title: Prediction of High-grade Vesicoureteral   Reflux in Children Younger Than 2 Years   Using Renal Sonography.
abstract: OBJECTIVE
  To investigate the predictive value of renal sonography for vesicoureteral reflux (VUR) and the efficacy of renal sonography, technetium Tc 99m–labeled dimercaptosuccinic acid (DMSA) scanning, and a combination of the two for VUR screening in children younger than 2 years with a first episode of febrile urinary tract infection.
  
  
  METHODS
  Thirty-eight patients younger than 2 years with a first febrile urinary tract infection were included in our study, which was conducted from April through October 2014. Each kidney was considered a separate renal unit. A retrospective review of clinical information and images (renal sonography, DMSA scanning, and voiding cystourethrography) was performed.
  
  
  RESULTS
  Of the 14 renal units (18.4%) with VUR, 4 (28.5%) had high-grade VUR. Among single findings, dilatation of the renal collecting system, wall thickening of the renal collecting system, and DMSA scans significantly predicted VUR (P= .038, .027, and .01, respectively). Dilatation was the most common single finding (46 of 76 renal units). The sensitivity values for dilatation, wall thickening, and DMSA scans were 85.7%, 64.2%, and 50.0%, and the negative predictive values were 93.3%, 89.7%, and 87.9%.
  
  
  CONCLUSIONS
  The negative predictive values indicate that normal renal sonographic and DMSA findings can predict the absence of high-grade VUR. We propose that renal sonographic findings of wall thickening as well as dilatation of the renal collecting system should be considered predictive of high-grade VUR.
authors.forename: Sun Kyoung
authors.initials: SK
authors.lastname: You
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Kim
authors.forename: Won Hong
authors.initials: WH
authors.lastname: Park
authors.forename: So Mi
authors.initials: SM
authors.lastname: Lee
authors.forename: Hyun-Hae
authors.initials: HH
authors.lastname: Cho
mesh_terms: D000465:Algorithms; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D007677:Kidney Function Tests / Q000379:methods*; D008297:Male; D064847:Multimodal Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid