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Prediction of High-grade Vesicoureteral Reflux in Children Younger Than 2 Years Using Renal Sonography A Preliminary Study
- Prediction of High-grade Vesicoureteral Reflux in Children Younger Than 2 Years Using Renal Sonography A Preliminary Study
- You, Sun Kyoung; Kim, Jong Chun; Park, Won Hong; Lee, So Mi; Cho, Hyun-Hae
- Ewha Authors
- Issue Date
- Journal Title
- JOURNAL OF ULTRASOUND IN MEDICINE
- JOURNAL OF ULTRASOUND IN MEDICINE vol. 35, no. 4, pp. 761 - 765
- pediatric ultrasound; renal sonography; technetium Tc 99m-labeled dimercaptosuccinic acid scanning; urinary tract infection; vesicoureteral reflux; voiding cystourethrography
- AMER INST ULTRASOUND MEDICINE
- SCIE; SCOPUS
- Document Type
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- Objectives-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.
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