Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans
Purpose This study evaluated the diagnostic performance of contrast-enhanced voiding ultrasonography (CeVUS) for detecting intrarenal reflux (IRR) and the correlation between CeVUS-detected IRR sites and photon defect sites in acute 99mTc-dimercaptosuccinic acid (DMSA) renal scans in pediatric patie...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Ultrasound in Medicine
2022-07-01
|
| Series: | Ultrasonography |
| Subjects: | |
| Online Access: | http://www.e-ultrasonography.org/upload/usg-21143.pdf |
| _version_ | 1818118634396975104 |
|---|---|
| author | Saelin Oh Ji Young Ha Yeon Jin Cho |
| author_facet | Saelin Oh Ji Young Ha Yeon Jin Cho |
| author_sort | Saelin Oh |
| collection | DOAJ |
| description | Purpose This study evaluated the diagnostic performance of contrast-enhanced voiding ultrasonography (CeVUS) for detecting intrarenal reflux (IRR) and the correlation between CeVUS-detected IRR sites and photon defect sites in acute 99mTc-dimercaptosuccinic acid (DMSA) renal scans in pediatric patients. Methods Fifty-four kidneys from 27 patients (20 males and seven females; mean age, 5.6±4.1 months) who underwent CeVUS and acute DMSA renal scans for recurrent urinary tract infection (UTIs) or pyelonephritis were included. Pediatric experts compared the results of CeVUS with acute DMSA renal scans. Results Thirteen renal units (13/54, 24.1%) in 10 patients (nine males and one female; mean age, 6.3±3.7 months; age range, 0 to 13 months) showed vesicoureteral reflux and eight renal units (8/54, 14.8%) demonstrated IRR on CeVUS. Ten renal units in eight patients (six males and two females; mean age, 6.9±1.4 months; age range, 2 to 13 months) showed 19 photon defects on acute DMSA renal scans. Fifty-two renal units (96.3%) showed concordant results, and two renal units (3.7%) showed discordant results between CeVUS and acute DMSA renal scans. IRR accounted for 15/19 (78.9%) photon defects in eight renal units of seven patients using CeVUS. In a per-renal-unit analysis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CeVUS were 80%, 100%, 100%, 95.7%, and 96.3%, respectively. Conclusion CeVUS showed good performance in detecting IRR, and the IRR sites detected by CeVUS closely correlated with photon defect sites in acute DMSA scans. CeVUS may play an important role in managing patients with recurrent UTIs or pyelonephritis with reduced radiation exposure. |
| first_indexed | 2024-12-11T04:57:25Z |
| format | Article |
| id | doaj.art-f8462c7d40d943d080313b6c3fe90f4e |
| institution | Directory Open Access Journal |
| issn | 2288-5919 2288-5943 |
| language | English |
| last_indexed | 2024-12-11T04:57:25Z |
| publishDate | 2022-07-01 |
| publisher | Korean Society of Ultrasound in Medicine |
| record_format | Article |
| series | Ultrasonography |
| spelling | doaj.art-f8462c7d40d943d080313b6c3fe90f4e2022-12-22T01:20:15ZengKorean Society of Ultrasound in MedicineUltrasonography2288-59192288-59432022-07-0141350251010.14366/usg.211431595Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scansSaelin Oh0Ji Young Ha1Yeon Jin Cho2 Department of Radiology, Korea University Anam Hospital, Seoul, Korea Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon, Korea Department of Radiology, Seoul National University Hospital, Seoul, KoreaPurpose This study evaluated the diagnostic performance of contrast-enhanced voiding ultrasonography (CeVUS) for detecting intrarenal reflux (IRR) and the correlation between CeVUS-detected IRR sites and photon defect sites in acute 99mTc-dimercaptosuccinic acid (DMSA) renal scans in pediatric patients. Methods Fifty-four kidneys from 27 patients (20 males and seven females; mean age, 5.6±4.1 months) who underwent CeVUS and acute DMSA renal scans for recurrent urinary tract infection (UTIs) or pyelonephritis were included. Pediatric experts compared the results of CeVUS with acute DMSA renal scans. Results Thirteen renal units (13/54, 24.1%) in 10 patients (nine males and one female; mean age, 6.3±3.7 months; age range, 0 to 13 months) showed vesicoureteral reflux and eight renal units (8/54, 14.8%) demonstrated IRR on CeVUS. Ten renal units in eight patients (six males and two females; mean age, 6.9±1.4 months; age range, 2 to 13 months) showed 19 photon defects on acute DMSA renal scans. Fifty-two renal units (96.3%) showed concordant results, and two renal units (3.7%) showed discordant results between CeVUS and acute DMSA renal scans. IRR accounted for 15/19 (78.9%) photon defects in eight renal units of seven patients using CeVUS. In a per-renal-unit analysis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CeVUS were 80%, 100%, 100%, 95.7%, and 96.3%, respectively. Conclusion CeVUS showed good performance in detecting IRR, and the IRR sites detected by CeVUS closely correlated with photon defect sites in acute DMSA scans. CeVUS may play an important role in managing patients with recurrent UTIs or pyelonephritis with reduced radiation exposure.http://www.e-ultrasonography.org/upload/usg-21143.pdfcontrast-enhanced voiding ultrasonographytechnetium tc 99m dimercaptosuccinic acidvesicoureteral refluxintrarenal refluxultrasonography |
| spellingShingle | Saelin Oh Ji Young Ha Yeon Jin Cho Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans Ultrasonography contrast-enhanced voiding ultrasonography technetium tc 99m dimercaptosuccinic acid vesicoureteral reflux intrarenal reflux ultrasonography |
| title | Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans |
| title_full | Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans |
| title_fullStr | Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans |
| title_full_unstemmed | Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans |
| title_short | Contrast-enhanced voiding ultrasonography to detect intrarenal reflux in children: comparison with 99mTc-DMSA renal scans |
| title_sort | contrast enhanced voiding ultrasonography to detect intrarenal reflux in children comparison with 99mtc dmsa renal scans |
| topic | contrast-enhanced voiding ultrasonography technetium tc 99m dimercaptosuccinic acid vesicoureteral reflux intrarenal reflux ultrasonography |
| url | http://www.e-ultrasonography.org/upload/usg-21143.pdf |
| work_keys_str_mv | AT saelinoh contrastenhancedvoidingultrasonographytodetectintrarenalrefluxinchildrencomparisonwith99mtcdmsarenalscans AT jiyoungha contrastenhancedvoidingultrasonographytodetectintrarenalrefluxinchildrencomparisonwith99mtcdmsarenalscans AT yeonjincho contrastenhancedvoidingultrasonographytodetectintrarenalrefluxinchildrencomparisonwith99mtcdmsarenalscans |