Investigation of vesicoureteral reflux with colour Doppler sonography in adult patients with spinal cord injury.
The aim of the study was to evaluate prospectively the performances of colour Doppler sonography for detection of vesicoureteral reflux in adult patients with neurogenic bladder due to spinal cord injury. One hundred eighty-seven adult patients who had developed neurogenic bladder due to spinal cord injury underwent retrograde cystography and sonographic evaluation by B-mode and colour flow Doppler sonography (CFDS). Results of both examinations were analyzed independently by two radiologists. Representative images of the sonographic evaluations were recorded on videotape and CD-Rom. CFDS detected reflux in 20 ureters while retrograde cystography revealed vesicoureteral reflux (VUR) in 25 ureters of a total of 374 ureters, which were examined by both methods. Sonography detected all cases of grades IV and V of reflux, 7 of 8 (87.5%) of grade III, 5 of 6 (83.3%) of grade II, and 4 of 7 (57.14%) of grade I. There were 6 false-positive and 5 false-negative findings with Doppler examination compared with retrograde cystography. Therefore, sensitivity and specificity of sonographic examination were 80 and 98.28%, respectively, with a positive predictive value of 76.92%. Colour flow Doppler sonography can play an important role in detection of VUR in spinally injured adult patients with neurogenic bladder and can be an effective imaging tool for follow-up.
Papadaki
P J
PJ
Department of Radiology, National Institute of Rehabilitation, Ilion 13122, Greece.
Vlychou
M K
MK
Zavras
G M
GM
Baltas
C S
CS
Kouni
S N
SN
Poulou
K E
KE
Rapidi
A C
AC
Petropoulou
K
K
Manavis
J B
JB
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000150:complications*; D018615:Ultrasonography, Doppler, Color; D001750:Urinary Bladder, Neurogenic / Q000000981:diagnostic imaging* / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging* / Q000209:etiology