Chinese Journal of Evidence -Based Pediatric ›› 2019, Vol. 14 ›› Issue (5): 380-383.DOI: 10.3969/j.issn.1673-5501.2019.05.012

• Original Papers • Previous Articles     Next Articles

The value of contrast-enhanced voiding urosonography in the diagnosis and follow-up in pediatric vesicoureteral reflux

ZHANG Zhi-qing1,2, SHEN Qian1,2, HE Li-li1, SUN Ying-hua1, XU Hong1,2   

  1. 1 Children's Hospital of Fudan University, Shanghai 201102, China;
    2 Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai 201102, China
  • Received:2019-06-17 Online:2019-10-25
  • Contact: XU Hong, E-mail: hxu@shmu.edu.cn

Abstract: Objective To evaluate the value of contrast-enhanced voiding urosonography in diagnosis and follow-up in pediatric vesicoureteral reflux(VUR).Methods Children with high risk of VUR admitted to Children's hospital of Fudan University between September 2018 and May 2019 were given Sulfur Hexafluoride Microbubbles (Sonovue) through bladder for CeVUS. The results of CeVUS examination combined with the clinical characteristics of children were analyzed.Results A total of 50 children received CeVUS examination, including 21 males (42%, 2 with isolated kidney) and 29 females (58%, 1 with isolated kidney).The median age of them is 25.0 (2.3~99.0) months. ①26 patients (50 PUUs) received CeVUS examination for the first time, and 15 /26 patients (57.7%) had VUR, among which 6 patients (23.1%) were low grade and 9 patients (34.6%) were high grade.VUR exists in 21/50 PUUs, and middle and high level (Ⅲ-Ⅴ) reflux accounted for 66.67%.② 24 patients(47 PUUs) had received MCU before and 24/47 (51.1%) PUUs still had reflux during the follow-up CeVUS examination.The follow-up interval between CeVUS and MCU in children with improved reflux was significantly longer than the time of children with worsening or similar reflux (19.1 month vs 12.2 months, P=0.02). ③ Among the children who received CeVUS, 14 cases have been found to have urinary or other malformations but VUR through early B-ultrasound and other examinations. In 9 cases, MCU examination indicated the presence of VUR before the CeVUS examination was completed.Conclusion Since CeVUS has no radiation, it can be used for diagnosis and follow-up of VUR. For follow-up patients, the frequency of examinations can be appropriately prolonged.

Key words: Children, Contrast enhanced voiding urosonography, Vesicoureteral reflux