Tags

Type your tag names separated by a space and hit enter

Voiding urosonography with second-generation ultrasound contrast versus micturating cystourethrography in the diagnosis of vesicoureteric reflux.
Eur J Pediatr. 2014 Aug; 173(8):1095-101.EJ

Abstract

Vesicoureteric reflux has been associated with paediatric urinary tract infection. Fluoroscopic micturating cystourethrography (MCU) has been the gold standard of diagnostic test for decades; however, it has been criticized owing to its lower detection rate and radiation dose to children. Therefore, new radiation-free reflux imaging modalities have been developed, in which ultrasound-based contrast-enhanced voiding urosonography (ceVUS) is a good example. However, ultrasonography has been considered as an operator-dependent examination. Therefore, our study aimed to examine the inter-observer agreement of this sonographic technique, which has not been evaluated before. Moreover, the second-generation ultrasound contrast SonoVue has been recently marketed, and the data on its efficacy on intravesical use in ceVUS is relatively scarce. Thus, we also aimed to investigate the diagnostic performance and safety profile of SonoVue-enhanced VUS in the diagnosis of vesicoureteric reflux. Our prospective comparative study compared the diagnostic performance of ceVUS with MCU in young children presenting with first episode of urinary tract infection. We performed sequential ceVUS and MCU examinations in 31 patients (62 pelvi-ureter units). Perfect inter-observer agreement (Cohen’s kappa statistics = 1.0, p < 0.001) was achieved in ceVUS, suggesting its good reliability in reflux detection and grading. Using MCU as reference, ceVUS had 100 % sensitivity and 84 % specificity and carried higher reflux detection rate than MCU (p < 0.001). There was no complication encountered.

Conclusion:

Voiding urosonography is a reliable, sensitive, safe and radiation-free modality in the investigation of vesicoureteric reflux in children. It should be incorporated in the diagnostic algorithm in paediatric urinary tract infection.

Authors+Show Affiliations

Department of Radiology and Imaging, Queen Elizabeth Hospital, Kowloon, Hong Kong. sunnytks@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24659313

Citation

Wong, L S., et al. "Voiding Urosonography With Second-generation Ultrasound Contrast Versus Micturating Cystourethrography in the Diagnosis of Vesicoureteric Reflux." European Journal of Pediatrics, vol. 173, no. 8, 2014, pp. 1095-101.
Wong LS, Tse KS, Fan TW, et al. Voiding urosonography with second-generation ultrasound contrast versus micturating cystourethrography in the diagnosis of vesicoureteric reflux. Eur J Pediatr. 2014;173(8):1095-101.
Wong, L. S., Tse, K. S., Fan, T. W., Kwok, K. Y., Tsang, T. K., Fung, H. S., Chan, W., Lee, K. W., Leung, M. W., Chao, N. S., Tang, K. W., & Chan, S. C. (2014). Voiding urosonography with second-generation ultrasound contrast versus micturating cystourethrography in the diagnosis of vesicoureteric reflux. European Journal of Pediatrics, 173(8), 1095-101.
Wong LS, et al. Voiding Urosonography With Second-generation Ultrasound Contrast Versus Micturating Cystourethrography in the Diagnosis of Vesicoureteric Reflux. Eur J Pediatr. 2014;173(8):1095-101. PubMed PMID: 24659313.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voiding urosonography with second-generation ultrasound contrast versus micturating cystourethrography in the diagnosis of vesicoureteric reflux. AU - Wong,L S, AU - Tse,K S, AU - Fan,T W, AU - Kwok,K Y, AU - Tsang,T K, AU - Fung,H S, AU - Chan,W, AU - Lee,K W, AU - Leung,M W Y, AU - Chao,N S Y, AU - Tang,K W, AU - Chan,S C H, PY - 2013/12/27/received PY - 2014/03/11/accepted PY - 2014/03/10/revised PY - 2014/3/25/entrez PY - 2014/3/25/pubmed PY - 2015/4/10/medline SP - 1095 EP - 101 JF - European journal of pediatrics JO - Eur. J. Pediatr. VL - 173 IS - 8 N2 - Vesicoureteric reflux has been associated with paediatric urinary tract infection. Fluoroscopic micturating cystourethrography (MCU) has been the gold standard of diagnostic test for decades; however, it has been criticized owing to its lower detection rate and radiation dose to children. Therefore, new radiation-free reflux imaging modalities have been developed, in which ultrasound-based contrast-enhanced voiding urosonography (ceVUS) is a good example. However, ultrasonography has been considered as an operator-dependent examination. Therefore, our study aimed to examine the inter-observer agreement of this sonographic technique, which has not been evaluated before. Moreover, the second-generation ultrasound contrast SonoVue has been recently marketed, and the data on its efficacy on intravesical use in ceVUS is relatively scarce. Thus, we also aimed to investigate the diagnostic performance and safety profile of SonoVue-enhanced VUS in the diagnosis of vesicoureteric reflux. Our prospective comparative study compared the diagnostic performance of ceVUS with MCU in young children presenting with first episode of urinary tract infection. We performed sequential ceVUS and MCU examinations in 31 patients (62 pelvi-ureter units). Perfect inter-observer agreement (Cohen’s kappa statistics = 1.0, p < 0.001) was achieved in ceVUS, suggesting its good reliability in reflux detection and grading. Using MCU as reference, ceVUS had 100 % sensitivity and 84 % specificity and carried higher reflux detection rate than MCU (p < 0.001). There was no complication encountered. Conclusion: Voiding urosonography is a reliable, sensitive, safe and radiation-free modality in the investigation of vesicoureteric reflux in children. It should be incorporated in the diagnostic algorithm in paediatric urinary tract infection. SN - 1432-1076 UR - https://www.unboundmedicine.com/medline/citation/24659313/Voiding_urosonography_with_second_generation_ultrasound_contrast_versus_micturating_cystourethrography_in_the_diagnosis_of_vesicoureteric_reflux_ L2 - https://dx.doi.org/10.1007/s00431-014-2297-3 DB - PRIME DP - Unbound Medicine ER -