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01-06-2004 | Topic Paper

Current status of vesicoureteral reflux diagnosis

Authors: Kassa Darge, Hubertus Riedmiller

Published in: World Journal of Urology | Issue 2/2004

Abstract

In children, diagnostic imaging for vesicoureteral reflux (VUR) encompasses both radiologic and sonographic modalities. The former comprises voiding cystourethrography (VCUG), the most widespread method for examination for reflux, and radionuclide cystography (RNC). In RNC the radiation exposure is significantly less than in VCUG with continuous fluoroscopy, but the anatomic details depicted are much inferior. With the introduction of pulsed fluoroscopy, the radiation exposure of VCUG has been markedly curtailed. VCUG is the first imaging choice for the urethra. The sonographic diagnosis of VUR with the intravesical administration of an ultrasound (US) contrast agent—voiding urosonography (VUS)—is being used increasingly in the routine diagnostic imaging work-up of reflux. Various sonographic reflux examination methods had been tried in the past. The real breakthrough came with the availability of stabilized US contrast media. Further impetus came with the introduction of harmonic US imaging. The recent release of a second generation US contrast medium promises to make a further positive impact on VUS. The diagnostic accuracy of contrast-enhanced VUS has been found to be comparable to radiologic methods. VUS is primarily performed in follow-up studies and as the primary reflux examination modality in girls.

Alzen G, Wildberger JE, Ferris EJ, Guenther RW (1994) Sonographic detection of vesicoureteral reflux with air: a new method. Eur Radiol 4:142–145

Amar AD (1964) Demonstration of vesicoureteral reflux without radiation exposure. J Urol 92:286–288PubMed

Amar AD, Chabra K (1964) Reduction of radiation exposure of children during urologic diagnosis including a non-radiographic method of demonstrating vesicoureteral reflux. Pediatrics 35:960–966

Ascenti G, Chimenz R, Zimbaro G, Mazziotti S, Scribano E, Fede C, Ricca M (2000) Potential role of colour-Doppler cystosonography with echocontrast in the screening and follow-up of vesicoureteral reflux. Acta Paediatr 89:1336–1339PubMed

Ascenti G, Zimbaro G, Mazziotti S, Chimenz R, Baldari S, Fede C (2003) Vesicoureteral reflux: comparison between urosonography and radionuclide cystography. Pediatr Nephrol 18:768–771CrossRefPubMed

Atala A, Ellsworth P, Share J, Paltiel H, Dixon Walker R, Retik AB (1998) Comparison of sonicated albumin enhanced sonography to fluoroscopic and radionuclide voiding cystography for detecting vesicoureteral reflux. J Urol 160:1820–1822PubMed

Avni EF, Ayadi K, Rypens F, Hall M, Schulmann CC (1997) Can careful ultrasound examination of the urinary tract exclude vesicoureteric reflux in neonate? Br J Urol 70:977–982

Balbay MD, Oezsan O, Oezbek E, Oezkan S, Guenes (1998) A comparison of screening of vesicoureteral reflux with renal ultrasound and voiding cystourethrography. Int Urol Nephrol 30:263–266PubMed

Bergius AR, Niskanen K, Kekomaeki M (1990) Detection of significant vesicoureteric reflux by ultrasound in infants and children. Z Kinderchir 45:144–145PubMed

10.

Berrocal T, Gaya F, Arjonilla A, Lonergan GJ (2001) Vesicoureteral reflux: diagnosis and grading with echo-enhanced cystosonography versus voiding cystourethrography. Radiology 221:359–365PubMed

11.

Beyer HJ, Hofmann V, Brettschneider (1985) The micturation sonourogram: a new possibility of determining vesicoureteral reflux in childhood. Ultraschall 6:182–188PubMed

12.

Blane CE, DiPietro MA, Zerin JM, Sedman AB, Bloom DA (1993) Renal sonography is not a reliable screening examination for vesicoureteral reflux. J Urol 150:752–755PubMed

13.

Bosio M (1998) Cystosonography with echocontrast: a new imaging modality to detect vesicoureteric reflux in children. Pediatr Radiol 28:250–255CrossRefPubMed

14.

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

15.

Cleveland RH, Constantinou C, Blickman JG, Jaramillo D, Webster E (1992) Voiding cystourethrography in children: value of digital fluoroscopy in reducing radiation dose. AJR 158:137–142

16.

Dacher JN (2001) Voiding cystourethrography. In: Fotter R (ed) Pediatric uroradiology. Springer, Heidelberg Berlin, pp 4–8

17.

Darge K, Troeger J, Duetting T, Zieger B, Rohrschneider W, Moehring K, Weber C, Toenshoff B (1999) Reflux in young patients: comparison of voiding US of the bladder and retrovesical space with echo enhancement versus voiding cystourethrography for diagnosis. Radiology 210:201–207PubMed

18.

Darge K, Zieger B, Rohrschneider W, Ghods S, Wunsch R, Troeger J (2001) Contrast-enhanced harmonic imaging for the diagnosis of vesicoureteral reflux. AJR 177:1411–1415

19.

Darge K, Zieger B, Rohrschneider W, Ghods S, Wunsch R, Troeger J (2001) Reduction in voiding cystourethrographies after the introduction of contrast enhanced sonographic reflux diagnosis. Pediatr Radiol 31:790–795PubMed

20.

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

21.

Darge K, Beer M, Gordjani N, Riedmiller H (2003) Erste Erfahrungen der kontrastverstärkten sonographischen Diagnose des vesiko-ureteralen Refluxes mittels dem 2. Generation Ultraschallkontrastmittel SonoVue® (abstract). Radiologe 10:885

22.

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

23.

Darge K, Trusen A, Gordjani N, Riedmiller H (2003) Intrarenal reflux: diagnosis with contrast-enhanced harmonic US. Pediatr Radiol 33:729–731CrossRefPubMed

24.

Darge K, Trusen A, Robrecht J, Gordjani N, Riedmiller H (2003) In-vitro comparison of a first and a second generation US contrast media for reflux diagnosis (abstract). Pediatr Radiol 33:S41CrossRef

25.

Egghart G, Schlickenrieder JHM, Hautmann R (1987) Diagnosis of reflux in children with CO₂and ultrasound—preliminary results. Urologe 25:329–332

26.

Elder JS, Snyder HM, Peters C, Arant B, Hawtrey CE, Hurwitz RS, Parrott TS, Weiss RA (1992) Variations in practice among urologists and nephrologists treating children with vesicoureteral reflux. J Urol 148:714–717PubMed

27.

Evans ED, Meyer JS, Harty MP, Bellah RD (1998) Assessment of increase in renal pelvic size on post-void sonography as a predictor of vesicoureteral reflux. Pediatr Radiol 29:291–294CrossRef

28.

Farina R, Arena C, Pennisi F, Di Benedetto V, Politi G, Benedetto (2000) A Vesicoureteral reflux: diagnosis and staging with voiding color Doppler US. Preliminary experience. Eur J Radiol 35:49–53.PubMed

29.

Galia M, Midiri M, Pennisi F, Farina R, Bartolotta TV, De Maria M, Lagalla R (2004) Vesicoureteral reflux in young patients: comparison of voiding color Doppler US with echo enhancement versus voiding cystourethrography for diagnosis or exclusion. Abdom Imaging (in press)

30.

Goldberg B, Liu JB, Forsberg F (1994) Ultrasound contrast agents: a review. Ultrasound Med Biol 20:319–333PubMed

31.

Gordon I (2001) Nuclear medicine. In: Fotter R (ed) Pediatric uroradiology. Springer, Heidelberg Berlin, pp 27–40

32.

Haberlik A (1997) Detection of low-grade vesicoureteral reflux in children by color Doppler imaging mode. Pediatr Surg Int 12:38–43CrossRefPubMed

33.

Hanbury DC, Coulden RA, Farman P, Sherwood T (1990) Ultrasound cystography in the diagnosis of vesicoureteric reflux. Br J Urol 65:250–253PubMed

34.

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

35.

Hiraoka M, Hashimoto G, Hori C, Tsukahara H, Konishi Y, Sudo M (1997) Use of ultrasonography in the detection of ureteric reflux in children suspected of having urinary infection. J Clin Ultrasound 25:195–199PubMed

36.

Hiraoka M, Hori C, Tsukahara H, Kasuga K, Ishihara Y, Kotsuji F, Mayumi M (1999) Vesicoureteral reflux in male and female neonates as detected by voiding ultrasonography. Kidney Int 55:1486–1490CrossRefPubMed

37.

Hofmann V (1981) Ultraschalldiagnostik beim vesikoureteralen Reflux im Kindesalter. Z Urol Nephrol 74:249–261PubMed

38.

Jequier S, Paitiel H, Lafortune M (1990) Ureterovesical jets in infants and children: duplex and color Doppler US studies. Radiology 175:349–353PubMed

39.

Kaneko K, Kuwatsuru R, Fukuda Y, Yamataka A, Yabuta K, Katayama H, Miyano T (1994) Contrast sonography for detection of vesicoureteral reflux. Lancet 344:687PubMed

40.

Kenda RB, Novljan G, Kenig A, Hojker S, Fettich JJ (2000) Echo-enhanced ultrasound voiding cystography in children: a new approach. Pediatr Nephrol 14:297–300PubMed

41.

Kessler RM, Altman DH (1981) Real-time sonographic detection of vesicoureteral reflux in children. AJR 138:1033–1036

42.

Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen-Moebius TE (1985) International system of radiographic grading of vesicoureteric reflux. Pediatr Radiol 15:105–109PubMed

43.

Marshall L, Johnson ND, De Campo MP (1990) Vesicoureteric reflux in children: prediction with color Doppler imaging. Radiology 175:355–358PubMed

44.

Martin WG, Schneider K, Lauer O, Fendel H, Pabst HW (1986) Investigations for vesicoureteric reflux in children: ultrasound vs. radionuclide voiding cystography. Uremia Invs 9:253–258

45.

Maté A, Bargiela A, Mosteiro S, Diaz A, Bello MJ (2003) Contrast ultrasound of the urethra in children. Eur Radiol 13:1534–1537CrossRefPubMed

46.

Mentzel HJ, Vogt S, Patzer L, Schubert R, John B, Misselwitz J, Kaiser WA (1999) Contrast-enhanced sonography of vesicoureterorenal reflux in children: preliminary results. AJR 173:737–740

47.

Mooney RB, McKinstry J (2001) Pediatric dose reduction with the introduction of digital fluorography. Radiat Prot Dosimetry 94:117–120PubMed

48.

Nakamura M, Wang Y, Shigeta K, Shinozaki T, Taniguchi N, Itoh K (2002) Simultaneous voiding cystourethrography and voiding urosonography: an in vitro and in vivo study. Clin Radiol 57:846–849CrossRefPubMed

49.

Nanda NC, Schlief R, Goldberg B (1997) Advances in echo imaging using contrast enhancement, 2nd edn. Kluwer, Dordrecht

50.

Oak S, Kulkarni B, Chaubal N (1999) Color flow Doppler sonography: a reliable alternative to voiding cystourethrogram in the diagnosis of vesicoureteral reflux in children. Urology 53:1211–1214

51.

Radmayr C, Klauser A, Pallwein L, Zurnedden D, Bartsch G, Frauscher F (2002) Contrast enhanced reflux sonography in children: a comparison to standard radiological imaging. J Urol 167:1428–1430PubMed

52.

Riccabona M (2003) Contrast ultrasound of the urethra in children. Eur Radiol 13:1494–1495CrossRefPubMed

53.

Riccabona M, Mache CJ, Lindbichler F (2003) Echo-enhanced color Doppler cystosonography of vesicoureteral reflux in children: improvement by stimulated acoustic emission. Acta Radiol 44:18–23PubMed

54.

Rohden von L, Bosse U, Wiemann D (1995) Refluxsonographie bei Kindern mit einem Ultraschallkontrastmittel im Vergleich zur Röntgenmiktionszystourethrographie. Paediat Prax 49:49–58

55.

Salih M, Baltaci S, Kilic S, Anafarta K, Beduek Y (1994) Color flow Doppler sonography in the diagnosis of vesicoureteric reflux. Eur Urol 26:93–97PubMed

56.

Schlief R, Schuerman R, Niendorf HP (1993) Basic properties and results of clinical trials of ultrasound contrast agents based on galactose. Ann Acad Med 22:762–767PubMed

57.

Schneider K, Jablonski C, Wiessner M, Kohn M, Fendel H (1984) Screening for vesicoureteral reflux in children using real-time sonography. Pediatr Radiol 14:400–403PubMed

58.

Schneider K, Kruger-Stollfuss I, Ernst G, Kohn MM (2001) Paediatric fluoroscopy—a survey of children’s hospitals in Europe. I. Staffing, frequency of fluoroscopic procedures and investigation technique. Pediatr Radiol 31:238–246PubMed

59.

Schneider M (1999) SonoVue, a new ultrasound contrast agent. Eur Radiol 9 [Suppl 3]:S347–348

60.

Siamplis D, Vasiou K, Giarmenitis S, Frimas K, Zavras G, Fezoulidis I (1996) Sonographic detection of vesicoureteral reflux with fluid and air cystography: comparison with VCUG. Röfo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 165:166–169

61.

Uhl M, Kromeier J, Zimmerhackl LB, Darge K (2003) Simultaneous voiding cystourethrography and voiding urosonography. Acta Radiol 44:265–268CrossRefPubMed

62.

Tremewan RN, Bailey RR, Little PJ, Maling TMJ, Peters TM, Tait JJ (1976) Diagnosis of gross vesicoureteric reflux using ultrasonography. Br J Urol 48:431–435PubMed

63.

Valentini AL, Salvaggio E, Manzoni C, Rendeli C, Destito C, Summaria V, Campioni P, Marano P (2001) Contrast-enhanced gray-scale and color Doppler voiding urosonography versus voiding cystourethrography in the diagnosis and grading of vesicoureteral reflux. J Clin Ultrasound 29:65–71CrossRefPubMed

64.

Weinberg B,Yeung N (1998) Sonographic sign of intermittent dilatation of the renal collecting system in 10 patients with vesicoureteral reflux. J Clin Ultrasound 26:65–68CrossRefPubMed

Title: Current status of vesicoureteral reflux diagnosis
Authors: Kassa Darge
Hubertus Riedmiller
Publication date: 01-06-2004
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 2/2004
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-004-0404-1

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