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Voiding cystourethrography: the initial radiologic study in children with urinary tract infection
Radiology
|September 1, 1985
Summary
For children with urinary tract infections, voiding cystourethrography (VCUG) is the recommended initial imaging test. Normal results from other tests like excretory urography (EU) or renal ultrasonography (US) do not rule out significant reflux.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Urology
Background:
- The optimal imaging sequence for pediatric urinary tract infections (UTIs) remains unclear.
- Current diagnostic approaches lack standardization for voiding cystourethrography (VCUG), excretory urography (EU), and renal ultrasonography (US).
Purpose of the Study:
- To establish a logical diagnostic study sequence for children diagnosed with UTIs.
- To evaluate the efficacy of VCUG as an initial screening tool.
Main Methods:
- A prospective study involving 389 children with UTIs.
- VCUG was performed first, followed by either US or EU.
- Analysis of reflux rates and correlation with imaging findings.
Main Results:
- 37% of children (133/358) exhibited vesicoureteral reflux.
- Among those with reflux, 22.5% (30/133) had abnormal excretory urograms.
- No significant correlation was found between patient age and reflux severity or abnormal excretory urogram rates.
Conclusions:
- Voiding cystourethrography (VCUG) is the preferred initial examination for children with urinary tract infections.
- Normal excretory urography (EU) or renal ultrasonography (US) results do not exclude significant vesicoureteral reflux.
- A standardized approach prioritizing VCUG can improve diagnostic accuracy in pediatric UTIs.