Color Doppler Ultrasound Evaluation of Ureteral Jet Angle to Detect Vesicoureteral Reflux in Children

Asanuma, Hiroshi; Matsui, Zenichi; Satoh, Hiroyuki; Nobuyoshi, Asai; Nukui, Chizuko; Aoki, Yujiro; Mizuno, Ryuichi; Oya, Mototsugu

doi:10.1016/j.juro.2016.01.055

Cited by 16 publications

(16 citation statements)

References 13 publications

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“…This procedure could be applied only patients aged ≥2 years because it required compliance from the patients. [9,10] The sensitivity of conventional US for detection of VUR was 40% with specificity 76% (5). The sensitivity of voiding urosonography for detecting VUR was demonstrated between 57% and 100% and specificity between 85% and 100%.…”

Section: Discussionmentioning

confidence: 97%

Comparative study of conventional urosonography without contrast enhancement and x-ray voiding cystourethrography for diagnosis of vesicoureteral reflux in children

Gülleroğlu

Gulleroglu

Baskın

2021

DCC

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Background: Vesicoureteral reflux is the most common urinary congenital anomaly in children. Given the risk associated with radiation exposure there has been an increasing need for radiation-free method in the diagnosis and follow-up of the vesicoureteral reflux. The aim of our study is to compare conventional urosonography without contrast enhancement and x-ray voiding cystourethrography.Patients and Methods: Children with recurrent urinary tract infection with suspected vesicoureteral reflux were included to the study. Vesicoureteral reflux is demonstrated and graded by x-ray voiding cystourethrography. DMSA is used for the evaluation of renal scar. Conventional sonographic procedure was performed in all patients. Ureterovesical junction insertion angle was evaluated. The diameter and length of the ureterovesical junction were also measured.Results: 268 children enrolled to the study. Vesicoureteral reflux was demonstrated in 62 children by x-ray voiding cystourethrography. Ureterovesical junction insertion angle measurement had a statistically significant relation for right and left vesicoureteral reflux presence (right: r: .646, p: .01 and left: r: .446, p: .01). Diagnosis sensitivity of vesicoureteral reflux with conventional ultrasonography is 95.10% and specificity is 81% (Youden’s index 76.1%) for the cutoff value of the ureterovesical junction insertion angle is 28.6 degrees. Positive predictive value is 87.2%, negative predictive value is 94.73% and diagnostic accuracy is 86.29% with conventional ultrasonography.Conclusions: Measurement of ureterovesical junction insertion angle, length and diameter by conventional urosonography is an easy accessible and cheap technique with high sensitivity and specificity for the diagnosis and followup of the vesicoureteral reflux without exposure to ionizing radiation.

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Section: Discussionmentioning

confidence: 97%

Comparative study of conventional urosonography without contrast enhancement and x-ray voiding cystourethrography for diagnosis of vesicoureteral reflux in children

Gülleroğlu

Gulleroglu

Baskın

2021

DCC

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“…In one study, the sensitivity of colored doppler RBUS in the evaluation of ureteral jet opening in children with VUR was determined to be 85% for grade III-IV and 94% for grade IV-V (20).…”

Section: Discussionmentioning

confidence: 99%

The Use of Artificial Neural Networks for Differential Diagnosis between Vesicoureteral Reflux and Urinary Tract Infection in Children

Keskınoğlu¹,

Özgür²

2020

jpr

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Vesicoureteral reflux (VUR) and urinary tract infection (UTI) are common problems in children. Our goal is to use different models for the clinical decision of differential diagnosis of VUR and UTI in children. Materials and Methods: This was a retrospective cross-sectional study with 611 pediatric patients enrolled. Detailed information for the patients was obtained from hospital records and patient files. Three models including different variables were evaluated via an artificial neural network for the differential diagnosis of VUR and recurrent UTI. Clinical findings were included in Model 1, clinical and laboratory findings were included in Model 2, and clinical, laboratory and detailed urinary ultrasonography (USG) findings were included in Model 3. A cross-validation technique was used to evaluate predictive models by partitioning the original sample into a training set to train the model, and a test set to evaluate it. Results: Of the 611 children, 425 (69.6%) had VUR and 186 (30.4%) had UTI. The sensitivity of Model 1 and Model 2 were 0.682 and 0.856, respectively. Also, Model 3 showed the best performance and highest sensitivity with 0.939 for differential diagnosis. Conclusion: Differential diagnosis between VUR and UTI in children can be predicted by using clinical, laboratory and USG variables via an Artificial Neural Network. Model 3, which included clinical, laboratory and USG variables together, showed the best performance and highest sensitivity.

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“…reported color Doppler ultrasound measurement of the ureteral jet angle for detecting VUR. Refluxing UVJ showed a greater ureteral jet angle than non‐refluxing . Ureteral jet waveform would be a useful parameter to detect and follow up VUR .…”

Section: Are There Any Alternatives To Vcug?mentioning

confidence: 95%

“…Refluxing UVJ showed a greater ureteral jet angle than non-refluxing. 145 Ureteral jet waveform would be a useful parameter to detect and follow up VUR. 146,147 However, this method is time-consuming, requiring at least 20 min.…”

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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Color Doppler Ultrasound Evaluation of Ureteral Jet Angle to Detect Vesicoureteral Reflux in Children

Abstract: Color Doppler ultrasound measurement of ureteral jet angle represents a simple and noninvasive method that is applicable as a screening tool to detect high grade vesicoureteral reflux in children.

Cited by 16 publications

References 13 publications

Comparative study of conventional urosonography without contrast enhancement and x-ray voiding cystourethrography for diagnosis of vesicoureteral reflux in children

Comparative study of conventional urosonography without contrast enhancement and x-ray voiding cystourethrography for diagnosis of vesicoureteral reflux in children

The Use of Artificial Neural Networks for Differential Diagnosis between Vesicoureteral Reflux and Urinary Tract Infection in Children

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

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