Feasibility of superb microvascular imaging to detect high-grade vesicoureteral reflux in children with urinary tract infection

Kim, Hee Kyung; O’Hara, Sara M.; Je, Bo-Kyung; Kraus, Steven J.; Horn, Paul S.

doi:10.1007/s00330-017-4974-x

Cited by 18 publications

(18 citation statements)

References 20 publications

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“…Since initial reports in March 2016 [14], SMI has been mainly used in oncologic conditions (especially breast lesions) [22–26], infectious diseases [16, 27, 28], gastrointestinal disorders [29–32], obstetric ultrasound [33, 34], musculoskeletal [35], vascular [36], and endocrine disorders [14]. In paediatric imaging, SMI has been used to detect direction of urinary flow in patients with vesico-urethral reflux without the use of contrast [16] and to demonstrate differences in vascular flow grades between normal and undescended testes, which were invisible by Power Doppler [17, 18]. Our paper is not the first reporting the use of SMI in cerebral imaging, but it is the first with a dedicated neuropediatric imaging approach.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding paediatric applications, SMI has been shown helpful in the assessment of vesico-urethral reflux [16] as well as in undescended testes [17, 18]. …”

Section: Introductionmentioning

confidence: 99%

“…Ishikawa et al used SMI to image tumour vessels and tumour margins during open brain surgery in adults [15]. Regarding paediatric applications, SMI has been shown helpful in the assessment of vesico-urethral reflux [16] as well as in undescended testes [17, 18].…”

Section: Introductionmentioning

confidence: 99%

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Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

et al. 2018

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ObjectivesTo evaluate the feasibility and reproducibility of superb microvascular imaging (SMI) of the neonatal brain and to describe normal imaging features.MethodsWe performed transcranial ultrasound with SMI in 19 healthy term-born neonates. SMI was done according to a structured examination protocol, using two linear 18 MHz and 14 MHz transducers. Superficial and deep scans were acquired in the coronal and sagittal planes, using the left and right superior frontal gyri as anatomical landmarks. All SMI views were imaged by monochrome and colour SMI and evaluated with respect to visibility of extrastriatal (i.e. cortical and medullary) and striatal microvessels.ResultsWe have described normal morphologic features of intraparenchymal brain microvasculature as “short parallel” cortical vessels, “smoothly curved” medullary vessels, and deep striatal vessels. In general, SMI performance was better on coronal views than on sagittal views. On superficial coronal scans, cortical microvessels were identifiable in 90–100%, medullary microvessels in 95–100%. On deep scans, cortical and medullary microvessels were visible in all cases, while striatal microvessels were identifiable in 71% of cases.ConclusionsCerebral SMI ultrasound is feasible and well-reproducible and provides a novel non-invasive imaging tool for the assessment of intraparenchymal brain microvasculature (extrastriatal and striatal microvessels) in neonates without the use of contrast.Key Points• Superb microvascular imaging (SMI) of the neonatal brain is feasible and reproducible. • SMI depicts extrastriatal and striatal microvessels. • SMI detects two types of extrastriatal microvessels: cortical and medullary.Electronic supplementary materialThe online version of this article (10.1007/s00330-018-5743-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…Regarding paediatric applications, SMI has been shown helpful in the assessment of vesico-urethral reflux [16] as well as in undescended testes [17, 18]. …”

Section: Introductionmentioning

confidence: 99%

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Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

et al. 2018

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“…The midline‐to‐orifice was larger in high‐grade reflux units than in non‐refluxing units . Superb microvascular imaging is the latest Doppler ultrasound technique that can detect reversed urinary flow jets into the distal ureter from the bladder and renal pelvic swirl sign, which can detect high‐grade VUR without contrast medium . USG is well tolerated, and the least burdensome to families and patients among the urological imaging techniques (VCUG, RNC, DMSA, MAG3).…”

Section: Are There Any Alternatives To Vcug?mentioning

confidence: 99%

Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children

et al. 2018

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Voiding cystourethrography is the most important fluoroscopic examination in pediatric urology for the investigation of lower urogenital tract diseases, such as vesicoureteral reflux or urethral stricture. However, this invasive procedure imposes a significant burden on children and their parents, and recently there has been a paradigm shift in the diagnosis and treatment of vesicoureteral reflux. In the 2011 revision, the American Academy of Pediatrics guidelines on urinary tract infection recommended abandoning routine voiding cystourethrography after the first febrile urinary tract infection. In 2014, the randomized intervention for children with vesicoureteral reflux study recommended discontinuation of routine continuous antibiotic prophylaxis for vesicoureteral reflux. The time is now ripe to radically reconsider indications for voiding cystourethrography and the procedure itself.

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“…Motion artifacts are minimized by eliminating signals attributed to tissue motion. The SMI technology was subsequently examined in various organ systems, including breast tumors, brain tumors, hepatic tumors, liver transplants, cholecystitis, hepatitis, undescended testes, detection of endoleaks after aneurysm repair, and the evaluation of high‐grade vesicoureteral reflux in children with urinary tract infections …”

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confidence: 99%

Characterization of Placental Microvasculature Using Superb Microvascular Imaging

Mack

Mastrobattista

Gandhi

et al. 2019

J of Ultrasound Medicine

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uses clutter suppression to extract flow signals at rapid frame rates, which provides high-resolution vessel-branching details without the need for contrast agents. The potential diagnostic benefits of SMI, as described in other areas of medicine, requires further exploration during pregnancy. In this pictorial essay, we demonstrate the complementary use of SMI compared to conventional Doppler ultrasound and how it may improve our ability to characterize placental microvascular patterns without the need for ultrasound contrast agents.

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Feasibility of superb microvascular imaging to detect high-grade vesicoureteral reflux in children with urinary tract infection

Abstract: • Superb microvascular imaging is feasible in children with urinary tract infection. • SMI enables detection of the direction of urinary flow. • Presence of reversed flow correlates with high-grade vesicoureteral reflux.

Cited by 18 publications

References 20 publications

Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

Microvessel ultrasound of neonatal brain parenchyma: feasibility, reproducibility, and normal imaging features by superb microvascular imaging (SMI)

Pediatric voiding cystourethrography: An essential examination for urologists but a terrible experience for children

Characterization of Placental Microvasculature Using Superb Microvascular Imaging

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