title: New noninvasive methods to diagnose vesicoureteral reflux.
abstract: OBJECTIVE
  The undesirable nature of bladder imaging in children for vesicoureteral reflux detection makes the search for noninvasive bladder imaging methods and devices an urgent concern.
  
  
  RESULTS
  Ultrasound imaging of the bladder aided by contrast agents can be performed without ionizing radiation. However, urethral catheterization and contrast instillation is still necessary. The accuracy and reliability are still significant problems with this method. A new method of 'hiding' gadolinium in lysosomes followed by external energy application to rupture the lysosomes releasing the gadolinium for MRI holds future hope, but this research is in its infancy. A novel method to apply external microwave energy to warm the bladder urine with microwave kidney temperature monitoring is being developed. Temperature changes noted in the kidney after bladder warming would indicate vesicoureteral reflux. Further studies are ongoing.
  
  
  CONCLUSIONS
  Ultrasonography imaging of the bladder to find vesicoureteral reflux has yet to be refined enough to be accurate and reliable for clinical use. MRI studies are in their infancy but may hold future benefit. Noninvasive bladder heating and kidney temperature monitoring is showing promise in animal studies to be a completely noninvasive reflux detection device.
authors.affiliation: Primary Children's Medical Center, University of Utah, Salt Lake City, Utah 84113, USA. brent.snow@hsc.utah.edu
authors.forename: Brent W
authors.initials: BW
authors.lastname: Snow
mesh_terms: D000818:Animals; D002675:Child, Preschool; D003287:Contrast Media; D003952:Diagnostic Imaging / Q000009:adverse effects / Q000379:methods; D003950:Diagnostic Techniques, Urological / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D013817:Thermography; D014463:Ultrasonography; D014546:Urinary Catheterization; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis* / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media