title: Voiding urosonography including urethrosonography: high-quality examinations with an optimised procedure using a second-generation US contrast agent.
abstract: BACKGROUND
  Voiding urosonography (VUS) is established as a technique for detecting vesicoureteral reflux in children.
  
  
  OBJECTIVE
  To evaluate the quality of images of the entire urinary tract when using a second-generation US contrast agent and a modified VUS technique.
  
  
  METHODS
  We evaluated 307 VUS examinations performed using SonoVue® in 591 pelvi-ureter units in 295 children of mean age, 27.1 (S.D., 42.5) months, with 154 (50.2%) of the examinations performed in boys; 58 children also underwent VUS using Levovist®. Three criteria were used for quality assessment of the bladder image: (1) progressive incorporation of contrast material in the bladder, (2) homogeneous bladder-filling to maximum capacity, and (3) visualisation of the posterior bladder wall.
  
  
  RESULTS
  Criterion 1 was fulfilled in 305 (99.3%), criterion 2 in 304 (99%) and criterion 3 in 304 (99%) studies. In children who underwent VUS with both contrast agents, the concordance between the two techniques was moderate for findings in the bladder (Cohen K = 0.487; P < 0001) and perfect for findings in the male urethra.
  
  
  CONCLUSIONS
  By a modified technique we obtained high-quality images of the bladder with the second-generation contrast agent.
authors.affiliation: Department of Radiology, UDIAT-Centre Diagnòstic, Institut Universitari Parc Taulí-UAB, Parc Taulí, Sabadell, 08208 Barcelona, Spain. cduran@tauli.cat
authors.forename: Carmina
authors.initials: C
authors.lastname: Duran
authors.forename: Javier
authors.initials: J
authors.lastname: del Riego
authors.forename: Luis
authors.initials: L
authors.lastname: Riera
authors.forename: Cesar
authors.initials: C
authors.lastname: Martin
authors.forename: Carlos
authors.initials: C
authors.lastname: Serrano
authors.forename: Pau
authors.initials: P
authors.lastname: Palaña
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011134:Polysaccharides; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014521:Urethra / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508