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Contrast-enhanced sonographic detection of vesicoureteral reflux in children: comparison with voiding

K Vassiou1, M Vlychou, R Moisidou

  • 1Department of Radiology, University of Thessalia, Larissa, Greece. avassiou@med.uth.gr

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|September 24, 2004
PubMed

Insights

Contrast-enhanced sonography (CES) accurately detects vesicoureteral reflux (VUR) in children, showing higher sensitivity and specificity than traditional methods. This imaging technique is a reliable alternative for VUR diagnosis and follow-up.

Area of Science:

  • Pediatric Radiology
  • Diagnostic Imaging
  • Urology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, often diagnosed using radiographic voiding cystourethrography (VCUG).
  • There is a need for alternative, potentially less invasive imaging modalities for VUR detection.

Purpose of the Study:

  • To prospectively evaluate contrast-enhanced sonography (CES) as a diagnostic alternative to VCUG for detecting VUR in pediatric patients.
  • To compare the efficacy of CES and VCUG in identifying renal units with VUR.

Main Methods:

  • Seventy-six children (0-9 years) with suspected VUR underwent both CES and VCUG.
  • CES involved instilling Levovist into the bladder, with reflux identified by hyperechogenic microbubbles in renal units.
  • VCUG was performed subsequently through the same catheter for direct comparison.

Main Results:

  • CES detected VUR in 24 renal units, while VCUG identified it in 18.
  • CES demonstrated high sensitivity (96%), specificity (94.8%), positive predictive value (77.4%), and negative predictive value (99.2%) compared to VCUG.
  • CES identified a statistically significant higher number of renal units with VUR than VCUG.

Conclusions:

  • Contrast-enhanced sonography (CES) is an accurate and reliable method for detecting VUR in children.
  • CES can serve as a valuable tool for VUR follow-up, potentially reducing the need for repeated radiographic examinations.
  • While CES shows promise, it may not entirely replace VCUG in all clinical scenarios.
Abstract

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