.
- The high sensitivity and specificity suggest VUS can be a valuable alternative or adjunct to VCUG in pediatric VUR diagnosis.
- VUS offers a potentially less invasive and effective imaging modality for pediatric urinary tract evaluations.
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