Ultrasound detection of vesicoureteral reflux in children.
OBJECTIVE
We present different ultrasound techniques to detect vesicoureteral reflux in children with special emphasis on voiding urosonography.


METHODS
Urinary tract infection is a common problem in children that may be related to vesicoureteral reflux. Currently there is no consensus on investigations in children after the first urinary tract infection. The least invasive imaging with the smallest radiation burden should be used in children. Ultrasound to detect reflux meets several of these criteria. The development of echo enhancing agents has markedly improved reflux visualization by ultrasound.


RESULTS
We discuss the clinical relevance of voiding urosonography. We reviewed the currently available literature and the results of our studies of this issue. We also describe our endeavors to avoid catheterization and detect vesicoureteral reflux based on various sonomorphological features, ie indirect voiding urosonography and ureteral jet Doppler waveform analysis, to avoid applying any substance into the bladder.


CONCLUSIONS
Voiding urosonography is safe and reliable to detect vesicoureteral reflux. When indicated, considerably decreased radiation exposure can be achieved by voiding urosonography instead of established cystography methods. Indirect voiding urosonography and ureteral jet Doppler waveform analysis could be an alternative to invasive voiding cystography, at least in children older than 3 years.
Novljan
Gregor
G
Department of Pediatric Nephrology and Pediatric Radiology Unit (DK, AK), University Medical Center, Ljubljana, Slovenia. gregor.novljan@mf.uni-lj.si
Levart
Tanja Kersnik
TK
Kljucevsek
Damjana
D
Kenig
Anton
A
Kenda
Rajko B
RB
D002648:Child; D003287:Contrast Media; D006801:Humans; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
D003287:Contrast Media