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http://dx.doi.org/10.3339/jkspn.2012.16.1.32

Ultrasonographic Findings in Children with Vesicoureteral Reflux  

Choi, Min-Jung (The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital)
Park, Se-Jin (The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital)
Shin, Jae-Il (The Institute of Kidney Disease, Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital)
Kim, Kee-Hyuck (Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital)
Publication Information
Childhood Kidney Diseases / v.16, no.1, 2012 , pp. 32-37 More about this Journal
Abstract
Purpose: The aim of this study is to investigate the renal ultrasonographic findings in children with vesicoureteral reflux (VUR). Methods: We retrospectively reviewed the medical records of 83 patients who were diagnosed with VUR and underwent ultrasonography at Ilsan hospital between January 2000 and December 2010. Results: Among 166 renal units, 108 (65.0%) were found to have vesicoureteral reflux (VUR). Fifty-one (73.9%) had VUR in renal units with abnormal ultrasonography (USG), whereas 57 (58.7%) had VUR in renal units with normal USG. Abnormal USG findings were independent risk factors for VUR (Odds ratio, 1.98; 95% CI, 1.01-3.89; $P$=0.045). In renal units with VUR, the number of normal USG finding was 52.8%, and the abnormal findings were as follows; increased cortical echogenicity 16.7%, hydronephrosis 17.6%, megaureter or ureter dilatation 8.3%, hydronephrosis and ureter dilatation 1.9%, duplication of ureter 1.9%, and atrophic kidney 0.9%. The prevalence of VUR was relatively higher in renal units with hydronephrosis (23/19, 82.6%), ureter dilatation (9/9, 100%), duplication of ureter (2/3, 66.6%), and atrophic kidney (1/1, 100%). Conclusion: Our study indicates that VUR was associated with abnormal USG findings. When there are abnormal USG findings such as hydronephrosis, ureter dilatation, duplication of ureter, and atrophic kidney in children with UTI, VCUG is recommended to detect VUR after controlling UTI.
Keywords
Vesicoureteral Reflux; Renal Ultrasonography; Children;
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1 Weiss R, Tamminen-Mobius T, Koskimies O, Olbing H, Smellie JM, Hirche H, et al. Characteristics at entry of children with severe primary vesicoureteral reflux recruited for a multicenter, international therapeutic trial comparing medical and surgical management. The international Reflux Study in children. J Urol 1992;148:1644-9.
2 Smellie JM, Ransley PG, Normand IC, Prescod N, Edwards D. Development of new renal scars : a collaborative study. BMJ Clin Res Ed 1985;290:1957-60.   DOI
3 Pattaragarn A, Alon US. Urinary tract infection in childhood. Review of guidelines and recommendations. Minerva Pediatr 2002;54:401-13.
4 American Academy of Pediatrics, Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics 1999;103:843-51.
5 Soylu A, Kasap B, Demir K, Turkmen M, Kavukcu S. Predictive value of clinical and laboratory variables for vesicoureteral reflux in children. Pediatr Nephrol 2007;22:844-8.   DOI   ScienceOn
6 Lee HY, Soh BH, Hong CH, Kim MJ, Han SW. The efficacy of ultrasound and dimercaptosuccinic acid scan in predicting vesicoureteral reflux in children below the age of 2 years with their first febrile urinary tract infection. Pediatr Nephrol 2009;24:2009-13.   DOI   ScienceOn
7 Berrocal T, Pinilla I, Gutierrez J, Prieto C, de-Pablo L, Del-Hoyo ML. Mild hydronephrosis in newborns and infants: can ultrasound predict the presence of vesicoureteral reflux. Pediatr Nephol 2007;22:91-6.   DOI   ScienceOn
8 Mahant S, Friedman J, MacArthur C. Renal ultrasound findings and vesicoureteral reflux in children hospitalized with urinary tract infection. Arch Dis Child 2002;86:419-20.   DOI   ScienceOn
9 Alshamsam L, Al Harbi A, Fakeeh K, Al Banyan E. The value of renal ultrasound in children with a first episode of urinary tract infection. Ann Saudi Med 2009;29:46-9   DOI   ScienceOn
10 Ismaili K, Wissing KM, Lolin K, Le PQ, Christophe C, Lepage P, Hall M. Characteristics of first urinary tract infection with fever in children: a prospective clinical and imaging study. Pediatr Infect Dis J 2011;30:371-4.   DOI   ScienceOn
11 Oh YS, Choi MJ, Park SJ, Lee JS, Shin JI, Kim KH. Prevalence of vesicoureteral reflux according to the timing of voiding cystourethrography in infantile urinary tract infection with renal cortical defect in 99mTc-2, 3-dimercaptosuccinic acid scintigraphy: a bicentric study. J Korean Soc Pediatr Nephrol 2011 Nov. [Epub ahead of print]
12 Hsieh MH, Madden-Fuentes RJ, Roth DR. Urologic diagnoses among infants hospitalized for urinary tract infection. Urology 2009;74:100-3.   DOI   ScienceOn
13 Rachmiel M, Aladjem M, Starinsky R, Strauss S, Villa Y, Goldman M. Symptomatic urinary tract infections following voiding cystourethrography. Pediatr Nephrol 2005;20:1449-52.   DOI   ScienceOn
14 Glynn B, Gordon IR. The risk of infection of the urinary tract as a result of micturating cystourethrography in children. Ann Radiol (Paris) 1970;13:283-7.
15 Zerin JM, Shulkin BL. Postprocedural symptoms in children who undergo imaging studies of the urinary tract: is it the contrast material or the catheter? Radiology 1992;182:727-30.
16 Hansson S, Dhamey M, Sigstrom O, Sixt R, Stokland E, Wennerstrom M. Dimercaptosuccinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infection. J urol 2004;172:1071-3.   DOI   ScienceOn
17 Kass EJ, Kernen KM, Carey JM. Pediatric urinary tract infection and the necessity of complete urological imaging. BJU Int 2000;86:94-6.
18 Foresman WH, Hulbert WC Jr, Rabinowitz R. Does urinary tract ultrasonography at hospitalization for acute pyelonephritis predict vesicoureteral reflux? J Urol 2001;165:2232-4.   DOI
19 Salih M, Baltaci S, Kilic S, Anafarta K, Beduk Y. Color flow Doppler sonography in the diagnosis of vesicoureteric reflux. Eur Urol 1994;26:93-7.
20 Hiraoka M, Hashimoto G, Hayashi S, Hori C, Tsuchida S, Tsukahara H, Konishi Y, Sudo M. Ultrasonography for the detection of ureteric reflux in infants with urinary infection. Acta Paediatr Jpn 1996;38:248-51.   DOI
21 Zamir G, Sakran W, Horowitz Y, Koren A, Miron D. Urinary tract infection: is there a need for routine renal ultrasonography? Arch Dis Child 2004;89:466-8.   DOI   ScienceOn
22 Kang HG, Kim NH, Kang JH, Ha IS, Cheong HI, Choi Y. Characteristics and recurrence risk factors of urinary tract infection in early infancy. J Korean Soc Pediatr Nephrol 2004;8:223-8.
23 Weinberg B, Yeung N. Sonographic sign of intermittent dilatation of the renal collecting system in 10 patients with vesicoureteral reflux. J Clin Ultrasound 1998;26:65-8.   DOI   ScienceOn
24 Kenney IJ, Negus AS, Miller FN. Is sonographically demonstrated mild distal ureteric dilatation predictive of vesicoureteric reflux as seen on micturating cystourethrography? Pediatr Radiol 2002;32:175-8.   DOI   ScienceOn
25 Hannula A, Venhola M, Perhomaa M, Pokka T, Renko M, Uhari M. Imaging the urinary tract in children with urinary tract infection. Acta Paediatr 2011 Jun 28. doi:10.1111/j.1651-2227.2011.02391.x.
26 Novljan G, Levart TK, Kljucevsek D, Kenig A, Kenda RB. Ultrasound detection of vesicoureteral reflux in children. J Urol 2010;184:319-24.   DOI   ScienceOn