Discrepancy between power-Doppler voiding urosonography and voiding cystourethrography is not relevant for the management of primary vesicoureteric reflux.
OBJECTIVE
The aim of this study was to assess if discrepancy between power-Doppler voiding urosonography (PD-VUS) and voiding cystourethrography (VCUG) affects the management of patients with primary vesicoureteric reflux (VUR).


METHODS
Fifty-six children with suspected or known VUR were assessed both by PD-VUS and VCUG. Two independent observers, both pediatric surgeons, each aware of the results of only one imaging modality, advised children's management according to present care standards. Agreement between diagnostic findings at the two imaging modalities and between therapeutic advice of the two observers was evaluated using kappa statistics.


RESULTS
PD-VUS diagnosed VUR in 3 patients and 6 ureteral units more than VCUG. VCUG showed VUR in 2 ureteral units, but in no patient more than PD-VUS. Accuracy of PD-VUS compared with VCUG was 92.8% and 94.6% considering ureteral units and patients, respectively. The two observers disagreed about the management of 4 (7%) of 56 cases. Agreement was significant (P < .001) both between findings at the two imaging modalities and between management options advised by the two independent observers.


CONCLUSIONS
Vesicoureteric reflux management based on PD-VUS findings is consistent with a management based on standard VCUG.
Castagnetti
Marco
M
Department of Paediatric Surgery, Istituto Materno Infantile, University of Palermo, Palermo, Italy. marcocastagnetti@hotmail.com
Cimador
Marcello
M
Tudisco
Vincenzo
V
De Grazia
Enrico
E
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D014563:Urodynamics; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*