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Pediatric Radiology

Published in:

01-06-2012 | Original Article

Voiding urosonography including urethrosonography: high-quality examinations with an optimised procedure using a second-generation US contrast agent

Authors: Carmina Duran, Javier del Riego, Luis Riera, Cesar Martin, Carlos Serrano, Pau Palaña

Published in: Pediatric Radiology | Issue 6/2012

Abstract

Background

Voiding urosonography (VUS) is established as a technique for detecting vesicoureteral reflux in children.

Objective

To evaluate the quality of images of the entire urinary tract when using a second-generation US contrast agent and a modified VUS technique.

Materials and methods

We evaluated 307 VUS examinations performed using SonoVue® in 591 pelvi-ureter units in 295 children of mean age, 27.1 (S.D., 42.5) months, with 154 (50.2%) of the examinations performed in boys; 58 children also underwent VUS using Levovist®. Three criteria were used for quality assessment of the bladder image: (1) progressive incorporation of contrast material in the bladder, (2) homogeneous bladder-filling to maximum capacity, and (3) visualisation of the posterior bladder wall.

Results

Criterion 1 was fulfilled in 305 (99.3%), criterion 2 in 304 (99%) and criterion 3 in 304 (99%) studies. In children who underwent VUS with both contrast agents, the concordance between the two techniques was moderate for findings in the bladder (Cohen K = 0.487; P < 0001) and perfect for findings in the male urethra.

Conclusion

By a modified technique we obtained high-quality images of the bladder with the second-generation contrast agent.

Papadopoulou F, Anthopoulou A, Siomou E et al (2009) Harmonic voiding urosonography with a second-generation contrast agent for the diagnosis of vesicoureteral reflux. Pediatr Radiol 39:239–244PubMedCrossRef

Hernandez RJ, Goodsitt MM (1996) Reduction of radiation dose in pediatric patients using pulsed fluoroscopy. AJR 167:1247–1253PubMed

Darge K (2010) Voiding urosonography with US contrast agent for the diagnosis of vesicoureteric reflux in children: an update. Pediatr Radiol 40:956–962PubMedCrossRef

Darge K, Grattan-Smith JD, Riccabona M (2010) Pediatric uroradiology: state of the art. Pediatr Radiol 41:82–91PubMedCrossRef

Darge K (2008) Voiding urosonography with US contrast agents for the diagnosis of vesicoureteric reflux in children. II. Comparison with radiological examinations. Pediatr Radiol 38:54–63PubMedCrossRef

Kis E, Nyitrai A, Várkonyi I et al (2010) Voiding urosonography with 2nd generation contrast agent versus voiding cystourethrography. Pediatr Nephrol 25:2289–2293PubMedCrossRef

Ascenti G, Zimbaro G, Mazziotti S et al (2004) Harmonic US imaging of vesicoureteric reflux in children: usefulness of a second generation US contrast agent. Pediatr Radiol 34:481–487PubMedCrossRef

Berrocal T, Gayá F, Arjonilla A et al (2001) Vesicoureteral reflux: diagnosis and grading with echo-enhanced cystosonography versus voiding cystourethrography. Radiology 221:359–365PubMedCrossRef

Berrocal T, Gayá F, Arjonilla A (2005) Vesicoureteral reflux: can the urethra be adequately assessed by using contrast-enhanced voiding US of the bladder? Radiology 234:235–241PubMedCrossRef

10.

Duran C, Valera A, Alguersuari A et al (2009) Voiding urosonography: the study of the urethra is no longer a limitation of the technique. Pediatr Radiol 39:124–131PubMedCrossRef

11.

Darge K, Beer M, Gordjani N et al (2004) Contrast-enhanced voiding urosonography with the use of a 2nd generation US contrast medium: preliminary results. Pediatr Radiol 34:S97CrossRef

12.

Schneider M (1999) SonoVue, a new ultrasound contrast agent. Eur Radiol 9:S347–348PubMedCrossRef

13.

Greis C (2004) Technology overview: SonoVue (Bracco, Milan). Eur Radiol 14:P11–15PubMedCrossRef

14.

Darge K (2008) Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children. I. Procedure. Pediatr Radiol 38:40–53PubMedCrossRef

15.

Darge K, Bruchelt W, Roessling G et al (2003) Interaction of normal saline solution with ultrasound contrast medium: significant implication for sonographic diagnosis of vesicoureteral reflux. Eur Radiol 13:213–218PubMed

16.

Darke K, Troeger J (2002) Vesicoureteral reflux grading in contrast-enhanced voiding urosonography. Eur J Radiol 43:122–128CrossRef

17.

Giordano M, Marzolla M, Puteo F (2007) Voiding urosonography as first step in the diagnosis of vesicoureteral reflux in children: a clinical experience. Pediatr Radiol 37:674–677PubMedCrossRef

18.

Quaia E (2007) Microbubble ultrasound contrast agents: an update. Eur Radiol 17:1995–2008PubMedCrossRef

19.

Maté A, Bargiela A, Mosteiro S et al (2003) Contrast ultrasound of the urethra in children. Eur Radiol 13:1534–1537PubMedCrossRef

20.

Bosio M, Manzoni GA (2002) Detection of posterior urethral valves with voiding cystourethrosonography with echo contrast. J Urol 168:1711–1715PubMedCrossRef

21.

Riccabona M, Avni FE, Blickman JG et al (2008) Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol 38:138–145PubMedCrossRef

Title: Voiding urosonography including urethrosonography: high-quality examinations with an optimised procedure using a second-generation US contrast agent
Authors: Carmina Duran
Javier del Riego
Luis Riera
Cesar Martin
Carlos Serrano
Pau Palaña
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Pediatric Radiology / Issue 6/2012
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-012-2360-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Voiding urosonography including urethrosonography: high-quality examinations with an optimised procedure using a second-generation US contrast agent

Abstract

Background

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

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