Types of Parenchymal Changes Diagnosed on DMSA Scans of Kidneys Affected by Different Grades of Vesicoureteral Reflux

Arapović, Adela; Punda, Ante; Brdar, Dubravka; Čapkun, Vesna; Bajo, Diana; Veljačić, Daniela; Punda, Hrvoje; Simičić-Majce, Ana; Saraga-Babić, Mirna; Vukojević, Katarina; Saraga, Marijan

doi:10.12659/msm.929617

Cited by 7 publications

(11 citation statements)

References 36 publications

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“…Moreover, that study showed significantly more parenchymal changes in the group of dilating VURs than in the group of non-dilating VURs and in the group without VURs. They suggested that kidneys without or with low-grade VURs represent the low-risk group regarding the development of renal parenchymal damage, while the group of dilating VURs represents the high-risk group and should be followed more carefully regarding the development of kidney damage ( 11 ). The changes in DMSA uptake in this study can be considered permanent because the mean time elapsed between the first febrile UTI and the DMSA scan was 8 months, which is more than 3–6 months that was recommended by Jakobsson B et al and Polito C et al ( 37 , 38 ).…”

Section: Discussionmentioning

confidence: 99%

“…VUR is the predisposing factor for urinary tract infections (UTI) and renal parenchymal damage in children. The prevalence of parenchymal damage was significantly correlated with reflux grade (5)(6)(7)(8)(9)(10)(11). Sometimes the VUR can be intrarenal when the urine reaches the kidney parenchyma and penetrates the tubulointerstitial area through papillary ducts.…”

Section: Introductionmentioning

confidence: 99%

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The Spectrum of Parenchymal Changes in Kidneys Affected by Intrarenal Reflux, Diagnosed by Contrast-Enhanced Voiding Urosonography and DMSA Scan

et al. 2022

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PurposeTo describe the parenchymal defects in kidneys with intrarenal reflux (IRR) diagnosed using contrast-enhanced voiding urosonography (ceVUS) and 99mTc-DMSA scintigraphy (DMSA scan).Materials and MethodsA group of 186 uretero-renal units (URUs) was analyzed using ceVUS and DMSA scans: 47 without vesicoureteral reflux (VUR) (group A) and 139 with VURs, comprising 73 VURs without (group B), and 66 with IRR (group C). VURs included non-dilating (grades I–II), mildly non-dilating (grade III), and non-dilating (grades IV–V) grades. The parenchymal changes were analyzed using a DMSA scan.ResultsThe median age for VUR diagnosis was 16.5 months in girls, and 8.5 months in boys (Z = 3.9; p = 0.001). IRR occurred in 51.4% of boys and in 25.9% of girls (χ2 = 12.4; p < 0.001). The non-dilating VUR occurred in 44% of boys and 24.1% of girls (χ2 = 7.7; p = 0.005). IRRs characterized upper and lower renal segments (81.8 and 63.6%) and middle segments (33.3%). Both incidence and increase in IRR correlated with the grade of VUR (p < 0.001). The incidence of reduced DMSA signal was statistically different among groups A + B and C, but not between groups A and B (χ2 = 32.2; p < 0.001). No statistically significant relationship existed between the reduced DMSA signal and the grade of VUR in group C. The reduced DMSA signal appeared in 9.9% positions in kidneys from group A, 14% from group B, and 32% from group C. Out of all 118 IRRs, 38.1% had reduced and 61.9% had normal DMSA signal. Among 11 parenchymal scars found in all three groups, 2 belonged to group B, 9 to group C, while group A had no scars.ConclusionThe parenchymal changes are the most prominent in the group with IRR, but they do not significantly differ among kidneys with different grades of VUR. VURs of higher grades are associated with a higher incidence of IRR and early clinical presentation. Scars can also appear in lower-grade VURs accompanied by IRR. Boys with VUR have earlier clinical presentation than girls, as they have significantly higher grades of VUR with a higher proportion of IRRs. Therefore, we suggest a subdivision of VURs into those with IRR and abundant parenchymal damage, and those without IRR and less parenchymal damage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Spectrum of Parenchymal Changes in Kidneys Affected by Intrarenal Reflux, Diagnosed by Contrast-Enhanced Voiding Urosonography and DMSA Scan

et al. 2022

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“…Diagnostic possibilities for direct detection of vesicoureteral reflux include voiding cystourethrography (VCUG), contrast-enhanced voiding urosonography (ceVUS), and radionuclide cystography (RNC) [10]. There are also additional nuclear medicine methods that can diagnose the complications of vesicoureteral reflux, like [99Tc]DMSA-scintigraphy of the kidneys to evaluate possible parenchymal damage [11].…”

Section: Possibilities For Reflux Testingmentioning

confidence: 99%

“…Diagnostische Möglichkeiten zur direkten Detektion des vesikoureterorenalen Refluxes sind die Miktionszysturethrografie (MCU/ Voiding cystourethrogram = VCUG), die kontrastmittelverstärkte Miktionsurosonografie (MUS, contrast enhanced Voiding urosonography, ceVUS) sowie die Radionuklid Zystourethrografie (radionuclide cystography, RNC) [10]. Daneben gibt es weitere nuklearmedizinische Verfahren, die Komplikationen eines vesikoureterorenalen Refluxes diagnostizieren können, wie die [99Tc]DMSA-Szintigrafie der Nieren zur Beurteilung von möglichen Parenchymschäden [11].…”

Section: Möglichkeiten Zur Refluxprüfungunclassified

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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“…Renal scars were classi ed according to standard classi cation. The types were classi ed as type 1: no more than two scars, type 2: more than two scars with some normal parenchyma between them, type 3: generalized damage to the whole kidney and type 4: end stage "shrunken kidney" (21). The HTN was de ned as having three elevated systolic or diastolic blood pressure readings for the subject's age, height, and sex.…”

Section: Study Variablesmentioning

confidence: 99%

Long-Term Outcome of Cohen Vs. Gil-Verent Methods in The Treatment 0f Vesicoureteral Reflux

Hosseini¹,

Mahdavynia

Hooman

et al. 2022

Preprint

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Introduction: The vesicoureteral reflux (VUR) is among the most common congenital disorder of urinary system. There are several surgical methods to manage this disease. In this study we aimed to assess and compare the result of the two common surgical techniques including Cohen and Gil-Vernet methods of in children with VUR.Method and materials: In this retrospective study, we gathered the record of all patients who underwent Cohen or Gil-Vernet surgeries during 2010-2017. We recruited all the infants and patients until age of 15 years who had moderate and high grade VUR in voiding cystourethrogram (VCUG). We gathered and compared information regarding the grade of VUR, the number of breaks through urinary tract infection (UTI), kidney parenchymal scars and the side effects of surgery between two methods. Results: In this study we recruited 89 patients with mean age of 66.56 ± 31.51months. Of all patients, 18 cases underwent Cohen surgery and for 71 patients Gil-Vernet was performed. All the patients showed improvement regarding the grade of reflux according to VCUG (p:.001). The incidence rate of UTI was decreased in both groups (p:0.001). The clinical profile of the study participants was improved in both group and there was not any difference between two surgical modalities in this respect. The mean follow-up time was 59.11 ± 23.4 months.Conclusion: Both Cohen or Gil-Vernet surgeries were effective methods for treating VUR. Also, there was not any significant difference between two surgical techniques.

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Types of Parenchymal Changes Diagnosed on DMSA Scans of Kidneys Affected by Different Grades of Vesicoureteral Reflux

Cited by 7 publications

References 36 publications

The Spectrum of Parenchymal Changes in Kidneys Affected by Intrarenal Reflux, Diagnosed by Contrast-Enhanced Voiding Urosonography and DMSA Scan

The Spectrum of Parenchymal Changes in Kidneys Affected by Intrarenal Reflux, Diagnosed by Contrast-Enhanced Voiding Urosonography and DMSA Scan

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

Long-Term Outcome of Cohen Vs. Gil-Verent Methods in The Treatment 0f Vesicoureteral Reflux

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