Nuclear cystography and renal sonography: findings in girls with urinary tract infection

Jl, Strife; Gs, Bisset; Dr, Kirks; Fj, Schlueter; Mj, Gelfand; Ds, Babcock; Han, Bo

doi:10.2214/ajr.153.1.115

Cited by 23 publications

(3 citation statements)

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“…VESICOURETERAL REFLUX (VUR) is associated with renal damage. The higher the grade of reflux, the greater the chance a renal injury will develop (1, 2). Therefore, voiding cystourethrography (VCUG) is recommended as an initial study for children younger than five years with urinary tract infection (UTI) (3).…”

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confidence: 99%

Magnetic resonance voiding cystography in the diagnosis of vesicoureteral reflux: Comparative study with voiding cystourethrography

Lee

Chang

Park

et al. 2005

Magnetic Resonance Imaging

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Purpose:To evaluate the feasibility of magnetic resonance voiding cystography (MRVC) compared with voiding cystourethrography (VCUG) for detecting and grading vesicoureteral reflux (VUR). Materials and Methods:MRVC was performed upon 20 children referred for investigation of reflux. Either coronal T1-weighted spin-echo (SE) or gradient-echo (GE) (fast multiplanar spoiled gradient-echo (FMPSPGR) or turbo fast lowangle-shot (FLASH)) images were obtained before and after transurethral administration of gadolinium solution, and immediately after voiding. The findings of MRVC were compared with those of VCUG and technetium-99m ( 99m Tc) dimercaptosuccinic acid (DMSA) single-photon emission computed tomography (SPECT) performed within 6 months of MRVC.Results: VUR was detected in 23 ureterorenal units (16 VURs by both methods, 5 VURs by VCUG, and 2 VURs by MRVC). With VCUG as the standard of reference, the sensitivity of MRVC was 76.2%; the specificity, 90.0%; the positive predictive value, 88.9%; and the negative predictive value, 78.3%. There was concordance between two methods regarding the grade of reflux in all 16 ureterorenal units with VUR detected by both methods. Of 40 kidneys, MRVC detected findings of renal damage or reflux nephropathy in 13 kidneys, and 99m Tc DMSA renal SPECT detected findings of reflux nephropathy in 17 kidneys. Conclusion:Although MRVC is shown to have less sensitivity for VUR than VCUG, MRVC may represent a method of choice offering a safer nonradiation test that can additionally evaluate the kidneys for changes related to reflux nephropathy.

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confidence: 99%

Magnetic resonance voiding cystography in the diagnosis of vesicoureteral reflux: Comparative study with voiding cystourethrography

Lee

Chang

Park

et al. 2005

Magnetic Resonance Imaging

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“…The prevalence of cortical defects was greaten in the kidneys of patients less than 2 years old (961290, 33%) than in older children (1 6/96, 17%) and greaten in those with vesicouretenal neflux (41192, 45%) than in those without it (71/294, 24%). Renal scarring, found in 6-10% of children with a urinary tract infection (UTI) [1], is important because of its association with hypertension, eclampsia in pregnancy, and renal impairment [2]. Because of this, one of the major aims of imaging in a child with a UTI is to detect renal scars in order to keep more from forming, if possible, and to identify those patients at risk for developing scans to keep them from occurring [3].…”

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confidence: 99%

“…Because of this, one of the major aims of imaging in a child with a UTI is to detect renal scars in order to keep more from forming, if possible, and to identify those patients at risk for developing scans to keep them from occurring [3]. Vesicoureteral reflux is associated with scarring, and the higher the grade of reflux the greater the chance a renal scar will develop [2,4] A p value less than .05 was considered significant. Table 2 shows the distribution of early cortical defects by age.…”

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confidence: 99%