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Prediction of High‐grade Vesicoureteral Reflux in Children Younger Than 2 Years Using Renal Sonography
Author(s) -
You Sun Kyoung,
Kim Jong Chun,
Park Won Hong,
Lee So Mi,
Cho Hyun-Hae
Publication year - 2016
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.15.04074
Subject(s) - medicine , vesicoureteral reflux , dimercaptosuccinic acid , urinary system , urology , reflux , cystourethrography , kidney , predictive value , thickening , positive predicative value , ultrasound , radiology , disease , chemistry , polymer science
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.