value of ultrasound in diagnosing vesicoureteral reflux in young children with urinary tract infection

Urinary tract infection is a common pediatric problem and vesicoureteral reflux is its most common complication. Detection of this reflux has classically been achieved by voiding cystouretrography [VCUG]. Ultrasonography for evaluation of vesicoureteral reflux is shown to be feasible but is not widely accepted. Our aim was to assess the value of routine sonography in detecting vesicoureteral reflux is young children with urinary tract infection. This study was carried out in 105 patients suffering from urinary tract infection admitted to Shahid Sadughi Hospital in Yazd, Iran. These patients were evaluated by two methods [sonography and VCUG]. Overall sensitivity and specificity value of sonography in suggesting vesicoureteral reflux were 63% and 95% respectively. The most accurate results were obtained with high grades reflux [75% and 955]. The results reconfirmed that sonography is reliable in the exclusion or verification of high grade reflux and it has a low sensitivity in low grade vesicoureteral reflux

Renal power doppler ultrasonographic evaluation of children with acute pyelonephritis

Urinary tract infections are common in children. The available gold standard method for diagnosis, Tc-99m dimercaptosuccinic acid scan is expensive and exposes patients to considerable amount of radiation. This study was performed to compare and assess the efficacy of Power Doppler Ultrasound versus Tc-99m DMSA scan for diagnosis of acute pyelonephritis. A quasi experimental study was conducted on 34 children with mean age of 2.8?2.7 years who were hospitalized with their first episode of febrile urinary tract infection. All children were evaluated in the first 3 days of admission by Doppler Ultrasound and Tc-99m DMSA scan. Patients with congenital structural anomalies were excluded. Each kidney was divided into three zones. The comparison between efficacy of Doppler Ultrasound and DMSA scan was carried out based on number of patients and on classified renal units. Based on the number of patients enrolled; the sensitivity, specificity, positive and negative predictive values and accuracy of Doppler Ultrasound were 89%, 53%, 70%, 80% and 74%, respectively but based on the renal units, it was 66%, 81%, 46%, 91% and 79%, respectively. Although Doppler Ultrasound has the potential for identifying acute pyelonephritis in children, but it is still soon to replace DMSA scan