title: [Imaging techniques and vesicoureteral reflux].
abstract: OBJECTIVE
  Although vesicoureteral reflux (VUR) is a very frequent pathology in the pediatric age and represents an important part of the activity of pediatricians, pediatric urologists, nephrologists, and radiologists, yet there is controversy about its global management both in diagnosis and treatment. The objective of this paper is to perform an update in the use of different imaging techniques in the diagnosis and followup of VUR and to propose a work up protocol.
  
  
  METHODS
  We describe the imaging techniques: VCUG, ultrasound, intravenous urography, bladder-ultrasound, DMSA, MRI, and their role in the evaluation and followup of VUR. We performed a bibliographic review about the topic and present the experience of our working group on VUR.
  
  
  RESULTS
  The bibliographic review shows a clear evolution of the concepts of VUR and also the management algorithms. The concepts of congenital renal lesion without urinary tract infection (UTI) or acquired lesion after UTI are clearly differentiated in the most recent reviews. Reflux is passing from being the center of the problem to a secondary phenomenon in relation to UTI, and this is leading to a change of diagnostic strategy, less and less invasive.
  
  
  CONCLUSIONS
  VCUG has been to date the first and indisputable technique for the management of VUR, mainly in the diagnostic phase, but technological advances in the area of ultrasound (ultrasound contrasts, harmonic image, etc.) have converted ultrasound in the first imaging technique for the management of VUR in pediatric age. On the other hand, work-up algorithms have changed due to the great impact prenatal diagnosis is having in the management of urinary tract anomalies.
authors.affiliation: Sección de Radiología Pediátrica, Hospital Materno Infantil Carlos Haya, Málaga, España. ialonsousa@gmail.com
authors.forename: Ignacio
authors.initials: I
authors.lastname: Alonso Usabiaga
authors.forename: Cristina
authors.initials: C
authors.lastname: Bravo Bravo
authors.forename: Pascual García-Herrera
authors.initials: PG
authors.lastname: Taillefer
authors.forename: Esperanza
authors.initials: E
authors.lastname: Valls Moreno
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Ceres Ruíz
mesh_terms: D000465:Algorithms; D006801:Humans; D011859:Radiography; D011877:Radionuclide Imaging; D014463:Ultrasonography; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis* / Q000000981:diagnostic imaging