Ureterovesical jets in infants and children: duplex and color Doppler US studies

Ureteric jets were studied with conventional duplex Doppler (79 patients) and with color Doppler flow imaging (22 patients). Correlation with voiding cystourethrography (VCUG), performed ont he same day, was obtained in all patients. Thirty-six patients with normal VCUG results and normal renal and bladder ultrasound (US) studies served as the control group for 39 patients with vesicoureteric reflux (VUR) and 26 patients with urinary tract disorders other than reflux. The site of the ureteric orifice and duration, direction, and turbulence of the jets were recorded. Duration varied from 0.4 sec to 7.5 sec and depended largely on fluid intake. Duration varied in an individual patient by up to 2 sec from one jet to another. The direction of the normal jet was anteromedial and upward. Jets from refluxing ureters can appear normal. Severe renal parenchymal scarring reduced frequency and amplitude of the jets. Doppler analysis of the ureteric jet does not allow diagnosis or exclusion of VUR. Color Doppler was more sensitive in demonstrating ureteric jets than was gray-scale, real-time US and facilitated the study, but it was equally unable to help predict reflux.