Detecting reflux: does ureteric jet Doppler waveform have a role?
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Vesicoureteral reflux (VUR) has a prevalence of 30–40 % post-febrile urinary tract infection (UTI). If not detected early and treated, renal scarring, hypertension, and renal failure may occur. Micturating cystourethrography (MCU) is an invasive procedure associated with radiation exposure. Hence, this study aimed at evaluating the utility of ureteric jet Doppler waveform (UJDW) as a screening tool in detecting VUR, and at assessing the feasibility of performing it in children aged 2–4 years.
Any child 2–18 years old who needed an MCU was included. Exclusion criteria were active UTI, indwelling catheter, and inability to drink the required amount of fluid. The UJDW was performed prior to the MCU.
One hundred eighty-two ureteric units were analyzed. Sensitivity and specificity of UJDW in detecting VUR was 80.3 and 87.9 %. Twenty-three children (45 ureteric units), aged 2–4 years were compared with 73 children (137 ureteric units), aged 5–18 years. Sensitivity and specificity of UJDW in detecting VUR in 2–4 years was 77.3 and 91.3 %, respectively; while in children ≥5 years, it was 81.8 and 87.1 %, respectively.
UJDW has a uniformly high specificity regardless of age or etiological groups, making it a good tool for follow-up. UJDW is a feasible technique, even in children aged 2–4 years.
- Bagga A, Babu K, Kanitkar M, Srivastava RN, Indian Pediatric Nephrology Group. Indian Academy of Pediatrics (2001) Consensus statement on management of urinary tract infections. Indian Pediatr 38:1106–1115
- Prasad MM, Cheng EY (2012) Radiographic evaluation of children with febrile urinary tract infection: bottom-up, top-down, or none of the above? Adv Urol 2012:716739 CrossRef
- Cooper CS (2009) Diagnosis and management of vesicoureteral reflux in children. Urology 6:481–489
- Kopač M, Kenig A, Ključevšek D, Kenda RB (2005) Indirect voiding urosonography for detecting vesicoureteral reflux in children. Pediatr Nephrol 20:1285–1287 CrossRef
- Kenda RB, Novljan G, Kenig A, Hojker S, Fettich JJ (2000) Echo-enhanced ultrasound voiding cystography in children: a new approach. Pediatr Nephrol 14:297–300 CrossRef
- Marshall JL, Johnson ND, De Campo MP (1990) Vesicoureteric reflux in children: prediction with colour Doppler imaging. Work in progress. Radiology 175:335–358
- Sakate M, Teixeira AS, Sakate ATY (2006) Study of the ureterovesical jet by means of color Doppler in patients with and without vesicoureteral reflux. Radiol Bras 39:425–428 CrossRef
- Jequier S, Paltiel H, Lafortune M (1990) Ureterovesical jets in infants and children: duplex and color Doppler US studies. Radiology 175:349–353
- Leung VY, Chu W, Yeung CK, Metreweli C (2007) Doppler waveforms of the ureteric jet: an overview and implications for the presence of a functional sphincter at the vesicoureteric junction. Pediatr Radiol 37:417–425 CrossRef
- Greenbaum LA, Mesrobian HO (2006) Vesicoureteral reflux. Pediatr Clin N Am 53:413–427 CrossRef
- Mattoo TK, Mathews R (2009) Vesicoureteral reflux and renal scarring. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa N (eds) Pediatric nephrology. Springer, Berlin Heidelberg New York, p 1311 CrossRef
- Ključevšek D, Ključevšek T, Kersnik Levart T, Kenda RB (2009) Ureteric jet Doppler waveform: is it a reliable predictor of vesicoureteric reflux in children? Pediatr Nephrol 24:313–318 CrossRef
- Strehlau J, Winkler P, Roche J (1997) The uretero-vesical jet as a functional diagnostic tool in childhood hydronephrosis. Pediatr Nephrol 11:460–467 CrossRef
- Leung VY, Chu W, Yeung CK, Metreweli C (2006) Ureteric jet Doppler waveform and bladder wall thickness in children with nocturnal enuresis. Pediatr Res 60:582–586 CrossRef
- Leung VY, Metreweli C, Yeung CK (2002) Immature ureteric jet Doppler patterns and urinary tract infection and vesicoureteric reflux in children. Ultrasound Med Biol 28:873–884 CrossRef
- Kusmic AC, Brkljacic B (2002) Color Doppler ultrasonography in the assessment of vesicoureteric reflux in children with bladder dysfunction. Pediatr Surg Int 18:135–139 CrossRef
- Leung VY, Chu W, Yeung CK, Metreweli C (2007) Gender difference in achieving rate of maturity of the vesicoureteric junction. Pediatr Radiol 37:189–193 CrossRef
- Detecting reflux: does ureteric jet Doppler waveform have a role?
Volume 28, Issue 9 , pp 1821-1826
- Cover Date
- Print ISSN
- Online ISSN
- Springer Berlin Heidelberg
- Additional Links
- Micturating cystourethrography
- Ureteric jet Doppler waveform
- Vesicoureteral reflux
- Industry Sectors
- Author Affiliations
- 1. Department of Pediatric Nephrology, St. John’s Medical College Hospital Bangalore, E10/2 Vijay Kiran Apartments, 32 Victoria Road, Bangalore, 560047, Karnataka, India
- 2. Department of Radiology, St. John’s Medical College Hospital Bangalore, Bangalore, India
- 3. Department of Pediatric Surgery, St. John’s Medical College Hospital Bangalore, Bangalore, India