title: Voiding urosonography with second-generation contrast as a main tool for examining the upper and lower urinary tract in children. Pilot Study.
abstract: BACKGROUND
  In this series, we analyse the diagnostic efficacy of serial voiding urosonography (VUS) with second-generation contrast, combined harmoniously and specifically with contrast technology, in the examination of the urinary tract in children. This examination includes the diagnosis and follow-up for vesicoureteral reflux (VUR) and urethral disorders, mainly those of the posterior urethral valve (PUV).
  
  
  METHODS
  After obtaining informed consent, a prospective study was conducted using urosonography with second-generation contrast (sulphur hexafluoride microbubbles, SonoVue®) from November 2014 to October 2015 (1 year) in paediatric patients with suspected VUR or PUV impairment. For patients with a high suspicion of VUR and in cases of PUV, we also conducted simultaneous voiding cystourethrography (VCUG).
  
  
  RESULTS
  We studied 40 patients (80 renal units) between the ages of 2 months and 13 years (median age, 14 months). The indication for the test was a suspected VUR (36 patients, group A) and PUV follow-up (4 patients, group B). The test was correlated with VCUG in 16 patients (12 cases with high suspicion of VUR in group A and with 4 cases of PUV in group B). The visualisation of the urethra was appropriate in cases of dilation or urethral stricture. For 3 of these patients with bilateral VUR demonstrated in the serial VUS, the VCUG showed only unilateral VUR in 2 of the patients and no VUR in 1 of the patients (κ=.73).
  
  
  CONCLUSIONS
  We have shown that the visualisation of the urethra is no longer a limitation and that serial VUS can be superior to conventional VCUG in diagnosing VUR.
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Clínico Universitario Virgen de la Arrixaca , Murcia, España. Electronic address: mfndezibieta@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Fernández-Ibieta
authors.affiliation: Servicio de Radiología, Hospital General Universitario de Albacete, Albacete, España.
authors.forename: C
authors.initials: C
authors.lastname: Parrondo-Muiños
authors.affiliation: Pediatría, Centro de Salud Madrigueras-Villamalea, Albacete, España.
authors.forename: L C
authors.initials: LC
authors.lastname: Fernández-Masaguer
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital General Universitario de Albacete, Albacete, España.
authors.forename: E
authors.initials: E
authors.lastname: Hernández-Anselmi
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital General Universitario de Albacete, Albacete, España.
authors.forename: V
authors.initials: V
authors.lastname: Marijuán-Sauquillo
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital General Universitario de Albacete, Albacete, España.
authors.forename: M
authors.initials: M
authors.lastname: Ramírez-Piqueras
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital General Universitario de Albacete, Albacete, España.
authors.forename: Y
authors.initials: Y
authors.lastname: Argumosa-Salazar
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital General Universitario de Albacete, Albacete, España.
authors.forename: T
authors.initials: T
authors.lastname: Moratalla-Jareño
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital General Universitario de Albacete, Albacete, España.
authors.forename: M S
authors.initials: MS
authors.lastname: Fernández-Córdoba
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010743:Phospholipids; D010865:Pilot Projects; D011446:Prospective Studies; D013459:Sulfur Hexafluoride; D014463:Ultrasonography; D014522:Urethral Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014551:Urinary Tract / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging* / Q000503:physiopathology*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: Echocystography; Ecocistografía; Posterior urethral valves; Reflujo vesicoureteral; Urosonografía; Urosonography; Vesicoureteral reflux; Válvulas de uretra posterior