Screening for vesicoureteral reflux in children using real-time sonography

Area of Science:

• Pediatric Nephrology
• Diagnostic Imaging
• Urology

Background:

• Vesicoureteral reflux (VUR) is a common condition in children, potentially leading to kidney infections and damage.
• Accurate and early diagnosis of VUR is crucial for effective management and prevention of renal scarring.
• Conventional diagnostic methods like voiding cystourethrography (VCU) can be invasive.

Purpose of the Study:

• To evaluate the efficacy of ultrasound (US) as a preliminary investigation for vesicoureteral reflux (VUR) in pediatric patients.
• To determine the sensitivity and specificity of sonographic findings in detecting VUR before VCU.
• To assess the utility of ultrasound in grading VUR severity.

Main Methods:

• One hundred and ten children (6 days to 14 years) underwent ultrasound examination prior to voiding cystourethrography (VCU).
• Sonographic criteria for VUR included retrovesical ureteral dilation and/or increased separation of the central renal echo complex (CRC).
• VUR grading was performed using established international scales based on sonographic and VCU findings.

Main Results:

• Ultrasound correctly identified 100% of VUR grades III and IV, and 84% of grade II cases.
• A 10% false positive rate was observed with the sonographic method.
• Sonography demonstrated high sensitivity and specificity for VUR detection.

Conclusions:

• Pre-VCU ultrasound is a sensitive and specific screening tool for pediatric vesicoureteral reflux.
• Sonographic evaluation can reliably detect and grade VUR, aiding in diagnostic workup.
• Ultrasound offers a non-invasive approach for VUR screening and follow-up.