Contrast-enhanced voiding urosonography for the diagnosis of vesicoureteral reflux and intrarenal reflux: a comparison of diagnostic performance with fluoroscopic voiding cystourethrography
- Authors
- Kim, Daehee; Choi, Young Hun; Choi, Gayoung; Lee, Seulbi; Lee, Seunghyun; Cho, Yeon Jin; Lim, Seon Hee; Kang, Hee Gyung; Cheon, Jung-Eun
- Issue Date
- Oct-2021
- Publisher
- 대한초음파의학회
- Keywords
- Vesicoureteral reflux; Ultrasonography; Contrast-enhanced ultrasonography; Intrarenal reflux; Voiding cystourethrography
- Citation
- ULTRASONOGRAPHY, v.40, no.4, pp 530 - 537
- Pages
- 8
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- ULTRASONOGRAPHY
- Volume
- 40
- Number
- 4
- Start Page
- 530
- End Page
- 537
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54450
- DOI
- 10.14366/usg.20157
- ISSN
- 2288-5919
2288-5943
- Abstract
- Purpose: This study evaluated the diagnostic performance of contrast-enhanced voiding urosonography (ce-VUS) using a second-generation ultrasound contrast agent for the diagnosis of vesicoureteral reflux (VUR) and intrarenal reflux (IRR), and compared it with that of standard fluoroscopic voiding cystourethrography (VCUG). Methods: Thirty-two consecutive children from April to October 2019 were included in this study. ce-VUS and VCUG were performed simultaneously by two operators with intravesical infusion of a mixture of ultrasound contrast medium, iodinated contrast medium and water. Two pediatric radiologists independently reviewed the ce-VUS and VCUG images and reported the presence and degree of VUR (grades I-V), and the presence and type of IRR. Results: Twenty-seven of 63 urinary systems showed VUR. Interobserver agreement for VUR grading was very good for both examinations (kappa=0.87; 95% confidence interval [CI], 0.82 to 0.92 for ce-VUS and kappa=0.92; 95% CI, 0.87 to 0.96 for VCUG). The detection rate of VUR showed no significant difference between the two examinations (P=0.370). Four cases of VUR were missed on ce-VUS, while one case of VUR was missed on VCUG. All four false-negative cases on ce-VUS were grade 1 VUR. The two examinations showed very good agreement regarding VUR grading (kappa=0.89; 95% CI, 0.81 to 0.96). IRR was more frequently detected with ce-VUS than with VCUG (10 cases with ce-VUS vs. 3 cases with VCUG, P=0.016). Conclusion: ce-VUS showed very good agreement with VCUG for detecting grade 2 VUR and above, while grade 1 VUR was sometimes missed with ce-VUS. IRR was more frequently detected with ce-VUS than with VCUG.
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Collections - 2. Clinical Science > Department of Radiology > 1. Journal Articles
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