M A DiPietro1, C E Blane, J M Zerin. 1. Department of Pediatric Radiology, University of Michigan Hospitals, Ann Arbor 48109-0252, USA.
Abstract
PURPOSE: To determine if a negative renal sonogram is reliably predictive of the absence of vesicoureteral reflux at voiding cystourethrography (VCUG) in children aged 5 years or older. MATERIALS AND METHODS: Imaging studies in 70 children aged 5 years or older who underwent renal ultrasound (US) and VCUG on the same day were reviewed. These children had initially undergone evaluation because of a urinary tract infection. RESULTS: Five of 70 children had abnormal sonograms; two (40%) of the five had reflux at VCUG. One had mild pelvicalyceal dilatation, and one had a small kidney. The other three (without reflux) had a pelvic kidney, a calyceal diverticulum, or a renal stone. Of 65 children with a negative sonogram, 19 (29%) had reflux at VCUG; 46 (71%) did not. Altogether, of the 70 children, 21 had reflux, 19 (90%) of whom had no sonographic abnormality. CONCLUSION: Children with abnormal screening renal sonograms often have vesicoureteral reflux, but a normal sonogram does not reliably exclude the condition even in children aged 5 years or older. Therefore, VCUG must be performed even in older children, regardless of US findings, if clinical decisions are influenced by documentation of the presence of VUR.
PURPOSE: To determine if a negative renal sonogram is reliably predictive of the absence of vesicoureteral reflux at voiding cystourethrography (VCUG) in children aged 5 years or older. MATERIALS AND METHODS: Imaging studies in 70 children aged 5 years or older who underwent renal ultrasound (US) and VCUG on the same day were reviewed. These children had initially undergone evaluation because of a urinary tract infection. RESULTS: Five of 70 children had abnormal sonograms; two (40%) of the five had reflux at VCUG. One had mild pelvicalyceal dilatation, and one had a small kidney. The other three (without reflux) had a pelvic kidney, a calyceal diverticulum, or a renal stone. Of 65 children with a negative sonogram, 19 (29%) had reflux at VCUG; 46 (71%) did not. Altogether, of the 70 children, 21 had reflux, 19 (90%) of whom had no sonographic abnormality. CONCLUSION:Children with abnormal screening renal sonograms often have vesicoureteral reflux, but a normal sonogram does not reliably exclude the condition even in children aged 5 years or older. Therefore, VCUG must be performed even in older children, regardless of US findings, if clinical decisions are influenced by documentation of the presence of VUR.
Authors: Myra A Carpenter; Alejandro Hoberman; Tej K Mattoo; Ranjiv Mathews; Ron Keren; Russell W Chesney; Marva Moxey-Mims; Saul P Greenfield Journal: Pediatrics Date: 2013-06-10 Impact factor: 7.124