Enhanced detection of vesicoureteral reflux in infants and children with use of cyclic voiding cystourethrography.

Paltiel, Harriet J.; Rupich, Reta; Kiruluta, H.G.

doi:10.1148/radiology.184.3.1509062

Cited by 120 publications

(53 citation statements)

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“…Cyclic voiding FC enhances the detection of VUR [9][10][11][12], and the present report indicates that VUR detection is further enhanced by IC. Possibly, the improvement in our diagnostic techniques will progressively reduce the frequency of the diagnosis of pyelonephritis and/or of renal scarring with no detectable VUR.…”

Section: Discussionmentioning

confidence: 52%

Enhanced detection of vesicoureteric reflux with isotopic cystography

et al. 2000

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We compared the accuracy of isotope cystography (IC) and fluoroscopic cystourethrography (FC) in detecting vesicoureteric reflux (VUR) in children. FC and IC were performed in 124 children, 56 boys and 68 girls, aged 1 month to 9.2 years (mean 2.1 years), admitted consecutively for suspected VUR over a 10-month period. VUR was diagnosed by one or both studies in 51 of 124 (41%) patients. The two methods were concordant for the detection of VUR in 84% of kidney-ureter units and in 93% for the detection or exclusion of severe VUR. IC detected VUR more accurately than FC, both when all grades of VUR were considered together (P=0.00001) and when only severe reflux was considered (P=0.004). VUR was missed by FC in 23 of 51 (45%) subjects. Of those 23, 12 had severe VUR detected on one side at least by IC. VUR was missed by IC in 3 subjects. IC is significantly more accurate than FC in the initial diagnosis of VUR, even of severe grade. IC is the method of choice for the first diagnosis of VUR. Boys with VUR diagnosed by IC also need FC to investigate for posterior urethral valves.

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Section: Discussionmentioning

confidence: 52%

Enhanced detection of vesicoureteric reflux with isotopic cystography

et al. 2000

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“…We use a similar approach for routine VCUG in our institution, but unfortunately the number of fillings at VCUG was not recorded. It is well established that the sensitivity of VCUG increases if it is performed with cyclic filling [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Low contrast dose voiding urosonography in children with phase inversion imaging

et al. 2004

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Voiding urosonography (VUS) using a microbubble contrast agent has been introduced as an alternative technique in the diagnosis of vesicoureteral reflux (VUR). This study was undertaken to assess if phase inversion ultrasound (PIUS), a recent microbubble specific imaging technique, has advantages over fundamental in VUS and if it allows a reduction of contrast agent dose. Forty-three children with suspected VUR (aged 3 days-12 years, average of 3.9 years) with 92 kidney-ureter units (KUU) were included. Everyone obtained a baseline US scan that was followed by VUS using Levovist as the contrast agent. Constant switching between fundamental and PIUS performed the enhanced part for comparison. Every child underwent VCUG immediately afterwards. Contrast enhancement was stronger and longer lasting on PIUS than on fundamental US in all 43 cases. Reflux was detected in a total of 21 KUU, out of 92 KUU (23%). PIUS revealed VUR in 18; fundamental in 14 KUU and VCUG depicted 16 cases of reflux (p> or =0.29). The mean volume of Levovist dose administered to the bladder was 7.4+/-3.4% of the bladder volume. VUS using PI mode provided considerably stronger and longer enhancement and slightly improved the detection of VUR. It allowed a reduction of contrast dose and cost by approximately 35% over current dose recommendations for fundamental US.

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“…and upright positioning (to allow for gravitydependent drainage) demonstrating the complete washout of contrast medium from the dilated right system, thus proving a dilated, but not obstructed, right system obviating any further intervention documentation reducing spot fi lms to the minimum. Try to fi ll the bladder at physiologic fi lling pressure and perform cyclic VCUG in the fi rst year(s) of life for the best yield, once you have decided to perform this study (Gelfand et al 1999 ;Paltiel et al 1992 ). Always dedicate your attention to the ureterovesical junction (oblique/lateral views mandatory!…”

Section: General Remarks On the Principles Of Imaging Children And Ramentioning

confidence: 99%

“…On the other hand, it offers a panoramic overview and allows for exquisite anatomic display of the urethra and the bladder and -if refl uxing -the entire ureter as well as the renal collecting system, also enabling the depiction of intrarenal refl ux. With modern fl uoroscopic techniques using ageadapted grids, pulsed fl uoroscopy, last image hold for documentation, and skilled device handling that allows for short fl uoroscopy time, the effective radiation burden can be signifi cantly reduced, even when performing cyclic investigation as recommended in the fi rst years of life (Lebovic and Lebowitz 1980 ;Gelfand et al 1992;Paltiel et al 1992 ;Hernandez and Goodsitt 1996 ;Ward 2006 ;Ward et al 2008 ). The entire procedure and grading (grade I-V) have been standardized; recommendations exist and have been published (Lebowitz et al 1985 ;Fernbach et al 2000 ;Riccabona 2002aRiccabona , 2005Riccabona et al 2008a ) ( Fig.…”

Section: Voiding Cystourethrographymentioning

confidence: 99%

The Pediatric Kidney

Riccabona

2014

Radiological Imaging of the Kidney

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Children are not small adults. In the urinary tract, particularly, there are many conditions that are more or less specifi c to children which need early and reliable diagnosis in order to provide proper treatment to prevent renal damage and severe long-term sequelae such as hypertension or renal insuffi ciency. This is particularly important for all congenital urinary tract malformations and also for many other congenital renal conditions -these are often detected prenatally and, after birth, need prompt and reliable diagnostic workup at minimal invasiveness. Additionally, even in conditions that are the same or similar to adults, the specifi c needs and conditions in childhood require different imaging approaches and algorithms, partially because of each of the following reasons: the child's higher sensitivity to radiation, different physiology, different size and imaging appearance, as well as different potential of the various imaging techniques. These differences are outlined, focusing on some important diseases and queries such as congenital hydronephrosis and obstructive uropathy, impact of vesicoureteral refl ux on the kidney, imaging in infants with urinary tract infection, childhood urolithiasis and nephrocalcinosis, pediatric renal masses, as well as other miscellaneous renal conditions that may manifest in the child and indicate imaging. Additionally, specifi c needs for adapting and applying the various imaging techniques in childhood are discussed.

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Enhanced detection of vesicoureteral reflux in infants and children with use of cyclic voiding cystourethrography.

Cited by 120 publications

References 0 publications

Enhanced detection of vesicoureteric reflux with isotopic cystography

Enhanced detection of vesicoureteric reflux with isotopic cystography

Low contrast dose voiding urosonography in children with phase inversion imaging

The Pediatric Kidney

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