title: Two-dimensional (2D), three-dimensional static (3D) and real-time (4D) contrast enhanced voiding urosonography (ceVUS) versus voiding cystourethrography (VCUG) in children with vesicoureteral reflux.
abstract: BACKGROUND
  Two-dimensional (2DUS) contrast enhanced voiding urosonography has been used in the diagnosis and treatment monitoring of the vesicoureteral reflux in children for over 15 years. The opportunity of performing this examination with the use of three-dimensional static (3DUS) and real-time (4DUS) techniques opens up new diagnostic horizons.
  
  
  OBJECTIVE
  To analyze if 3DUS/4DUS bring additional information leading to an increased detection rate or change in the grading of reflux compared to 2DUS and voiding cystouretrography.
  
  
  METHODS
  We evaluated 69 patients (mean 4.1 years) who underwent 2DUS/3DUS/4DUS contrast enhanced voiding urosonography (ceVUS) and voiding cystourethrography (VCUG) for the diagnosis and grading of vesicoureteral reflux.
  
  
  RESULTS
  2DUS and 3DUS/4DUS urosonography diagnosed 10 more refluxes (7.25%) than cystourethrography and in 3 refluxes (2.17%) detected a higher grade. In 9 refluxes (6.52%) 3DUS/4DUS urosonography and cystourethrography diagnosed a higher grade than 2DUS. There was a statistically significant difference between cystourethrography and 3DUS/4DUS urosonography when the number of detected refluxes and differences in grading were compared. 4DUS enabled a better visualization of reflux than 3DUS.
  
  
  CONCLUSIONS
  3DUS/4DUS techniques bring additional information leading to a change in reflux grading compared to 2DUS and a detect higher number of refluxes compared to cystourethrography.
authors.affiliation: Department of Pediatric Radiology, Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland. Electronic address: mwozniak@hoga.pl.
authors.forename: Magdalena Maria
authors.initials: MM
authors.lastname: Woźniak
authors.affiliation: Department of Pediatric Radiology, Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland.
authors.forename: Andrzej Paweł
authors.initials: AP
authors.lastname: Wieczorek
authors.affiliation: Department of Pediatric Radiology, Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Pawelec
authors.affiliation: Department of Pediatric Radiology, Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Brodzisz
authors.affiliation: Department of Pediatric Nephrology, Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland.
authors.forename: Maria Małgorzata
authors.initials: MM
authors.lastname: Zajączkowska
authors.affiliation: Department of Pediatric Nephrology, Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland.
authors.forename: Halina
authors.initials: H
authors.lastname: Borzęcka
authors.affiliation: Department of Pediatric Surgery and Traumatology, Medical University of Lublin, Al. Racławickie 1, Lublin 20-059, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Nachulewicz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D000070621:Cystography / Q000379:methods; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008297:Male; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*; D014554:Urination; D014567:Urography / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: 3D/4D ultrasound; Children; Contrast enhanced voiding urosonography; SonoVue(®); Vesicoureteral reflux