Zou Xiangyu,Sun Peixuan,Shi Jing,et al.Role of contrast-enhanced voiding urosonography in the diagnosis of pediatric vesicoureteral reflux[J].Journal of Clinical Pediatric Surgery,,21():151-155.[doi:10.3760/cma.j.cn.101785-202006044-010]
Role of contrast-enhanced voiding urosonography in the diagnosis of pediatric vesicoureteral reflux
- Keywords:
- Vesico-Ureteral Reflux/DI; Urography; Enhanced Contrast Agent; Child
- Abstract:
- Objective To determine the value of contrast-enhanced voiding urosonography (CeVUS) for diagnosing vesicoureteral reflux (VUR) in children.Methods A total of 116 cases (232 pyelo-ureter units, PUUs) of suspicious VUR and postoperative children were admitted from December 2018 to June 2020.The safety and positive rate were analyzed.Twenty-four children (48 PUUs) were compared with voiding cystourethrography (VCUG) for its sensitivity, specificity, and consistency.Results All of them were examined successfully and no adverse reactions occurred.The diagnosis was positive for CeVUS (n=69) with a positive rate of 59.5%.Among 232 PUUs, 103 were positive for VUR with a positive diagnostic rate of 44.4%.Moreover, among 24 patients (48 PUUs) 23 were detected by VCUG, 25 by CeVUS and 21 were all positive.As compared with VCUG, CeVUS had a sensitivity of 91.3%, a specificity of 84.0%, a positive predictive value of 84% and a negative predictive value of 91.3%.Contrast-enhanced ultrasound and VCUG had a high consistency in the examination of VUR (Kappa=0.75).Among them, VCUG diagnosed no reflux in 25 PUUs and CeVUS in 21 PUUs with 4 grade Ⅱ VUR.The overall consistency rate was 72.9%.Moreover, VCUG diagnosed 15 grade Ⅳ-Ⅴ VUR, except CeVUS Ⅲ diagnosed 1 with a consistency rate of 66.7% in grade Ⅳ-Ⅴ VUR.Conclusion CeVUS has certain diagnostic significance in detecting and grading VUR with its safety and non-radioactive characteristics.It is considered as a first choice for suspected or post-operated VUR in children.
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Memo
收稿日期:2020-06-18。
基金项目:国家自然科学基金（81900618）；上海"科技创新行动计划"扬帆计划（18YF1415000）
通讯作者:孙杰,Email:sunjie@scmc.com.cn