TY - JOUR
T1 - Prediction of high-grade vesicoureteral reflux in children younger than 2 years using renal sonography
T2 - A preliminary study
AU - You, Sun Kyoung
AU - Kim, Jong Chun
AU - Park, Won Hong
AU - Lee, So Mi
AU - Cho, Hyun Hae
N1 - Publisher Copyright:
© 2016 by the American Institute of Ultrasound in Medicine.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Objectives - To investigate the predictive value of renal sonography for vesicoureteral reflux (VUR) and the efficacy of renal sonography, technetium Tc 99m-labeled dimercaptosuccinic acid (DMSA) scanning, and a combination of the two for VUR screening in children younger than 2 years with a first episode of febrile urinary tract infection. Methods - Thirty-eight patients younger than 2 years with a first febrile urinary tract infection were included in our study, which was conducted from April through October 2014. Each kidney was considered a separate renal unit. A retrospective review of clinical information and images (renal sonography, DMSA scanning, and voiding cystourethrography) was performed. Results - Of the 14 renal units (18.4%) with VUR, 4 (28.5%) had high-grade VUR. Among single findings, dilatation of the renal collecting system, wall thickening of the renal collecting system, and DMSA scans significantly predicted VUR (P= .038, .027, and .01, respectively). Dilatation was the most common single finding (46 of 76 renal units). The sensitivity values for dilatation, wall thickening, and DMSA scans were 85.7%, 64.2%, and 50.0%, and the negative predictive values were 93.3%, 89.7%, and 87.9%. Conclusions - The negative predictive values indicate that normal renal sonographic and DMSA findings can predict the absence of high-grade VUR. We propose that renal sonographic findings of wall thickening as well as dilatation of the renal collecting system should be considered predictive of high-grade VUR.
AB - Objectives - To investigate the predictive value of renal sonography for vesicoureteral reflux (VUR) and the efficacy of renal sonography, technetium Tc 99m-labeled dimercaptosuccinic acid (DMSA) scanning, and a combination of the two for VUR screening in children younger than 2 years with a first episode of febrile urinary tract infection. Methods - Thirty-eight patients younger than 2 years with a first febrile urinary tract infection were included in our study, which was conducted from April through October 2014. Each kidney was considered a separate renal unit. A retrospective review of clinical information and images (renal sonography, DMSA scanning, and voiding cystourethrography) was performed. Results - Of the 14 renal units (18.4%) with VUR, 4 (28.5%) had high-grade VUR. Among single findings, dilatation of the renal collecting system, wall thickening of the renal collecting system, and DMSA scans significantly predicted VUR (P= .038, .027, and .01, respectively). Dilatation was the most common single finding (46 of 76 renal units). The sensitivity values for dilatation, wall thickening, and DMSA scans were 85.7%, 64.2%, and 50.0%, and the negative predictive values were 93.3%, 89.7%, and 87.9%. Conclusions - The negative predictive values indicate that normal renal sonographic and DMSA findings can predict the absence of high-grade VUR. We propose that renal sonographic findings of wall thickening as well as dilatation of the renal collecting system should be considered predictive of high-grade VUR.
KW - Pediatric ultrasound
KW - Renal sonography
KW - Technetium Tc 99m-labeled dimercaptosuccinic acid scanning
KW - Urinary tract infection
KW - Vesicoureteral reflux
KW - Voiding cystourethrography
UR - http://www.scopus.com/inward/record.url?scp=84962473581&partnerID=8YFLogxK
U2 - 10.7863/ultra.15.04074
DO - 10.7863/ultra.15.04074
M3 - Article
C2 - 28027609
AN - SCOPUS:84962473581
VL - 35
SP - 761
EP - 765
JO - Journal of Ultrasound in Medicine
JF - Journal of Ultrasound in Medicine
SN - 0278-4297
IS - 4
ER -