The accuracy of voiding urosonography in detecting vesico-ureteral reflux: a summary of existing data

Abstract

the existing data indicate that false-negative voiding urosonographic diagnoses (8%-31%) and underestimated reflux grading cases using the same technique are related to anatomical conditions, patient cooperation and contrast medium administration. False-positive (3%-14%) and overestimated reflux grading cases using voiding urosonography could be correctly assessed cases. The intermittent nature of vesico-ureteral reflux is better detected by a technique employing a prolonged observation time, such as voiding urosonography. This might question the current role of voiding cystourethrography in the investigation of reflux.

Discrepancy between power-Doppler voiding urosonography and voiding cystourethrography is not relevant for the management of primary vesicoureteric reflux

“…We adopted a procedure already standardized and validated [10,11]; hence, not surprisingly, sensitivity, specificity, PPV, NPV, and accuracy of PD-VUS comparing with VCGU were consistent with previous reports [3].…”

“…Indeed, PD-VUS seems to be superior to VCUG [3], and also to DRVC [6,18], in this respect. The prolonged duration of PD-VUS could allow detection of short-lasting refluxes possibly overlooked by VCUG.…”

“…It was seldom the primary imaging modality in our patients and never in boys, in whom presence of posterior urethral valves always has to be ruled out. According to present knowledge, VCUG is superior to VUS in demarking the urethral profile [2,3,10,11]. However, Bosio and Manzoni showed that infravesical obstruction can be detected also by VUS [22], whereas de Kort et al [23] reported that VCUG could be unreliable in detecting urethral obstruction, including minor degree of posterior urethral valves, beyond the neonatal period.…”

“…Effectiveness of this tool has already been evaluated in several studies comparing on the same child findings at VUS and at a reference imaging modality either VCUG or direct radionuclide voiding cystography (DRVC) [3][4][5][6]. Nevertheless, both VCUG and DRVC are partially unreliable reference standards presenting some limitation in the assessment of laterality and/or grading of VUR.…”

Application of a second-generation US contrast agent in infants and children—a European questionnaire-based survey

“…The number of patients could not be retrieved from these data, but appears to be less than the above number, as some patients may have undergone repeated examinations. The highest number of responses [23] came from Germany. The other countries were-in alphabetical order-Austria, Finland, France, Greece, Hungary, Italy, Norway, Poland, Romania, Slovenia, Spain, Sweden and Switzerland.…”