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Accuracy of ultrasonography in predicting vesicoureteral reflux in children: A meta-analysis

Mikhail Saltychev1, Marko Tapani Ristola2, Katri Laimi1

  • 1a Department of Physical and Rehabilitation Medicine , Turku University Hospital and University of Turku , Turku , Finland ;

Scandinavian Journal of Urology
|June 17, 2016
PubMed

Insights

Renal and bladder ultrasonography is not recommended for predicting vesicoureteral reflux in children after their first urinary tract infection. Current evidence shows low accuracy for this diagnostic approach in pediatric cases.

Area of Science:

  • Pediatric Nephrology
  • Diagnostic Imaging
  • Urology

Background:

  • Urinary tract infections (UTIs) are common in children.
  • Vesicoureteral reflux (VUR) is a significant risk factor for recurrent UTIs and renal scarring.
  • Accurate prediction of VUR is crucial for appropriate management.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of renal and bladder ultrasonography (RBUS) in identifying VUR in children presenting with their first UTI.
  • To synthesize existing evidence through a meta-analysis.

Main Methods:

  • Systematic literature search across CENTRAL, MEDLINE, Embase, and Web of Science databases.
  • Random effects meta-analysis of fourteen studies involving 3544 participants.
  • Assessment of risk of bias and applicability concerns.

Main Results:

  • Pooled sensitivity for RBUS in predicting VUR was 0.37 (95% CI 0.34-0.40).
  • Pooled specificity was 0.81 (95% CI 0.80-0.83).
  • Diagnostic accuracy metrics (LR+, LR-, DOR, AUC) indicated limited predictive value.

Conclusions:

  • The current evidence does not support the recommendation of RBUS for predicting VUR in children with a first UTI.
  • Further research may be needed to explore alternative or refined imaging techniques.
Abstract

Keywords:
Accuracycystourethrographymeta-analysisultrasonographyurinary tract infectionvesicoureteral reflux

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