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


  • 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




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


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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How to Cite

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 Jun. 25];5(2):215-21. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2017.055



B - Clinical Sciences