Screening for vesicoureteral reflux in children using real-time sonography

Abstract

One hundred and ten children, ages 6 days to 14 years, were investigated for vesicoureteral reflux (VUR) using ultrasound before voiding cystourethrography (VCU). Sonographically a VUR was assumed if a retrovesical dilated ureter and/or an increase of the separation of the central renal echo complex (CRC) could be detected. By means of sonography VUR grades III and IV were seen in 100%, grade II in 84% of all cases. There was a false positive rate of 10%. Sonographic reflux study is a sensitive and specific screening and follow-up procedure for VUR.

Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: a systematic review and economic model

“…describe the reference standard in sufficient detail to permit replication; 115,123,149,165,187,191,195,199,202 six studies reported insufficient detail to allow assessment of the avoidance of test review bias, 115,123,187,195,199,202 and three studies reported insufficient detail to allow assessment of the avoidance of disease progression bias. 165,187,195 The remaining study used direct radionuclide voiding cystography as the reference standard.…”

“…Where studies reported more than one data set for the same population, only one data set was included in further analyses; this was to prevent duplicate inclusion of the same study participants. One study 123 reported data using cut-off thresholds of both reflux grade 2 or above, and reflux grade 3 or above; a second study 199 reported data using cut-off points of both reflux grade 2 or above, and presence of any reflux; data for the lower cut-off were used in both cases. One study 124 reported data by patient and by renal unit.…”

“…Fourteen studies assessed the diagnostic accuracy of cystosonography, 123,124,144,149,165,179,187,191,195,199,202,213 or other contrast-enhanced techniques, 115,197 using a variety of contrast agents. All but one of these studies used MCUG as the reference standard.…”

Color Flow Doppler Sonography in the Diagnosis of Vesicoureteric Reflux

“…Several investigators have used sonography to detect VUR, but the effectiveness of ultrasound in the diagnosis of reflux has so far been limited [5,6]. Schneider et al [6] reported in 1984 that, by means of real-time sonography, VUR grades III and IV were detected in 100% and grade II in 84% of all cases.…”

“…Attempts have been made to replace VCU with less invasive tests. Ultrasono graphy involves no ionizing radiation and has been pro posed for the detection of VUR [3,[5][6][7], In a recent study, ultrasound cystography has been proposed as an alterna tive to standard VCU for the detection of reflux [2], Color flow Doppler sonographic (CFDS) measurement of the …”