Skip to main content

Advertisement

Log in

Beyond reflux: the spectrum of voiding cystourethrogram findings in the pediatric population

  • Pictorial Essay
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Voiding cystourethrography (VCUG) is a widely accepted radiographic imaging technique that has been traditionally used for identifying vesicoureteral reflux in children. Given the simultaneous evaluation of the lower urinary tract that is afforded by VCUG, many common and uncommon abnormalities of the ureters, bladder and urethra can also be elucidated. Knowledge of the appearance of these urological entities may facilitate their proper identification.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17
Fig. 18
Fig. 19
Fig. 20
Fig. 21
Fig. 22
Fig. 23
Fig. 24

Similar content being viewed by others

References

  1. Bates G, Riccabona M (2013) Vesicoureteral reflux. In: Coley B (ed) Caffey’s pediatric diagnostic imaging, 12th edn. Mosby, Philadelphia, pp 1253–1261

    Google Scholar 

  2. Riccabona M, Avni FE, Blickman JG et al (2007) Imaging recommendations in pediatric 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 38:138–145

    Article  Google Scholar 

  3. Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB (2011) Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 128:595–610

    Article  Google Scholar 

  4. Lebowitz RL, Olbing H, Parkkulainen KV et al (1985) International reflux study in children. International system of radiographic grading of vesicoureteral reflux. Pediatr Radiol 15:105–109

    Article  CAS  Google Scholar 

  5. Darge K (2008) Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children. I procedure. Pediatr Radiol 38:40–53

    Article  Google Scholar 

  6. Conway JJ, King LR, Belman AB, Thorson T Jr (1972) Detection of vesicoureteral reflux with radionuclide cystography. A comparison study with roentgenographic cystography. Am J Roentgenol Radium Ther Nucl Med 115:720–727

    Article  CAS  Google Scholar 

  7. Vasanawala SS, Kennedy WA, Ganguly A et al (2009) MR voiding cystography for evaluation of vesicoureteral reflux. AJR Am J Roentgenol 192:W206–W211

    Article  Google Scholar 

  8. American College of Radiology, Society for Pediatric Radiology (2015) ACR-SPR practice parameter for the performance of voiding cystourethrography in children. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/VoidingCysto.pdf. Accessed 9 July 2021

  9. Don S, Macdougall R, Strauss K et al (2013) Image gently campaign back to basics initiative: ten steps to help manage radiation dose in pediatric digital radiography. AJR Am J Roentgenol 200:W431–W436

    Article  Google Scholar 

  10. Image Gently (2014) Educational modules – image gently: enhancing radiation protection in pediatric fluoroscopy. https://www.imagegently.org/Procedures/Fluoroscopy/Pause-and-Pulse-Resources. Accessed 14 July 2021

  11. Ward VL, Strauss KJ, Barnewolt CE et al (2008) Pediatric radiation exposure and effective dose reduction during voiding cystourethrography. Radiology 249:1002–1009

    Article  Google Scholar 

  12. Domina JG, Sanchez R, Meesa IR, Christodoulou E (2015) Evaluation of pediatric VCUG at an academic children’s hospital: is the radiographic scout image necessary? Pediatr Radiol 45:855–861

  13. Churchill BM, Abara EO, McLorie GA (1987) Ureteral duplication, ectopy and ureteroceles. Pediatr Clin N Am 34:1273–1289

    Article  CAS  Google Scholar 

  14. Berrocal T, Lopez-Pereira P, Arjonilla A, Gutierrez J (2002) Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics 22:1139–1164

    Article  Google Scholar 

  15. Blane CE, Zerin JM, Bloom DA (1994) Bladder diverticula in children. Radiology 190:695–697

    Article  CAS  Google Scholar 

  16. Zderic SA, Weiss DA (2015) Voiding dysfunction: what can radiologists tell patients and pediatric urologists? AJR Am J Roentgenol 205:W532–W541

    Article  Google Scholar 

  17. Babbitt DP, Dobbs J, Boedecker RA (1979) Multiple bladder diverticula in Williams “elfin-facies” syndrome. Pediatr Radiol 8:29–31

    Article  CAS  Google Scholar 

  18. Young LW, Yunis EJ, Girdany BR, Sieber WK (1981) Megacystis-microcolon-intestinal hypoperistalsis syndrome: additional clinical, radiologic, surgical, and histopathologic aspects. AJR Am J Roentgenol 137:749–755

    Article  CAS  Google Scholar 

  19. Harcke HT Jr, Capitanio MA, Grover WD, Valdes-Dapena M (1977) Bladder diverticula and Menkes syndrome. Radiology 124:459–461

    Article  Google Scholar 

  20. Dunetz GN, Bauer SB (1985) Complete duplication of bladder and urethra. Urology 25:179–182

    Article  CAS  Google Scholar 

  21. Kawashima A, Sandler CM, Wasserman NF et al (2004) Imaging of urethral disease: a pictorial review. Radiographics 24:S195–S216

    Article  Google Scholar 

  22. Bates G (2013) Bladder and urethra. In: Coley B (ed) Caffey’s pediatric diagnostic imaging, 12th edn. Mosby, Philadelphia, pp 1262–1266

    Google Scholar 

  23. Jones EA, Freedman AL, Erlich RM (2002) Megalourethra and urethral diverticula. Urol Clin North Am 29:341–348

    Article  Google Scholar 

  24. Saxton HM, Borzyskowski M, Mundy AR, Vivian GC (1988) Spinning top urethra: not a normal variant. Radiology 168:147–150

    Article  CAS  Google Scholar 

  25. Yu N, Raman SS, Patel M, Barbaric Z (2004) Fistulas of the genitourinary tract: a radiologic review. Radiographics 24:1331–1352

    Article  Google Scholar 

  26. Fernbach SK, Feinstein KA, Schmidt MB (2000) Pediatric voiding cystourethrography: a pictorial guide. Radiographics 20:155–168

    Article  CAS  Google Scholar 

  27. Mitty HA (1971) Roentgen features of reflux into the prostate, seminal vesicles and vas deferntia. Am J Roentgenol Radium Therapy, Nucl Med 112:603–606

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Archana Malik.

Ethics declarations

Conflicts of interest

None

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Higgins, J.J., Urbine, J.A. & Malik, A. Beyond reflux: the spectrum of voiding cystourethrogram findings in the pediatric population. Pediatr Radiol 52, 134–143 (2022). https://doi.org/10.1007/s00247-021-05161-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-021-05161-1

Keywords

Navigation