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Updated: May 16, 2026
Photoacoustic Cystography
Published on: June 11, 2013
Predict the spontaneous resolution of vesicoureteral reflux by direct radionuclide cystography
1Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Insights
Direct radionuclide cystography (DRC) effectively predicts spontaneous resolution of vesicoureteral reflux (VUR) in children. Mild and transient VUR show higher resolution rates, aiding in prognosis.
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
- Nephrology
Background:
- Vesicoureteral reflux (VUR) is a common condition in children, increasing the risk of urinary tract infections and renal damage.
- Accurate prognostication of spontaneous VUR resolution is crucial for guiding management and preventing complications.
Purpose of the Study:
- To assess the predictive capability of initial direct radionuclide cystography (DRC) for the spontaneous resolution of VUR in pediatric patients.
- To correlate VUR grading by DRC with observed resolution rates over a 1-6 year follow-up period.
Main Methods:
- A cohort of 51 children with initial VUR diagnosis via DRC underwent 1-6 years of follow-up.
- VUR was anatomically graded (mild, moderate, severe) and functionally classified (transient, persistent) based on DRC findings.
- Spontaneous resolution rates were analyzed according to initial VUR grade and classification.
Main Results:
- Spontaneous VUR resolution was observed in 92% of mild, 59% of moderate, and 25% of severe cases (P=.003).
- Transient VUR resolved spontaneously in 80% of cases, compared to 44% of persistent VUR (P=.003).
- DRC provided valuable prognostic information regarding VUR resolution.
Conclusions:
- Direct radionuclide cystography is an effective tool for diagnosing, staging, and predicting the outcome of VUR in children.
- The anatomic and functional grading of VUR by DRC allows for informed prognostic assessments.
- DRC findings are instrumental in predicting spontaneous resolution and guiding clinical management of pediatric VUR.
Objectives:
To evaluate the prognostic value of initial direct radionuclide cystography (DRC) for spontaneous resolution of vesicoureteral reflux (VUR).
Methods:
Fifty-one children with initial diagnosis and 1-6 years' follow-up of VUR by DRC were enrolled in this study. VUR was graded according to the anatomic grading as (1) mild reflux corresponding to tracer just in ureter, (2) moderate reflux with accumulation of activity in a non-dilated collecting system and ureter, and (3) severe reflux equated with a dilated ureter and collecting system. The severity of VUR was also expressed according to the functional classification as (1) transient reflux, which occurred at filling or voiding phase only and (2) persistent reflux, present in both filling and voiding phases.
Results:
Twenty-nine of the 51 children had unilateral VUR, and the other 22 had bilateral VUR. In the total of 73 refluxing ureters, there were 12 mild, 49 moderate and 12 severe VUR according to anatomic grading, and 30 transient and 43 persistent VUR according to the functional grading. After follow-up, resolution of VUR was found in 92% (11/12) of mild, 59% (29/49) of moderate and 25% (3/12) of severe VUR (P=.04, mild vs. moderate; P=.003, mild vs. severe). Eighty percent (24/30) of transient and 44% (19/43) of persistent reflux showed spontaneous resolution (P=.003).
Conclusions:
DRC allows anatomic and functional classification of VUR. It is an ideal method for the diagnosis, staging and follow-up of VUR, and provides valuable information to predict the patient's outcome.
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