The value of direct radionuclide cystography in the detection of vesicoureteral reflux in children with normal voiding cystourethrography

Dalirani, Reza; Mahyar, Abolfazl; Sharifian, Mostafa; Mohkam, Masoumeh; Esfandiar, Nasrin; Ardestani, Azam Ghehsareh

doi:10.1007/s00467-014-2871-y

Cited by 17 publications

(10 citation statements)

References 20 publications

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“…Direct radionuclide cystography is a sensitive method and has lower radiation dose compared to voiding [7] however,, do not provide anatomical detail thus not preferred as first imaging method in the male patients at the first diagnosis. In a recent comparative study the direct radionuclide methods has been found to be more correlated with DMSA findings and clinical results [8]. The DMSA scan findings of the patients are summarized in Table 2.…”

Section: Discussionmentioning

confidence: 97%

Ureter Visualization on Tc-99m DMSA Scintigraphy in Pediatric Patients

Kara¹,

Zp²,

Mk³

2017

J Kidney

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Purpose: The aim of this study is to investigate possible reasons of ureter visualization on Tc-99m DMSA scintigraphy. Methods:The planar static renal scintigraphies of pediatric patients (n=2290) who attended for any reason between January 2009 and May 2015 were analyzed retrospectively by the same nuclear medicine physician. In our analysis 15 patients (12 Male (M), 3 Female (F); 0-12, mean: 4 ± 3, 8 years old) were included in the study due to bilateral or unilateral ureter visualization on Tc-99m DMSA scintigraphy. Results:In the visual assessment of scintigraphies, there were 7 patients with bilateral visualization and 8 patients (right in 4 patients, left in 4 patients) with unilateral. Additionally increased background activity was observed in two patients. Cortical defects and/or atrophy of kidneys were observed in 10 (66%) of the patients. The background pathology in these patients were posterior urethral valve (n=3), neurogenic bladder due to meningomyelocele (n=4), vesicoureteral reflux (n=3), urethral atresia (n=2), ureterovesical obstruction (n=1) and unknown (n=2). Conclusion:Ureter visualization on Tc-99m DMSA imaging usually accompanies severe kidney damage and ureteral or bladder pathology. Additionally this finding may point out the patients who could not be corrected completely by the surgical way but this issue has to be evaluated by future studies.

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Section: Discussionmentioning

confidence: 97%

Ureter Visualization on Tc-99m DMSA Scintigraphy in Pediatric Patients

Kara¹,

Zp²,

Mk³

2017

J Kidney

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“…RNC requires catheterization, but less radiation exposure than VCUG. Although continuous monitoring is available, the details on the film are not more precise than VCUG, although RNC might show occult VUR, which cannot be detected by VCUG in children with hydronephrosis, abnormal acute DMSA and/or recurrent febrile UTI . Generally, the main advantage of RNC is that the patient is exposed to only one‐tenth of the radiation required for VCUG .…”

Section: Are There Any Alternatives To Vcug?mentioning

confidence: 99%

“…Although continuous monitoring is available, the details on the film are not more precise than VCUG, although RNC might show occult VUR, which cannot be detected by VCUG in children with hydronephrosis, abnormal acute DMSA and/or recurrent febrile UTI. 134 Generally, the main advantage of RNC is that the patient is exposed to only onetenth of the radiation required for VCUG. 135 Recent techniques to reduce radiation exposure, such as the digital grid-controlled, variable rate and pulsed acquisition technique, are also available.…”

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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“…Vesicoureteral reflux (VUR), most important predisposing factor for UTI, may consequently lead to the complications such as renal scarring, hypertension, and chronic renal failure. Direct radionuclide voiding cystography (DRNC), the procedure causing 50-to 100-fold less radiation exposure to the gonads and bladder than VCUG 26) , is helpful in diagnosis and follow-up of patients with VUR with higher sensitivity and higher temporal resolution than VCUG 27) , even though accurate anatomical information of urethra and bladder and degree of reflux cannot be provided with DRNC. Besides its poor image resolution, DRNC has not been widely used probably because most urologists are familiar with the radiologic grading system 28) .…”

Section: Vericoureteral Refluxmentioning

confidence: 99%

Nuclear Medicine in Pediatric Urology

Jang

2015

Child Kidney Dis

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Renal scintigraphic methods, which are physiologic and minimally invasive, have played important role in the management of various renal diseases in children, providing sensitive tool for early detection of disease even before structural changes become prominent and giving valuable functional and anatomical information to aid medical decision makings in the treatment and follow-up of patients. This review article focuses on the concept and advantages of renal scintigraphy in pediatric patients with various urologic diseases.

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The value of direct radionuclide cystography in the detection of vesicoureteral reflux in children with normal voiding cystourethrography

Abstract: Based on our results, we suggest that DRNC may reveal VUR despite a normal VCUG in children with hydronephrosis, abnormal acute DMSA, and/or recurrent febrile UTI.

Cited by 17 publications

References 20 publications

Ureter Visualization on Tc-99m DMSA Scintigraphy in Pediatric Patients

Ureter Visualization on Tc-99m DMSA Scintigraphy in Pediatric Patients

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

Nuclear Medicine in Pediatric Urology

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