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Direct radionuclide cystography by supra-pubic puncture: comparison with conventional voiding cystourethrography
Thomas Eluvathingal Jose1, Hadi Mohiudheen, Chetan Patel
1Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India. drthomasej@yahoo.com
Nuclear Medicine Communications
|April 21, 2004
Summary
Supra-pubic direct radionuclide cystography (SDRC) offers a simple, well-tolerated alternative to catheterization for diagnosing vesicoureteric reflux (VUR) in children. This method demonstrates high accuracy and avoids the discomfort associated with traditional VCU and DRC procedures.
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
- Nuclear Medicine
Background:
- Vesicoureteric reflux (VUR) and its complications are common in pediatric practice.
- Voiding cystourethrography (VCU) and direct radionuclide cystography (DRC) are standard diagnostic tools for VUR.
- Both VCU and DRC necessitate catheterization, which is poorly tolerated by children.
Purpose of the Study:
- To evaluate radionuclide cystography via direct supra-pubic puncture (SDRC) as a non-catheterizing alternative for VUR diagnosis.
- To compare the efficacy of SDRC with the conventional VCU method.
Main Methods:
- A prospective study involving 43 pediatric patients (mean age 5.73 years).
- SDRC procedure involved supra-pubic puncture and radiotracer instillation into the bladder, avoiding catheterization.
- Results were compared against VCU findings.
Main Results:
- SDRC detected VUR in 22 out of 86 renal units, while VCU identified it in 29.
- High concordance (90%) between SDRC and VCU results was observed.
- SDRC demonstrated a sensitivity of 75.86%, specificity of 100%, and overall accuracy of 91.86% compared to VCU.
Conclusions:
- Supra-pubic direct radionuclide cystography (SDRC) is a simple and effective technique for VUR detection and grading.
- The SDRC procedure avoids catheterization, leading to better tolerance in children.
- SDRC presents as a safe diagnostic option with minimal side effects.