Vesicoureteric reflux: Evaluation by bladder volume graded direct radionuclide cystogram

Area of Science:

• Pediatric Urology
• Diagnostic Imaging
• Radiology

Background:

• Vesicoureteric reflux (VUR) is a common condition in children, increasing the risk of urinary tract infections and renal scarring.
• Accurate diagnosis and grading of VUR are crucial for appropriate management and prevention of kidney damage.
• Conventional diagnostic methods have limitations in sensitivity and comprehensive assessment.

Purpose of the Study:

• To evaluate the efficacy of bladder volume graded direct radionuclide cystogram (BVG DRC) in diagnosing VUR in children.
• To compare the diagnostic accuracy of BVG DRC with voiding cystourethrogram (VCUG).
• To assess the correlation between VUR detected by BVG DRC and renal cortical scarring.

Main Methods:

• A prospective study involving 33 children with suspected VUR.
• All patients underwent both VCUG and BVG DRC.
• Renal cortical scarring was assessed using radioisotope renal scans (DMSA scan).

Main Results:

• BVG DRC detected VUR in 35 out of 36 affected renal units (97.2%), significantly higher than VCUG (20 units, 55.5%).
• BVG DRC demonstrated a higher test accuracy (98.6%) compared to VCUG (77.8%).
• A positive correlation was observed between VUR bladder volume grades and the presence of renal scarring on DMSA scans.

Conclusions:

• BVG DRC is a sensitive and accurate method for evaluating VUR in children.
• This technique provides valuable information regarding VUR at different bladder filling stages.
• BVG DRC offers superior diagnostic performance over conventional direct radionuclide cystogram for VUR grading.