Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans

Oh, Saelin; Ha, Ji Young; Cho, Yeon Jin

doi:10.14366/usg.21143

Cited by 5 publications

(8 citation statements)

References 20 publications

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“…There is currently only insufficient literature regarding the periprocedural application of an antibiotic for ceVUS. Some individual studies were performed without the administration of antibiotics [38] or with a single administration on the day of the examination [39]. In comparison, administration of an antibiotic the day before, the day of, and the day after VCUG is recommended [40].…”

Section: Alternative Method: Cevusmentioning

confidence: 99%

“…However, this is being reexamined in new studies from the year 2023 [4,41]. In the case of additional obstructive diseases of the urinary tract, antibiotic prophylaxis should be implemented [38].…”

Section: Alternative Method: Cevusmentioning

confidence: 99%

“…Zur periprozeduralen Anwendung eines Antibiotikums gibt es für die ceVUS bislang keine ausreichende Literatur. Einzelstudien wurden teilweise ohne Antibiotikagabe durchgeführt [38] oder mit einer Einmalgabe am Untersuchungstag [39]. Im Vergleich hierzu wird für die Durchführung der VCUG eine Antibiotikagabe am Vortag, am Untersuchungstag und am Folgetag empfohlen [40].…”

Section: Wann Sollte Welche Untersuchung Erfolgen?unclassified

“…Eine dauerhafte antibiotische Prophylaxe wird bei einem diagnostizierten vesikoureterorenalen Reflux von aktuellen Leitlinien empfohlen, in neuen Studien aus dem Jahr 2023 allerdings wieder diskutiert [4,38]. Bei zusätzlicher obstruktiver Erkrankung des Harnsystems soll eine antibiotische Prophylaxe erfolgen [38].…”

Section: Wann Sollte Welche Untersuchung Erfolgen?unclassified

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Value of contrast-enhanced sonography in the diagnosis of vesicoureteral reflux

Conen,

Thiemann,

Stredele

et al. 2024

Rofo

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Background Contrast-enhanced ultrasound of the urinary tract and bladder (ceVUS) is an alternative examination method to micturition cysturethrography (MCU/VCUG) for suspected vesicoureteral reflux (VUR) that is increasing in practice. The purpose of this review is to present the current value of ceVUS in the diagnosis. Method A systematic literature search was performed using the keywords “vesicoureteral reflux”, “ceVUS”, “VCUG” of the databases MEDLINE and Cochrane Library as well as a review of current German, European, and American guidelines on this topic. In addition, recommendations for action in clinical practice were developed. Conclusion ceVUS is a quick-to-learn examination method that is equivalent to VCUG for the diagnosis of vesicoureteral reflux and should be used as the diagnostic method of first choice when available given the absence of radiation exposure. Key Points Citation Format

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Section: Alternative Method: Cevusmentioning

confidence: 99%

Section: Alternative Method: Cevusmentioning

confidence: 99%

Section: Wann Sollte Welche Untersuchung Erfolgen?unclassified

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Value of contrast-enhanced sonography in the diagnosis of vesicoureteral reflux

Conen,

Thiemann,

Stredele

et al. 2024

Rofo

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“…Nowadays, the diagnosis of VUR, as well as the diagnosis of IRR, is possible without radiation burden by using the ceVUS method, especially with the second generation of contrast media [9,10,55,[62][63][64][65][66]. The use of ceVUS opened new possibilities for the diagnosis of IRR, showing that the incidence of IRR appeared in a range between 11.9 and 61.5% out of all diagnosed VURs [9,10,55,[64][65][66]. The study by Simičić A. et al showed that 100% of VURs grade IV and V and 83.8% of VURs grade III had IRR.…”

Section: The Diagnostic Methods For the Detection Of Irr: Cevusmentioning

confidence: 99%

The Intrarenal Reflux Diagnosed by Contrast-Enhanced Voiding Urosonography (ceVUS): A Reason for the Reclassification of Vesicoureteral Reflux and New Therapeutic Approach?

Saraga,

Saraga-Babić,

Arapović

et al. 2024

Biomedicines

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Vesicoureteral reflux (VUR) is defined as the urine backflow from the urinary bladder to the pyelo-caliceal system. In contrast, intrarenal reflux (IRR) is the backflow of urine from the renal calyces into the tubulointerstitial space. VURs, particularly those associated with IRR can result in reflux nephropathy when accompanied by urinary tract infection (UTI). The prevalence of IRR in patients with diagnosed VUR is 1–11% when using voiding cystourethrography (VCUG), while 11.9–61% when applying the contrast-enhanced voiding urosonography (ceVUS). The presence of IRR diagnosed by VCUG often correlates with parenchymal scars, when diagnosed by a 99mTc dimercaptosuccinic acid scan (DMSA scan), mostly in kidneys with high-grade VURs, and when diagnosed by ceVUS, it correlates with the wide spectrum of parenchymal changes on DMSA scan. The study performed by both ceVUS and DMSA scans showed IRRs associated with non-dilated VURs in 21% of all detected VURs. A significant difference regarding the existence of parenchymal damage was disclosed between the IRR-associated and IRR-non-associated VURs. A higher portion of parenchymal changes existed in the IRR-associated VURs, regardless of the VUR grade. That means that kidneys with IRR-associated VURs represent the high-risk group of VURs, which must be considered in the future classification of VURs. When using ceVUS, 62% of places where IRR was found were still unaffected by parenchymal changes. That was the basis for our recommendation of preventive use of long-term antibiotic prophylaxis until the IRR disappearance, regardless of the VUR grade. We propose a new classification of VURs using the ceVUS method, in which each VUR grade is subdivided based on the presence of an IRR.

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