Voiding urosonography including urethrosonography: high-quality examinations with an optimised procedure using a second-generation US contrast agent
- 463 Downloads
Voiding urosonography (VUS) is established as a technique for detecting vesicoureteral reflux in children.
To evaluate the quality of images of the entire urinary tract when using a second-generation US contrast agent and a modified VUS technique.
Materials and methods
We evaluated 307 VUS examinations performed using SonoVue® in 591 pelvi-ureter units in 295 children of mean age, 27.1 (S.D., 42.5) months, with 154 (50.2%) of the examinations performed in boys; 58 children also underwent VUS using Levovist®. Three criteria were used for quality assessment of the bladder image: (1) progressive incorporation of contrast material in the bladder, (2) homogeneous bladder-filling to maximum capacity, and (3) visualisation of the posterior bladder wall.
Criterion 1 was fulfilled in 305 (99.3%), criterion 2 in 304 (99%) and criterion 3 in 304 (99%) studies. In children who underwent VUS with both contrast agents, the concordance between the two techniques was moderate for findings in the bladder (Cohen K = 0.487; P < 0001) and perfect for findings in the male urethra.
By a modified technique we obtained high-quality images of the bladder with the second-generation contrast agent.
KeywordsVesicoureteral reflux Voiding urosonography Second-generation contrast agent Child
Special thanks to Inés Artacho, Antoni Malet Munte MD, Eva Castañer MD, John Giba, and Joan Carles Oliva.
- 21.Riccabona M, Avni FE, Blickman JG et al (2008) Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol 38:138–145PubMedCrossRefGoogle Scholar