Vesicoureteral reflux in older children: concordance of US and voiding cystourethrographic findings.
OBJECTIVE
To determine if a negative renal sonogram is reliably predictive of the absence of vesicoureteral reflux at voiding cystourethrography (VCUG) in children aged 5 years or older.


METHODS
Imaging studies in 70 children aged 5 years or older who underwent renal ultrasound (US) and VCUG on the same day were reviewed. These children had initially undergone evaluation because of a urinary tract infection.


RESULTS
Five of 70 children had abnormal sonograms; two (40%) of the five had reflux at VCUG. One had mild pelvicalyceal dilatation, and one had a small kidney. The other three (without reflux) had a pelvic kidney, a calyceal diverticulum, or a renal stone. Of 65 children with a negative sonogram, 19 (29%) had reflux at VCUG; 46 (71%) did not. Altogether, of the 70 children, 21 had reflux, 19 (90%) of whom had no sonographic abnormality.


CONCLUSIONS
Children with abnormal screening renal sonograms often have vesicoureteral reflux, but a normal sonogram does not reliably exclude the condition even in children aged 5 years or older. Therefore, VCUG must be performed even in older children, regardless of US findings, if clinical decisions are influenced by documentation of the presence of VUR.
DiPietro
M A
MA
Department of Pediatric Radiology, University of Michigan Hospitals, Ann Arbor 48109-0252, USA.
Blane
C E
CE
Zerin
J M
JM
D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D011237:Predictive Value of Tests; D014463:Ultrasonography; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*