Voiding Urosonography with Second-Generation Ultrasound Contrast Agent for Diagnosis of Vesicoureteric Reflux: First Local Pilot Study

Authors

  • Dafina Kuzmanovska University Children’s Hospital, Medical Faculty, Ss Cyril and Methodius University of Skopje, Vodnjanska 17, Skopje
  • Aleksandar Risteski Private Hospital Plodnost , ASNOM 9, Bitola
  • Margarita Kambovska Private Hospital Plodnost , ASNOM 9, Bitola
  • Tase Trpcevski Private Hospital Plodnost , ASNOM 9, Bitola
  • Emilija Sahpazova University Children’s Hospital, Medical Faculty, Ss Cyril and Methodius University of Skopje, Vodnjanska 17, Skopje
  • Mile Petrovski University Pediatric Surgery Clinic, Medical Faculty, Ss Cyril and Methodius University of Skopje, Vodnjanska 17, Skopje

DOI:

https://doi.org/10.3889/oamjms.2017.055

Keywords:

Vesicoureteric reflux (VUR), pediatric urinary tract infection, Fluoroscopic voiding uretrocystography, radionuclide cystography, Contrast-enhanced voiding urosonography (ceVUS)

Abstract

BACKGROUND: Vesicoureteric reflux (VUR) is an important association of paediatric urinary tract infection (UTI) found in 30-50% of all children presenting with first UTI. Contrast-enhanced voiding ultrasonography (ceVUS) has become an important radiation-free method for VUR detection in children. Its sensitivity in detecting VUR has greatly improved due to the development of the contrast-specific ultrasound techniques and the introduction of the second-generation ultrasound contrast agent, superseding the diagnostic accuracy of standard radiological procedures.

AIM: This article aimed to summarise the current literature and discuss the first local pilot study performed in our institution on detection of vesicoureteric reflux by contrast-enhanced voiding ultrasonography with second- generation agent (SonoVue, Bracco, Italy).

MATERIAL AND METHODS: Retrospective review of the first 31 ceVUS (24 girls, 7 boys) was presented.  Age range was 2 months to 18 years (mean = 6.4 ± 4.9).

RESULTS:  All examinations were well tolerated without any adverse incident. VUR was shown in 20 (64.5%) children in 32/62 (51.6) nephroureteral units (NUUs). In 18 NUUs, VUR was grade II/V, in 11 Grade III/V and in 3 grade IV/V, respectively. Urethra was shown in 19/31 children and in all boys, without pathological finding. In two girls spinning top urethra has been detected. Subsequent urodynamic studies revealed functional bladder problem in both. 

CONCLUSIONS: Contrast-enhanced voiding urosonography using intravesical second generation ultrasound contrast agent could be recommend  as a valid alternative diagnostic modality for detecting vesicoureteral reflux and evaluation of the distal urinary tract in children, based on its radiation-free, highly efficacious, reliable, and safe characteristics.

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Published

2017-04-11

How to Cite

1.
Kuzmanovska D, Risteski A, Kambovska M, Trpcevski T, Sahpazova E, Petrovski M. Voiding Urosonography with Second-Generation Ultrasound Contrast Agent for Diagnosis of Vesicoureteric Reflux: First Local Pilot Study. Open Access Maced J Med Sci [Internet]. 2017 Apr. 11 [cited 2021 Oct. 24];5(2):215-21. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2017.055

Issue

Section

B - Clinical Sciences