Vesicoureteral refux detection in children: a comparison of the midline-to-orifice distance measurement by ultrasound and voiding urosonography

Battelino, Nina; Ključevšek, Damjana; Tomažič, Mojca; Levart, Tanja Kersnik

doi:10.1007/s00467-015-3301-5

Cited by 9 publications

(6 citation statements)

References 39 publications

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“…But others believe that VCUG must be done as soon as possible. After VUS is introduced, the number of VCUG investigations were reduced by over half and, consequently, a significant reduction of radiation exposure in children can be achieved [22][23][24][25][26][27].…”

Section: Resultsmentioning

confidence: 99%

“…At Baruch-Padeh Poria Medical Center, we are performing all these imaging tests as following: In children with age less than half year, renal US is recommended during admission or nearby. If the ultrasound is abnormal and if there is no response to treatment with antibiotics during 48 hrs, VCUG must be performed during the coming two weeks [24][25][26][27], and renal scan 3 to 5 months after the UTI [28]. Children with age above half year, ultrasound will be performed first, and renal DMSA scan few months later [26][27][28][29].…”

Section: Resultsmentioning

confidence: 99%

“…VCUG is the method of choice for diagnosis of VUR. The timing of VCUG is controversial [23][24][25]. Many researchers suggest postponing the VCUG until 4-6 weeks after treatment.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between urinary tract infection and Vesicourethral reflux in children from eastern galilee region-israel

Nasser¹,

Said²,

Nasser³

et al. 2018

Gen Med Open

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Background:The incidence of vesicoureteral (VUR) in the general population is less than 1%. Reflux carries an increased risk of pyelonephritis and renal failure. The purpose of the current study was to check whether the voiding cystourethrography (VCUG) test is necessary in most cases of upper urinary tract infection (UTI) in children, and to investigate if there is a correlation between the presence of VUR and urinary tract infection, or the reflux is a random finding that does not require monitoring. In the same time, we studied the correlation with various markers of inflammation, renal ultrasound findings (US), 99m technetium (Tc)-dimercaptosuccinic acid (DMSA) nuclear renal scans findings, and the clinical presentation. Methods:The current study is retrospective, based on tests taken at the Poriya medical center in Tiberius (Eastern Galilee population), between 2009-2013. The study includes 88 children up to 2 years that were asked for VCUG. All the children had symptoms of UTI. Prior to performing the imaging tests, the children had laboratory tests (blood, urine, culture), then renal US. VCU was performed within two weeks to one month from the beginning of the complaints, for children up to six-month-old. Older children did the voiding test after doing DMSA. DMSA was done 3-5 months after the acute UTI.Results: Approximately 40% (37.5 %) of patients suffered from reflux: 66.7% with incorrect DMSA (filling defect / scar) had reflux. Only 18.2 % of children with normal DMSA results had reflux. Renal US test was not correlated with VCU results. High inflammation factors levels (CRP, ESR) were found in all subjects with reflux, and only 52.6 % of cases with positive reflux had low lymphocytes levels compared with only 14.3% in patients without reflux. Conclusions:VCUG is not required in most cases of upper UTI. Suitable replacement test can be done by renal DMSA, which has also an added value of detecting a potential renal damage (scars). High levels of inflammation factors, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) strongly suggest a possible existence of reflux. In contrast, lower levels deny the existence of reflux in children with upper UTI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The relationship between urinary tract infection and Vesicourethral reflux in children from eastern galilee region-israel

Nasser¹,

Said²,

Nasser³

et al. 2018

Gen Med Open

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“…USG measurement of the distance from midline of the bladder to the orifice showed lateralization of the refluxing ureteral orifice. 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 .…”

Section: Are There Any Alternatives To Vcug?mentioning

confidence: 99%

“…The midlineto-orifice was larger in high-grade reflux units than in nonrefluxing units. 148 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. 149 USG is well tolerated, and the least burdensome to families and patients among the urological imaging techniques (VCUG, RNC, DMSA, MAG3).…”

Section: Rncmentioning

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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Contrast-Enhanced Voiding Urosonography (ceVUS): Current Experience and Advanced Techniques

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Darge

Ntoulia

2020

Contrast-Enhanced Ultrasound in Pediatric Imaging

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Vesicoureteral refux detection in children: a comparison of the midline-to-orifice distance measurement by ultrasound and voiding urosonography

Abstract: Despite the statistically significant difference between the MOD of refluxing versus non-refluxing units identified in our study, the MOD measurement needs further evaluation to determine its potential value as a diagnostic tool for the detection of VUR.

Cited by 9 publications

References 39 publications

The relationship between urinary tract infection and Vesicourethral reflux in children from eastern galilee region-israel

The relationship between urinary tract infection and Vesicourethral reflux in children from eastern galilee region-israel

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

Contrast-Enhanced Voiding Urosonography (ceVUS): Current Experience and Advanced Techniques

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