Reflux in Young Patients: Comparison of Voiding US of the Bladder and Retrovesical Space With Echo Enhancement Versus Voiding Cystourethrography for Diagnosis

Darge, Kassa; Troeger, Jochen; Duetting, T.; Zieger, B; Rohrschneider, W; Moehring, Klaus; Weber, Christian; Toenshoff, Burkhard

doi:10.1097/00005392-199907000-00096

Cited by 114 publications

(50 citation statements)

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“…The high NPV of Doppler voiding urosonography described in previous studies and in our investigation, especially in younger children, indicates the reliability of this method in this respect. 14 Similar to previously reported investigations, the total duration of the examination applying both direct radionuclide voiding cystography and Doppler voiding urosonography was about 20 to 30 minutes for each patient. Although this process might be regarded as time-consuming, one should not forget that a longer sonographic examination time also improves the probability of detecting intermittent reflux.…”

Section: Discussionsupporting

confidence: 81%

“…In comparison with most available studies, we aimed to assess the diagnostic efficacy of color Doppler voiding urosonography without the application of contrast enhancement. Although echo-enhancing agents were shown to be well tolerated by patients, 14 their availability may be Both direct radionuclide voiding cystography and Doppler voiding urosonography have similar diagnostic capabilities and similar disadvantages. They offer low anatomic resolution and lack visualization of the urethra.…”

Section: Discussionmentioning

confidence: 99%

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Comparative Study of Color Doppler Voiding Urosonography Without Contrast Enhancement and Direct Radionuclide Voiding Cystography for Diagnosis of Vesicoureteric Reflux in Children

Fallah

Falahati

Mohammadi

et al. 2012

Journal of Ultrasound in Medicine

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Comparative Study of Color Doppler Voiding Urosonography Without Contrast Enhancement and Direct Radionuclide Voiding Cystography for Diagnosis of Vesicoureteric Reflux in Children

Fallah

Falahati

Mohammadi

et al. 2012

Journal of Ultrasound in Medicine

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“…Various authors have described numerous "false-positive" sonographic examination results in low-grade refluxes. [5][6][7][8] There were no special factors involved in our case of grade IV reflux not shown by VCUG. Mentzel et al 6 and Bosio 7 also found grade IV refluxes identified only by EC.…”

Section: Discussionmentioning

confidence: 57%

“…It involves instillation of a contrast-enhancing agent into the bladder to demonstrate or rule out the presence of reflux and to identify associated anomalies of the urinary tract, and it avoids radiation exposure. [2][3][4][5][6][7] Comparative studies between VCUG and EC have shown good results, with sensitivities between 70% and 100% and specificities from 86% to 97%. [5][6][7] We obtained similar values in specificity and negative predictive value (92% and 94%, respectively), but our sensitivity was lower (66%).…”

Section: Discussionmentioning

confidence: 99%

“…4 Sometimes grade I reflux is physiological and can be found in asymptomatic patients. 5 In many cases, therefore, a diagnosis of grade I reflux does not change treatment; 12 consequently, in such cases, its diagnosis and the disparity between the techniques in these cases are of little importance. The presence of grade II reflux, however, could affect long-term prophylactic therapy, and for this reason its diagnosis is important.…”

Section: Discussionmentioning

confidence: 99%

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Usefulness of echocystography in the study of vesicoureteral reflux.

Escape

Martínez

Bastart

et al. 2001

J of Ultrasound Medicine

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The aim of our study was to assess the usefulness of contrast-enhanced sonography in detecting and staging vesicoureteral reflux in pediatric patients. Forty-nine children between birth and 5 years of age were studied for vesicoureteral reflux. Echocystography with the use of an endovesical signal enhancer was performed first, followed immediately by conventional voiding cystourethrography. The findings obtained by echocystography and voiding cystourethrography were consistent in 89 (90.8%) of 98 ureterorenal units (a ureterorenal unit is 1 kidney with its own ureter). Reflux was demonstrated by voiding cystourethrography in 13 cases; in 9 of these cases diagnosis had also been made by echocystography. Five cases of reflux detected by echocystography were not identified by voiding cystourethrography. With voiding cystourethrography as the standard of reference, sensitivity was 69%; specificity, 94%; positive predictive value, 64%; and negative predictive value, 95%. In conclusion, echocystography is a useful tool for the diagnosis of vesicoureteral reflux. Its ability to detect reflux is similar to that of cystography in cases of high-grade reflux, and it may be an appropriate complementary technique to voiding cystourethrography, because it avoids exposure to radiation.

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Contrast-enhanced gray-scale and color doppler voiding urosonography versus voiding cystourethrography in the diagnosis and grading of vesicoureteral reflux

Valentini

Salvaggio

Manzoni

et al. 2001

J. Clin. Ultrasound

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Purpose The purpose of this study was to compare contrast‐enhanced gray‐scale voiding urosonography (CE‐VUS) and contrast‐enhanced color Doppler voiding urosonography (CE‐CDVUS) with voiding cystourethrography (VCUG) to verify whether the use of color Doppler imaging improves the diagnosis and grading of vesicoureteral reflux (VUR). Methods In 74 patients, CE‐VUS and CE‐CDVUS were compared with VCUG, which was used as the gold standard. SHU 508 A (Levovist) was used as the echo‐enhancing contrast agent. VUR was diagnosed if hyperechoic dots or color signals were visualized in the ureter on sonograms. VUR grading was based on morphologic and dynamic findings on CE‐VUS and morphologic and color findings on CE‐CDVUS. VCUG was performed conventionally, and grading by VCUG was in accordance with the international system of radiographic VUR grading. Patients who voided during 1 examination only (either CE‐VUS and CE‐CDVUS or VCUG) were excluded from the study. Agreement between the results of CE‐VUS and VCUG and between those of CE‐CDVUS and VCUG in diagnosing VUR was calculated by κ statistics. CE‐VUS and CE‐CDVUS were compared for diagnostic accuracy by the McNemar test. Results The agreement between CE‐VUS and VCUG in predicting VUR was 90% (κ score, 0.77; p < 0.001). The agreement between CE‐CDVUS and VCUG was 96% (κ score, 0.91; p < 0.001). CE‐CDVUS showed a significantly higher diagnostic accuracy than did CE‐VUS (96% versus 90% of cases correctly classified; McNemar χ2 = 4; p < 0.05). This was mainly related to the lower number of false‐negative results for grade I and grade II VUR when CE‐CDVUS was used. Conclusions The use of color Doppler imaging significantly improves the accuracy of contrast voiding urosonography in the detection and grading of VUR. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:65–71, 2001.

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Reflux in Young Patients: Comparison of Voiding US of the Bladder and Retrovesical Space With Echo Enhancement Versus Voiding Cystourethrography for Diagnosis

Cited by 114 publications

References 1 publication

Comparative Study of Color Doppler Voiding Urosonography Without Contrast Enhancement and Direct Radionuclide Voiding Cystography for Diagnosis of Vesicoureteric Reflux in Children

Comparative Study of Color Doppler Voiding Urosonography Without Contrast Enhancement and Direct Radionuclide Voiding Cystography for Diagnosis of Vesicoureteric Reflux in Children

Usefulness of echocystography in the study of vesicoureteral reflux.

Contrast-enhanced gray-scale and color doppler voiding urosonography versus voiding cystourethrography in the diagnosis and grading of vesicoureteral reflux

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