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Elucidation of Renal Scars in Children With Vesicoureteral Reflux Using Contrast-Enhanced Ultrasound: A Pilot Study

David S Hains1,2, Harris L Cohen3,4, M Beth McCarville5

  • 1Center for Innate Immunity Translational Research, Children's Foundation Research Institute at Le Bonheur Children's Hospital, Memphis, Tennessee, USA.

Kidney International Reports
|November 17, 2017
PubMed

Insights

Contrast-enhanced ultrasound (CEUS) effectively detects renal scars in children with vesicoureteral reflux, offering a radiation-free alternative to DMSA scintigraphy. This rapid, cost-effective method shows high sensitivity for identifying kidney scarring.

Area of Science:

  • Pediatric Nephrology
  • Diagnostic Imaging
  • Medical Technology

Background:

  • Vesicoureteral reflux commonly causes kidney scarring in children after pyelonephritis.
  • 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy is the standard for detecting renal scars but has limitations like radiation exposure.
  • Contrast-enhanced ultrasound (CEUS) uses inert gas microspheres, avoiding radiation, but its pediatric kidney application is limited.

Purpose of the Study:

  • To evaluate the utility of CEUS in characterizing renal scars in children with reflux nephropathy.
  • To assess CEUS as a diagnostic tool for pediatric kidney scarring.

Main Methods:

  • CEUS was performed in 7 children with known renal scars from reflux nephropathy.
  • Radiographic imaging confirmed the presence of renal scars prior to CEUS.

Main Results:

  • CEUS successfully identified all previously documented radiologic abnormalities.
  • New areas of hypoenhancing renal parenchyma were detected by CEUS.
  • No serious adverse events were reported in any of the study participants.

Conclusions:

  • This study is the first to report CEUS for characterizing renal scars in pediatric reflux nephropathy.
  • CEUS is a sensitive, rapid, and cost-effective imaging modality for detecting and monitoring renal scars in children with vesicoureteral reflux.
Abstract

Keywords:
contrast-enhanced ultrasoundreflux nephropathyvesicoureteral reflux

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