Contrast-enhanced voiding urosonography part 2: urethral imaging

Acharya, Patricia T.; Pascual, Elisa Aguirre; Back, Susan J.; Salazar, Vivian P Beltrán; Chan, Pui Kwan Joyce; Chow, Jeanne S.; Robinot, D. Coca; Darge, Kassa; Durán, Carmina; Ključevšek, Damjana; Kwon, Jeannie K.; Ntoulia, Aikaterini; Papadopoulou, Frederica; Woźniak, Magdalena; Piskunowicz, Maciej

doi:10.1007/s00247-021-05116-6

Cited by 16 publications

(16 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, radiologists should be aware that VCUG alone might not accurately demonstrate certain abnormalities of the male anterior urethra because the urethra is not fully distended to the degree seen on RUG [1]. Another possible reason for the low RUG frequency is the growing trend of radiologists to use contrast-enhanced voiding urosonography (ceVUS) as an alternative urethral imaging procedure for both VCUG and RUG to limit exposure of pediatric patients to ionizing radiation [10,11].…”

Section: Discussionmentioning

confidence: 99%

Retrograde urethrography in children: a decade of experience at a children’s hospital

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background Retrograde urethrography (RUG) is a radiologic procedure that optimizes imaging evaluation of the urethra, particularly in settings of difficulty with micturition or urethral injury. Objective To review our experience with RUG at a large pediatric radiology practice. Materials and methodsWe conducted a retrospective review of medical records and fluoroscopic images of RUGs performed from January 2010 to December 2020. ResultsWe identified 180 RUG exams (median frequency 17 exams per year), all in male children (median age 13 years). The most common indications were stricture (42%; n=76), postsurgical evaluation (34%; n=62) and trauma (16%; n=29). The most commonly used catheter was Foley (40%; n=72), with a median catheter size of 5 French (Fr) for infants younger than 1 year, 7 Fr for children ages 1-5 years and 8 Fr for children older than 5 years. About a third of the children (57; 32%) had combined voiding cystourethrography (VCUG)-RUG exams. Water-soluble contrast agent, either 17% or 43% Cysto-Conray, was used. Most RUG exams were normal (46%; n=83). The most common urethral pathology was stricture (30%; n=54), commonly involving a bulbar urethra (n=26). Urethral trauma was seen in 11 children (6%), 10 bulbar and 1 membranous. Most children with stricture were surgically treated (n=40; 74%), whereas most children with trauma were conservatively treated (n=8; 73%). The remaining diagnoses included diverticula, polyps, valves, fistulas and duplications, constituting <17% of our sample; most of these were surgically treated. Four exams (2%) were non-diagnostic. RUG showed 89% sensitivity and 97% specificity compared to cystourethroscopy/VCUG findings. Technical difficulties occurred in 14 (8%) children (e.g., pain or inappropriate catheter seal). Conclusion Our experience indicates that when catheterization techniques are properly tailored, RUG provides a useful and successful radiologic method of evaluating the pediatric male urethra.

show abstract

Section: Discussionmentioning

confidence: 99%

Retrograde urethrography in children: a decade of experience at a children’s hospital

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…UCA enhances US imaging and improves its diagnostic performance, reducing the need for CT and other diagnostic procedures in dogs who need lower urinary tract evaluation 1,3 . Additionally, the use of UCA can improve the reliability of US 2–4,6,7 …”

Section: Discussionmentioning

confidence: 99%

“…CE-VUS has been considered a safe and highly sensitive diagnostic method for the evaluation of the urethra in human patients. 2,4 In the veterinary literature, two studies have been reported…”

Section: Discussionmentioning

confidence: 99%

“…9 The advantages of CE-VUS include the evaluation of periurethral soft tissues and a more accurate measurement of the stricture length. 4 Compared with the other imaging methods (RUG, VCUG, CT urography, and MRI), sedation or general anesthesia may not be required for the CE-VUS examination. 3 Furthermore, CE-VUS is a fast and cheap diagnostic method, and it does not expose the patient to ionizing radiation.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] The safety of IV and intravesical administration of UCA in humans, especially in children, has been established in the literature. 2,4 In veterinary medicine, studies investigated the safety profile of IV and intravesical administration of Sonovue. No adverse effects have been published.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis of traumatic urethral stricture in a canine patient with contrast‐enhanced voiding urosonography : A case report

Trikoupi,

Papadopoulou,

Adamama‐Moraitou

et al. 2023

Vet Radiology Ultrasound

View full text Add to dashboard Cite

A 5‐year‐old intact male mixed‐breed dog presented with a 3‐day history of stranguria and dysuria. Results of physical examination, plain radiographs, and ultrasonography were consistent with a traumatic urethral stricture in the prescrotal urethra just under the previous trauma region, resulting in partial obstruction of urine outflow. Contrast‐enhanced voiding urosonography (CE‐VUS) was performed, and a urethral stricture was confirmed. The dog underwent surgery. A scrotal urethrostomy was performed. After 3 days of hospitalization, the dog was discharged from the Clinic. Based on an extensive literature review, this is the first report using CE‐VUS to evaluate urethral pathology in a canine patient.

show abstract

Novel use of contrast enhanced ultrasonography with urodynamics in children: A comparison study to fluoroscopy

Kennady,

Hutchison,

Corbett

et al. 2024

Neurourology and Urodynamics

View full text Add to dashboard Cite

IntroductionVideo urodynamics (UDS) has classically been performed using fluoroscopy (fluoro). Contrast enhanced voiding ultrasonography (ceVUS) has rarely been reported for use with UDS. This is the first study to compare the imaging characteristics of ceVUS versus fluoro UDS.MethodsChildren were enrolled for ceVUS UDS who previously underwent fluoro UDS. Demographics, imaging data for ceVUS and fluoro UDS, time between studies, and clinical data between studies were recorded. Changes in clinical status included implantation/cessation of catheterization or anticholinergic medications, leakage between, urinary tract infections, hydronephrosis and neurologic changes. Comparison testing was performed using McNemar's Chi‐Squared and Wilcoxon matched‐pairs signed rank test.ResultsSeventy‐five children were recruited. Median time between studies was 1.3 years (IQR 0.9−2.9). There were no differences for bladder shape (p = 0.59), vesicoureteral reflux (p = 0.10), bladder neck (p = 0.59) or urethra (p = 1.0) between studies. In 5 cases, the bladder neck could not be visualized adequately due to layering of the microbubble contrast against urine. Benefits to ceVUS included ability to visualize the exact moment the bladder neck opened. Following exclusion of patients with clinical changes that might affect imaging findings, an analysis of 28 patients demonstrated no differences between the two studies.ConclusionsCeVUS can be used adequately in conjunction with UDS. Limitations to ceVUS include more granular imaging for bladder shape versus fluoro and inability to visualize bladder neck if residual urine is in the bladder, mitigated by bladder emptying. Benefits include ability to visualize the dynamic activity of the bladder neck due to constant imaging with ceVUS.

show abstract

Contrast-enhanced voiding urosonography part 2: urethral imaging

Cited by 16 publications

References 86 publications

Retrograde urethrography in children: a decade of experience at a children’s hospital

Retrograde urethrography in children: a decade of experience at a children’s hospital

Diagnosis of traumatic urethral stricture in a canine patient with contrast‐enhanced voiding urosonography : A case report

Novel use of contrast enhanced ultrasonography with urodynamics in children: A comparison study to fluoroscopy

Contact Info

Product

Resources

About