Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder
ABSTRACT Purpose: This study aimed to analyze the diagnostic accuracy of dynamic and static ultrasound (DSUS) in detecting vesicoureteral reflux (VUR) and renal scarring in a cohort of children with neurogenic bladder (NB). Materials and Methods: A retrospective, longitudinal, observational study...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2024-03-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382023000600700&lng=en&tlng=en |
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| author | Carlos Magno Paiva da Silva Mônica Maria de Almeida Vasconcelos Eleonora Moreira Lima José de Bessa Junior Otávio Augusto Fonseca Reis Maria Francisca Tereza Freire Filgueiras Roberta Vasconcellos Menezes de Azevedo José Murillo Bastos Netto Eduardo Araújo Oliveira Flávia Cristina de Carvalho Mrad |
| author_facet | Carlos Magno Paiva da Silva Mônica Maria de Almeida Vasconcelos Eleonora Moreira Lima José de Bessa Junior Otávio Augusto Fonseca Reis Maria Francisca Tereza Freire Filgueiras Roberta Vasconcellos Menezes de Azevedo José Murillo Bastos Netto Eduardo Araújo Oliveira Flávia Cristina de Carvalho Mrad |
| author_sort | Carlos Magno Paiva da Silva |
| collection | DOAJ |
| description | ABSTRACT Purpose: This study aimed to analyze the diagnostic accuracy of dynamic and static ultrasound (DSUS) in detecting vesicoureteral reflux (VUR) and renal scarring in a cohort of children with neurogenic bladder (NB). Materials and Methods: A retrospective, longitudinal, observational study was conducted using the Reporting Diagnostic Accuracy Studies guideline. The DSUS (index test) data were compared with voiding cystourethrography (VCUG) and renal scintigraphy 99mTc-dimercaptosuccinic (reference tests). Overall performance for predicting VUR and renal scarring was assessed using renal pelvic diameter (RPD)/distal ureteral diameter and renal parenchymal thinning on DSUS, respectively. Results: A total of 107 patients (66 girls, median age 9.6 years) participated. Seventeen patients (15.9%) presented VUR, eight bilateral. For overall reflux grade, the AUC was 0.624 for RPD and 0.630 for distal ureteral diameter. The diagnostic performance for detecting high-grade VUR was slightly better for DSUS parameters. The AUC was 0.666 for RPD and 0.691 for distal ureteral diameter. The cut-offs of 5 mm for RPD and 6.5 mm for distal ureteral diameter presented the best diagnostic odds ratio (DOR) to identify high-grade VUR. The increase of RPD during detrusor contractions showed an accuracy of 89.2%. The thinness of renal parenchyma presented an accuracy of 88% for renal scarring. Conclusion: DSUS predicts VUR and renal scarring in children with NB with fair to good accuracy, and all measurements exhibited a high negative predictive value (NPV). The increase in RPD during voiding or detrusor contractions proved to be the most accurate parameter for indicating the presence of VUR in this study. |
| first_indexed | 2024-04-25T00:43:39Z |
| format | Article |
| id | doaj.art-03c0ce94c7524630ba99d8e89a29f302 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-25T00:43:39Z |
| publishDate | 2024-03-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-03c0ce94c7524630ba99d8e89a29f3022024-03-12T07:40:28ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192024-03-0149670071510.1590/s1677-5538.ibju.2023.0311Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladderCarlos Magno Paiva da SilvaMônica Maria de Almeida VasconcelosEleonora Moreira LimaJosé de Bessa JuniorOtávio Augusto Fonseca ReisMaria Francisca Tereza Freire FilgueirasRoberta Vasconcellos Menezes de AzevedoJosé Murillo Bastos Nettohttps://orcid.org/0000-0002-9959-6160Eduardo Araújo OliveiraFlávia Cristina de Carvalho MradABSTRACT Purpose: This study aimed to analyze the diagnostic accuracy of dynamic and static ultrasound (DSUS) in detecting vesicoureteral reflux (VUR) and renal scarring in a cohort of children with neurogenic bladder (NB). Materials and Methods: A retrospective, longitudinal, observational study was conducted using the Reporting Diagnostic Accuracy Studies guideline. The DSUS (index test) data were compared with voiding cystourethrography (VCUG) and renal scintigraphy 99mTc-dimercaptosuccinic (reference tests). Overall performance for predicting VUR and renal scarring was assessed using renal pelvic diameter (RPD)/distal ureteral diameter and renal parenchymal thinning on DSUS, respectively. Results: A total of 107 patients (66 girls, median age 9.6 years) participated. Seventeen patients (15.9%) presented VUR, eight bilateral. For overall reflux grade, the AUC was 0.624 for RPD and 0.630 for distal ureteral diameter. The diagnostic performance for detecting high-grade VUR was slightly better for DSUS parameters. The AUC was 0.666 for RPD and 0.691 for distal ureteral diameter. The cut-offs of 5 mm for RPD and 6.5 mm for distal ureteral diameter presented the best diagnostic odds ratio (DOR) to identify high-grade VUR. The increase of RPD during detrusor contractions showed an accuracy of 89.2%. The thinness of renal parenchyma presented an accuracy of 88% for renal scarring. Conclusion: DSUS predicts VUR and renal scarring in children with NB with fair to good accuracy, and all measurements exhibited a high negative predictive value (NPV). The increase in RPD during voiding or detrusor contractions proved to be the most accurate parameter for indicating the presence of VUR in this study.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382023000600700&lng=en&tlng=enUrinary BladderNeurogenicMeningomyeloceleVesico-Ureteral Reflux |
| spellingShingle | Carlos Magno Paiva da Silva Mônica Maria de Almeida Vasconcelos Eleonora Moreira Lima José de Bessa Junior Otávio Augusto Fonseca Reis Maria Francisca Tereza Freire Filgueiras Roberta Vasconcellos Menezes de Azevedo José Murillo Bastos Netto Eduardo Araújo Oliveira Flávia Cristina de Carvalho Mrad Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder International Brazilian Journal of Urology Urinary Bladder Neurogenic Meningomyelocele Vesico-Ureteral Reflux |
| title | Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder |
| title_full | Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder |
| title_fullStr | Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder |
| title_full_unstemmed | Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder |
| title_short | Dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder |
| title_sort | dynamic and static ultrasound features predictive of vesicoureteral reflux and renal damage in children and adolescents with neurogenic bladder |
| topic | Urinary Bladder Neurogenic Meningomyelocele Vesico-Ureteral Reflux |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382023000600700&lng=en&tlng=en |
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