Safety assessment and diagnostic evaluation of patients undergoing contrast-enhanced urosonography in the setting of vesicoureteral reflux confirmation

2021 ◽  
pp. 1-9
Author(s):  
Constantin A. Marschner ◽  
Vincent Schwarze ◽  
Regina Stredele ◽  
Matthias F. Froelich ◽  
Johannes Rübenthaler ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Vesicoureteral Reflux ◽  
Sensitivity And Specificity ◽  
Diagnostic Tool ◽  
High Sensitivity ◽  
Upper Urinary Tract ◽  
Clinical Diagnostics ◽  
Voiding Cystourethrography

BACKGROUND: Vesicoureteral reflux (VUR) represents a common pediatric anomaly in children with an upper urinary tract infection (UTI) and is defined as a retrograde flow of urine from the bladder into the upper urinary tract. There are many diagnostic options available, including voiding cystourethrography (VCUG) and contrasted-enhanced urosonography (ceVUS). ceVUS combines a diagnostic tool with a high sensitivity and specificity which, according to previous study results, was even shown to be superior to VCUG. Nevertheless, despite the recommendation of the EFSUMB, the ceVUS has not found a widespread use in clinical diagnostics in Europe yet. MATERIALS AND METHODS: Between 2016 and 2020, 49 patients with a marked female dominance (n = 37) were included. The youngest patient had an age of 5 months, the oldest patient 60 years. The contrast agent used in ceVUS was SonoVue®, a second-generation blood-pool agent. All examinations were performed and interpreted by a single experienced radiologist (EFSUMB Level 3). RESULTS: The 49 patients included in the study showed no adverse effects. 51%of patients (n = 26) were referred with the initial diagnosis of suspected VUR, while 49%of patients (n = 23) came for follow-up examination or to rule out recurrence of VUR. The vast majority had at least one febrile urinary tract infection in their recent medical history (n = 45; 91,8%). CONCLUSION: ceVUS is an examination method with a low risk profile which represents with its high sensitivity and specificity an excellent diagnostic tool in the evaluation of vesicoureteral reflux, especially in consideration of a generally very young patient cohort.

scholarly journals Comparison of Renal Ultrasound and Voiding Cystourethrography (VCUG) in the Detection of Vesicoureteral Reflux

2013 ◽  
Vol 2 (2) ◽  
pp. 54-59
Author(s):  
Sedigheh Ebrahimi
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Vesicoureteral Reflux ◽  
Sensitivity And Specificity ◽  
Medical Records ◽  
Voiding Cystourethrography ◽  
Renal Ultrasound ◽  
Renal Ultrasonography ◽  
Ultrasound Findings

Introduction: This study evaluates the accuracy of renal ultrasonography (US) in the detection of vesicoureteral reflux (VUR) compared to voiding cystourethrography (VCUG).Methods: We retrospectively reviewed the medical records of 131 children with urinary tract infection. Ultrasound findings were considered to be suggestive of VUR if a “pelvocalyceal dilatation”‚ “retrovesical ureteral dilatation” and/or an “increase in one or both kidneys’ size” were reported.Results: Ultrasound findings were positive for VUR in 5 of 24 patients with confirmed VUR on VCUG, and were negative in all of 107 patients without VUR on VCUG. Altogether, of the 131 children‚ 24 had reflux on VCUG, 19 (79%) of who had no sonographic findings suggestive for reflux. The sensitivity and specificity of ultrasound in Suggesting VUR were 20% and 100%, respectively.Conclusion: The results of this study showed that ultrasonography cannot accurately detect or predict vesicoureteral reflux. This outcome should be mentioned by clinicians in evaluation of patients with complaints which are suggestive for VUR.

scholarly journals Congenital bilateral hydronephrosis diagnosed before birth, associated with vesicoureteral reflux, highlighted by urinary tract infection at the he age of 2 months - case presentation

2013 ◽  
Vol 19 (1) ◽  
pp. 39-45
Author(s):  
Anca Gabriela Bădescu ◽  
C. Tica ◽  
Larisia Mihai
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Vesicoureteral Reflux ◽  
Renal Pelvis ◽  
Kidney Development ◽  
Urine Analysis ◽  
Voiding Cystourethrography ◽  
Fetal Ultrasonography ◽  
Bilateral Hydronephrosis

Abstract Vesicoureteral reflux is characterized by the retrograde flow of urine from the bladder to the kidneys. Vesicoureteral reflux may be associated with urinary tract infection, hydronephrosis, and abnormal kidney development (renal dysplasia). Hydronephrosis - literally “water inside the kidney” - refers to distension and dilatation of the renal pelvis and calyces, usually caused by obstruction of the free flow of urine from the kidney. Untreated, it leads to progressive atrophy of the kidney. In cases of hydroureteronephrosis, there is distention of both the ureter and the renal pelvis and ureteres. However, in the current era, hydronephrosis that is evident on fetal ultrasonography often heralds a ureteral abnormality. Hydronephrosis is defined as dilatation of the renal pelvis and/or calyces. Vesicoureteral reflux may present before birth as prenatal hydronephrosis, an abnormal widening of the ureter or with a urinary tract infection or acute pyelonephritis. The authors present a case of bilateral VUR of IVth grade associated with congenital hydronephrosis of IIIrd grade, diagnosed before birth with bilateral hydronephrosis, and taken into evidence at 2 months when he was first diagnosed with urinary tract infection. Positive diagnosis was facilitated by laboratory investigations (urine analysis, urine culture, voiding cystourethrography, static renal scintigraphy).

Influence of Vesicoureteral Reflux and Urinary Tract Infection on Renal Growth in Children with Upper Urinary Tract Duplication

1989 ◽  
Vol 30 (4) ◽  
pp. 391-394
Author(s):  
L. Hannerz ◽  
I. Wikstad ◽  
G. Celsi ◽  
A. Aperia
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Vesicoureteral Reflux ◽  
Upper Urinary Tract ◽  
Renal Growth ◽  
Group A ◽  
Group B ◽  
Parenchymal Thickness ◽  
Renal Length

The growth of the renal parenchyma was examined in children with duplicated outflow systems, vesicoureteral reflux (VUR), urinary tract infection (UTI) and no sign of obstruction. Ten patients with reflux occurring only in the caudal system (group A) and 4 patients with reflux both to the caudal and the apical system (group B) were studied shortly after their first UTI (study 1) and then 1.5 to 9 years later (study 2). The frequency of UTI was relatively high during the follow-up period. At urography, renal length and renal area were normal in group A in studies 1 and 2. Parenchymal thickness of the apical pole (APT/L) did not differ from normal values in any of the studies. Parenchymal thickness of the caudal pole (CPT/L) was significantly smaller than normal in both studies. There was also a significant decrease in CPT/L between study 1 and 2. UTI during the first year of life was associated with a greater reduction in CPT/L. The determination of renal length and renal area in children with a duplicated ureter, VUR and UTI, does not identify subjects at risk of developing renal growth retardation while serial determinations of parenchymal thickness appear to be an appropriate method.

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