Evaluation of contrast ultrasonography in comparison with voiding cystourethrography in diagnosis of vesicoureteral reflux in young children

ABSTRACT

The aim of this study was to compare contrast ultrasonography with voiding cystourethrography in the diagnosis of vesicoureteral reflux in children. Thirty-one children were studied [21 girls and ten boys with age range 1-6 years]; 21 patients had bilateral reflux and ten patients had unilateral reflux with resultant 52 kidneys studied. The children were examined by conventional voiding cystourethrography. Ultrasonography using agitated saline as contrast material was done with monitoring the retrovesical ureters and the kidneys to detect refluxing material. Reflux was diagnosed by detecting the microbubbles in the ureters or the pelvicalyceal system. The results have indicated that voiding cystourethrography was used as gold standard for calculating the sensitivity and specificity of ultrasonography. Ultrasonography could not detect grade I reflux. It showed 84% sensitivity in the detection of grade II or greater reflux. Ultrasonography showed 100% sensitivity in the detection of grade III or greater reflux. The specificity of the procedure was 100%. It was concluded that contrast ultrasonography could be considered as a useful tool in the diagnosis and follow up of patients with vesicoureteral reflux except in grade I