Journal of Ultrasound in Medicine, Vol 20, Issue 2 145-149, Copyright © 2001 by American Institute of Ultrasound in Medicine
Usefulness of echocystography in the study of vesicoureteral reflux
I. Escape, J. Martinez, F. Bastart, C. Solduga and P. Sala
Servei de Radiologia, Sociedad Cooperativa de Instalaciones Asistenciales Sanitarias, Hospital de Barcelona, Spain.
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.
