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Voiding urosonography and voiding cystourethrography in primary vesicoureteral reflux associated with mild prenatal hydronephrosis: a comparative study.
Pediatr Radiol. 2020 Aug; 50(9):1271-1276.PR

Abstract

BACKGROUND

Contrast-enhanced harmonic voiding urosonography has been introduced as a sensitive, radiation-free imaging method for the diagnosis of vesicoureteric reflux.

OBJECTIVE

To evaluate the occurrence/severity of vesicoureteric reflux in infants with mild prenatal hydronephrosis comparing voiding cystourethrography and voiding urosonography.

MATERIALS AND METHODS

Sixty infants with prenatal hydronephrosis were studied (anteriοposterior pelvic diameter 5-9 mm on ultrasound [US] at gestational weeks 21-30). Postnatal US was performed within the first month of life, as well as voiding cystourethrography and contrast-enhanced voiding urosonography at 1.5-2.5 months at the same session.

RESULTS

Vesicoureteric reflux was diagnosed on at least one modality in 19/60 (32%) infants, and more often on contrast-enhanced voiding urosonography (18/60, 30%) than on voiding cystourethrography (8/60, 13%), P=0.046. Among girls, reflux was more often seen on contrast-enhanced voiding urosonography (6/16, 38%) than on voiding cystourethrography (1/16, 6%), P=0.03. Vesicoureteric reflux missed by voiding cystourethrography was more severe (Grades I, II and III in one, nine and four kidney-ureter-units, respectively), compared with a single case missed by contrast-enhanced voiding urosonography (Grade I in one kidney-ureter-unit).

CONCLUSION

In the absence of a reference standard, our results imply that voiding cystourethrography might underdiagnose reflux, and/or contrast-enhanced voiding urosonography may overdiagnose reflux.

Authors+Show Affiliations

Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, GR-45 500, Ioannina, Greece. eksiomou@yahoo.gr.Department of Neonatal Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece.Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, GR-45 500, Ioannina, Greece.Department of Obstetrics-Gynecology, University Hospital of Ioannina, Ioannina, Greece.Department of Radiology, University Hospital of Ioannina, Ioannina, Greece.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32638052

Citation

Siomou, Ekaterini, et al. "Voiding Urosonography and Voiding Cystourethrography in Primary Vesicoureteral Reflux Associated With Mild Prenatal Hydronephrosis: a Comparative Study." Pediatric Radiology, vol. 50, no. 9, 2020, pp. 1271-1276.
Siomou E, Giapros V, Serbis A, et al. Voiding urosonography and voiding cystourethrography in primary vesicoureteral reflux associated with mild prenatal hydronephrosis: a comparative study. Pediatr Radiol. 2020;50(9):1271-1276.
Siomou, E., Giapros, V., Serbis, A., Makrydimas, G., & Papadopoulou, F. (2020). Voiding urosonography and voiding cystourethrography in primary vesicoureteral reflux associated with mild prenatal hydronephrosis: a comparative study. Pediatric Radiology, 50(9), 1271-1276. https://doi.org/10.1007/s00247-020-04724-y
Siomou E, et al. Voiding Urosonography and Voiding Cystourethrography in Primary Vesicoureteral Reflux Associated With Mild Prenatal Hydronephrosis: a Comparative Study. Pediatr Radiol. 2020;50(9):1271-1276. PubMed PMID: 32638052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voiding urosonography and voiding cystourethrography in primary vesicoureteral reflux associated with mild prenatal hydronephrosis: a comparative study. AU - Siomou,Ekaterini, AU - Giapros,Vasileios, AU - Serbis,Anastasios, AU - Makrydimas,George, AU - Papadopoulou,Frederica, Y1 - 2020/07/07/ PY - 2019/12/17/received PY - 2020/05/18/accepted PY - 2020/04/01/revised PY - 2020/7/9/pubmed PY - 2020/7/9/medline PY - 2020/7/9/entrez KW - Infants KW - Ultrasound KW - Ultrasound contrast KW - Vesicoureteric reflux KW - Voiding cystourethrography KW - Voiding urosonography SP - 1271 EP - 1276 JF - Pediatric radiology JO - Pediatr Radiol VL - 50 IS - 9 N2 - BACKGROUND: Contrast-enhanced harmonic voiding urosonography has been introduced as a sensitive, radiation-free imaging method for the diagnosis of vesicoureteric reflux. OBJECTIVE: To evaluate the occurrence/severity of vesicoureteric reflux in infants with mild prenatal hydronephrosis comparing voiding cystourethrography and voiding urosonography. MATERIALS AND METHODS: Sixty infants with prenatal hydronephrosis were studied (anteriοposterior pelvic diameter 5-9 mm on ultrasound [US] at gestational weeks 21-30). Postnatal US was performed within the first month of life, as well as voiding cystourethrography and contrast-enhanced voiding urosonography at 1.5-2.5 months at the same session. RESULTS: Vesicoureteric reflux was diagnosed on at least one modality in 19/60 (32%) infants, and more often on contrast-enhanced voiding urosonography (18/60, 30%) than on voiding cystourethrography (8/60, 13%), P=0.046. Among girls, reflux was more often seen on contrast-enhanced voiding urosonography (6/16, 38%) than on voiding cystourethrography (1/16, 6%), P=0.03. Vesicoureteric reflux missed by voiding cystourethrography was more severe (Grades I, II and III in one, nine and four kidney-ureter-units, respectively), compared with a single case missed by contrast-enhanced voiding urosonography (Grade I in one kidney-ureter-unit). CONCLUSION: In the absence of a reference standard, our results imply that voiding cystourethrography might underdiagnose reflux, and/or contrast-enhanced voiding urosonography may overdiagnose reflux. SN - 1432-1998 UR - https://www.unboundmedicine.com/medline/citation/32638052/Voiding_urosonography_and_voiding_cystourethrography_in_primary_vesicoureteral_reflux_associated_with_mild_prenatal_hydronephrosis:_a_comparative_study L2 - https://dx.doi.org/10.1007/s00247-020-04724-y DB - PRIME DP - Unbound Medicine ER -
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