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3D/4D contrast-enhanced urosonography (ceVUS) in children - is it superior to the 2D technique?

Magdalena Maria Woźniak1, Paweł Osemlak2, Aikaterini Ntoulia3

  • 1Department of Pediatric Radiology, Medical University of Lublin, Lublin, Poland.

Journal of Ultrasonography
|October 19, 2018
PubMed

Insights

Three-dimensional (3D) and 4D contrast-enhanced voiding urosonography (ceVUS) offer improved grading for pediatric vesicoureteral reflux compared to standard 2D ceVUS. While both methods detect reflux equally, 3D/4D ceVUS provides more conspicuous visualization.

Area of Science:

  • Pediatric Urology
  • Medical Imaging
  • Diagnostic Techniques

Background:

  • Two-dimensional contrast-enhanced voiding urosonography (2D ceVUS) is established for diagnosing and monitoring pediatric vesicoureteral reflux.
  • Recent approvals in the USA and Europe have solidified 2D ceVUS's role.
  • Three-dimensional (3D) and real-time 4D techniques with ultrasound contrast agents introduce advanced diagnostic capabilities.

Purpose of the Study:

  • To evaluate if 3D and 4D ceVUS are superior to standard 2D ceVUS for diagnosing pediatric vesicoureteral reflux.
  • To compare the diagnostic accuracy and visualization quality between 2D and 3D/4D ceVUS techniques.

Main Methods:

  • A study involving 150 pediatric patients (mean age 3.7 years) was conducted.
  • Patients underwent both standard 2D ceVUS and advanced 3D/4D ceVUS.
  • The procedures aimed to diagnose and grade vesicoureteral reflux.

Main Results:

  • Both 2D ceVUS and 3D/4D ceVUS identified the same number of vesicoureteral reflux cases.
  • A statistically significant difference was observed in the grading of reflux between the two methods.
  • 3D/4D ceVUS led to a change in the initial reflux grade in 17.76% of cases, with 4D offering superior visualization.

Conclusions:

  • While 2D ceVUS and 3D/4D ceVUS detect vesicoureteral reflux equally, 3D/4D ceVUS demonstrates a significant difference in grading.
  • The 3D/4D ceVUS technique provides more conspicuous visualization of reflux.
  • 3D/4D ceVUS is considered at least as valid as, and potentially superior to, 2D ceVUS for pediatric vesicoureteral reflux diagnosis and grading.
Abstract

Keywords:
childrencontrast agentsultrasoundurinary tract infectionsvesicoureteral reflux

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