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Voiding urosonography with second-generation contrast agent versus voiding cystourethrography

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Abstract

Contrast-enhanced voiding urosonography (VUS) is becoming more widely used for the diagnosis of vesicoureteric reflux (VUR). The purpose of this study was to evaluate the sensitivity of VUS using a second-generation ultrasound (US) contrast agent and compare it with standard fluoroscopic voiding cystourethrography (VCUG). A total of 183 children with 366 kidney-ureter units (KUUs) underwent VUS and VCUG in the same session with the same catheterization. VUS was performed after intravesical administration of 1 ml of a second-generation ultrasound contrast agent (UCA; SonoVue, Bracco, Italy). VUR was detected in 140 out of 366 cases (38%); in 89 (24.3%) by both methods, in 37 (10.1%) by VUS only, and in 14 (3.8%) by VCUG only. Although there was considerable agreement in the diagnosis of VUR by VUS and VCUG (κ=0.68, standard error [κ]=0.04), the difference in the detection rate of reflux between VUS and VCUG was significant (p<0.00001). The grade of VUR detected with VUS showed moderate agreement with grading by VCUG. Our findings suggest that contrast-enhanced harmonic VUS using a second-generation contrast agent is superior to VCUG in the detection and grading of VUR, and it should be the method of choice for this clinical indication.

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Authors and Affiliations

  1. 1st Department of Pediatrics, Pediatric Radiology Unit, Semmelweis Medical University, 53–54 Str. János Bókay, Budapest, Hungary

    Éva Kis, Anna Nyitrai & Ildikó Várkonyi

  2. 1st Department of Pediatrics, Pediatric Nephrology Unit, Semmelweis Medical University, Budapest, Hungary

    István Máttyus, Orsolya Cseprekál, György Reusz & Attila Szabó

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  1. Éva Kis
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  2. Anna Nyitrai
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  3. Ildikó Várkonyi
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  4. István Máttyus
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  5. Orsolya Cseprekál
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  6. György Reusz
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  7. Attila Szabó
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Correspondence to Éva Kis.

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Kis, É., Nyitrai, A., Várkonyi, I. et al. Voiding urosonography with second-generation contrast agent versus voiding cystourethrography. Pediatr Nephrol 25, 2289–2293 (2010). https://doi.org/10.1007/s00467-010-1618-7

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  • DOI: https://doi.org/10.1007/s00467-010-1618-7

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