Comparison of contrast-enhanced voiding urosonography with voiding cystourethrography in pediatric vesicoureteral reflux

Mane, Narsing; Sharma, Amit; Patil, Abhijit; Gadekar, Chetan; Andankar, Mukund; Pathak, H. K.

doi:10.5152/tud.2018.76702

Cited by 26 publications

(12 citation statements)

References 33 publications

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“…In this retrospective study, patients with recurrent febrile UTIs or with first febrile UTIs, accompanied with abnormal findings on renal ultrasonography underwent ceVUS, regadless the sex, according to the current recommendations (16,(19)(20)(21). The study lasted 3 years (from March 2017 until the end of February 2020).…”

Section: Patients and Data Collectionmentioning

confidence: 99%

“…The new ceVUS procedure with second generation of UCA brought the new possibilities in the diagnostics of VUR and IRR, especially in the grading system in five grades. Some studies reported higher sensitivity of ceVUS compared with VCUG and comparable results with direct radionuclide cystography, regarding the VUR detection (16)(17)(18)(19)(20)(21)(22)(23). The aim of this study was to analyze the incidence of IRR among VURs diagnosed by Abbreviations: ceVUS, contrast-enhanced voiding urosonography; IRR, intrarenal reflux; UCA, ultrasound contrast agent; URU, ureterorenal unit; VUR, vesicoureteral reflux; VCUG, voidingcystourethrography.…”

Section: Introductionmentioning

confidence: 99%

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Intrarenal Reflux in the Light of Contrast-Enhanced Voiding Urosonography

et al. 2021

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Purpose: The aim of this study was to analyze the incidence of intrarenal reflux (IRR) among vesicoureteral refluxes (VURs), diagnosed by contrast-enhanced voiding urosonography (ceVUS), to define VURs which are positive to IRR and their locations in the kidney.Materials and Methods: Seventy patients with VURs, including 103 uretero-renal units (URUs) with VURs of grades II–V (37 URUs were excluded because of renal anomalies or absence of VUR) were examined with ceVUS due to recurrent febrile UTI or first febrile UTI accompanied by abnormalities on renal ultrasonography. Patients were examined on GE Logiq S8 ultrasound machine, using second generation of ultrasound contrast agent.Results: Out of 103 VURs, 51 (49.51%) had IRR regardless the grade of VUR, showing increase in IRR incidence with VUR severity (p < 0.0001). The median age at the time of IRR diagnosis was 5 months (IQR, 3–14.3), whereas in patients without IRR, it was 15.5 months (IQR, 5–41.5), (p = 0.0069). IRR was most common in superior pole (80%), followed by inferior pole (62.7%), and middle segments (37%), and to all segments (27%) (p < 0.0001).Conclusion: In the present study, patients with IRR-associated VUR showed earlier clinical presentation. The distribution of IRRs corresponded to the natural distribution of composed papillae types II and III, while the incidence of IRR increased with severity of VUR. Further clinical studies may point to the importance of considering IRR in the future classification of VUR.

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Section: Patients and Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intrarenal Reflux in the Light of Contrast-Enhanced Voiding Urosonography

et al. 2021

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“…The possibility of performing the examination directly at the patient’s bedside can also generate a relaxed atmosphere for the patient, which has a positive effect on the doctor-patient relationship, especially for small children. In terms of cost-effectiveness, ceVUS is also superior to VCUG [ 20 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to its radiation-free nature, the ceVUS also offers high sensitivity and specificity in comparison to the VCUG, as well as a good diagnostic evaluation of the urethra, which makes ceVUS interesting in the diagnostic cascade for the exclusion or quantification of VUR [ 6 , 16 , 17 ]. Compared to VCUG, ceVUS shows excellent diagnostic sensitivity of up to 100% in detecting VUR [ 18 , 19 , 20 ]. In order to visualize and diagnose VUR, contrast medium is injected into the bladder via a urinary catheter.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Diagnostic Value of Contrast-Enhanced Voiding Urosonography with Regard to the Further Therapy Regime and Patient Outcome—A Single-Center Experience in an Interdisciplinary Uroradiological Setting

et al. 2021

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Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1–2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, is not yet widely used. In the present single-center study, subsequent therapeutic procedures and outcomes after ceVUS of 49 patients were investigated. The aim of the study is to investigate the efficacy of ceVUS with the intention of broader clinical implementation. Materials and Methods: Between 2016 and 2020, 49 patients were retrospectively included and received a ceVUS to evaluate VUR. With a distribution of 47:2 (95.9%), a clear female predominance was present. The age of the patients varied between 5 months and 60 years at the time of ceVUS. All examinations were all performed and subsequently interpreted by a single experienced radiologist (EFSUMB level 3). Results: Compared to intraoperative findings, ceVUS shows a sensitivity of 95.7% with a specificity of 100%. Allergic reactions to the contrast medium could not be observed. Conclusion: With its high sensitivity and intraoperative validation, ceVUS offers an excellent alternative to VCUG, the gold standard in the diagnosis of VUR. In addition, ceVUS is a radiation-free examination method with a low risk profile that offers an exceptional diagnostic tool in the diagnostic clarification of recurrent urinary tract infections with the suspected diagnosis of VUR and should also be included in the consideration of a diagnosis next to the established VCUG, especially in younger children.

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“…In a study of 1010 children ages 15 days to 17.6 years evaluated with ceVUS, no serious adverse event occurred, and only a few minor events occurred, likely because of catheterization. 22 More recent prospective clinical trials in which the authors compared the diagnostic sensitivity of VCUG and ceVUS revealed comparable 23 or superior 24 diagnostic sensitivity of ceVUS in comparison with the conventional VCUG. The higher sensitivity of ceVUS in the detection of vesicoureteral reflux and the ability to conduct a detailed evaluation of the urethra have enabled ceVUS to replace VCUG.…”

Section: Figurementioning

confidence: 99%

Advanced Ultrasound Techniques for Pediatric Imaging

2019

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Ultrasound has become a useful tool in the workup of pediatric patients because of the highly convenient, cost-effective, and safe nature of the examination. With rapid advancements in anatomic and functional ultrasound techniques over the recent years, the diagnostic and interventional utility of ultrasound has risen tremendously. Advanced ultrasound techniques constitute a suite of new technologies that employ microbubbles to provide contrast and enhance flow visualization, elastography to measure tissue stiffness, ultrafast Doppler to deliver high spatiotemporal resolution of flow, three-and four-dimensional technique to generate accurate spatiotemporal representation of anatomy, and high-frequency imaging to delineate anatomic structures at a resolution down to 30 mm. Application of these techniques can enhance the diagnosis of organ injury, viable tumor, and vascular pathologies at bedside. This has significant clinical implications in pediatric patients who are not easy candidates for lengthy MRI or radiation-requiring examination, and are also in need of a highly sensitive bedside technique for therapeutic guidance. To best use the currently available, advanced ultrasound techniques for pediatric patients, it is necessary to understand the diagnostic utility of each technique. In this review, we will educate the readers of emerging ultrasound techniques and their respective clinical applications.

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Comparison of contrast-enhanced voiding urosonography with voiding cystourethrography in pediatric vesicoureteral reflux

Abstract: ce-VUS is a good imaging modality when compared to voiding cystourethrography to assess pediatric vesicoureteral reflux, in view of its superior diagnostic performance, feasibility and radiation safety for children.

Cited by 26 publications

References 33 publications

Intrarenal Reflux in the Light of Contrast-Enhanced Voiding Urosonography

Intrarenal Reflux in the Light of Contrast-Enhanced Voiding Urosonography

Evaluation of the Diagnostic Value of Contrast-Enhanced Voiding Urosonography with Regard to the Further Therapy Regime and Patient Outcome—A Single-Center Experience in an Interdisciplinary Uroradiological Setting

Advanced Ultrasound Techniques for Pediatric Imaging

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