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Simultaneous voiding cystourethrography and voiding urosonography.

M Uhl1, J Kromeier, L-B Zimmerhackl

  • 1Department of Pediatric Radiology, Freiburg University Hospital, Germany. uhl@mrs1.ukl.uni-freiburg.de

Acta Radiologica (Stockholm, Sweden : 1987)
|May 20, 2003
PubMed
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Voiding urosonography (VUS) and voiding cystourethrography (VCUG) show comparable accuracy for diagnosing vesicoureteral reflux (VUR) in children when performed simultaneously. VUS is a reliable method for reflux verification or exclusion.

Area of Science:

  • Pediatric Radiology
  • Diagnostic Imaging
  • Urology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children.
  • Accurate diagnosis of VUR is crucial for appropriate management and prevention of renal damage.
  • Voiding cystourethrography (VCUG) is the traditional gold standard, but involves radiation exposure.

Purpose of the Study:

  • To compare the diagnostic accuracy of contrast-enhanced voiding urosonography (VUS) and fluoroscopic voiding cystourethrography (VCUG).
  • To evaluate both imaging modalities when performed simultaneously in pediatric patients.

Main Methods:

  • A total of 24 children underwent simultaneous VCUG and VUS for reflux examination.
  • Radiographic contrast and ultrasound contrast agents were administered sequentially via transurethral catheterization.

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  • Fluoroscopy and ultrasound were performed concurrently, with imaging of contralateral sides.

    • Main Results:

    • Vesicoureteral reflux (VUR) was detected in 19 of 47 kidney-ureter-units (KUUs).
    • Both VCUG and VUS detected reflux in 16 KUUs; VCUG alone detected reflux in 3 cases (all grade 1).
    • VUS demonstrated 84% sensitivity and 100% specificity compared to VCUG as the reference standard.

    Conclusions:

    • Simultaneous performance allows for dependable comparison between VUS and VCUG.
    • Contrast-enhanced voiding urosonography (VUS) is confirmed as a reliable imaging technique for VUR diagnosis in children.
    • VUS offers a valuable alternative or adjunct to VCUG for reflux evaluation.