Contrast-enhanced Voiding Urosonography with Second-generation Ultrasound Contrast Agent versus Micturating Cystourethrogram for Diagnosis of Vesicoureteric Reflux

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JAWK Tang, JCH Tse, AYT Lai, BMH Lai, KYK Tang, SY Luk, DPY Lai, KY Che, WWC Wong, WK Kan

Hong Kong J Radiol 2018;21:16-25

Objective: To review the performance of contrast-enhanced voiding urosonography (ceVUS) and micturating cystourethrogram (MCU) in diagnosing vesicoureteric reflux (VUR), and to evaluate the safety profile of ceVUS and the relevant imaging findings.
Methods: We retrospectively reviewed all patients who underwent both ceVUS and MCU in the same setting between August 2016 and May 2017. All ceVUS were performed with Philips Affiniti 70 ultrasound system. SonoVue was used as the contrast agent for ceVUS. All the patients then received MCU under fluoroscopic screening using iodinated contrast. Follow-up phone interviews were done up to 5 days after the examination.
Results: In total, 22 patients, including 18 male and four female patients (age range, 19 days to 24 months) were included, giving a total of 44 pelvi-ureteric units (PUUs) examined. VUR was detected in four out of the 44 PUUs. Except for one PUU which showed grade 2 VUR on ceVUS but grade 1 VUR on MCU, all other PUUs showed concordant findings on both examinations. Regarding detection of VUR irrespective of its severity, ceVUS showed sensitivity of 100% and specificity of 100% in our cohort. Other findings included: hydronephrosis (n=10), ureterocoele (n=1), multicystic dysplastic kidney (n=1), renal cysts (n=3), and urethral diverticulum (n=1). All the patients tolerated the procedures well with no significant complications from the procedures.
Conclusion: ceVUS is accurate, safe, and allows one-stop anatomical and functional assessment. Our unique case of urethral diverticulum detected on ceVUS also expanded our understanding in the utility of ceVUS for urethral pathology.


Author affiliation(s):
JAWK Tang, JCH Tse, AYT Lai, BMH Lai, KYK Tang, SY Luk, DPY Lai, KY Che, WWC Wong, WK Kan: Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong




第二代超聲造影劑進行的造影增強排尿性尿道超聲波 造影(ceVUS)與排尿性透視膀胱尿道攝影(MCU) 在膀胱輸尿管反流的診斷



方法:我們回顧分析由2016年8月至2017年5月期間同時接受ceVUS和MCU的所有病人。所有ceVUS均採用Philips Affiniti 70超聲系統進行。SonoVue被用作ceVUS的造影劑,然後所有病人再以碘化造影劑在螢光透視儀下接受MCU。我們在病人完成檢查後5天內進行後續電話訪談。