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KMID : 1103720190800061179
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Journal of the Korean Society of Radiology
2019 Volume.80 No. 6 p.1179 ~ p.1189
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Diagnostic Accuracy of Renal Ultrasonography for Vesicoureteral Reflux in Infants and Children Aged Under 24 Months with Urinary Tract Infections
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Kim Ji-Eun
Lim Yun-Jung
Yi Ji-Sook
Hahn Seok
Lee Ho-Joon
Shin Min-Woo
Jung Hyun-Kyung
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Abstract
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Purpose: To compare the diagnostic accuracies of renal ultrasonography (US) and voiding cystourethrography (VCUG) for vesicoureteral reflux (VUR).
Materials and Methods: This retrospective study included infants and children (× 24 months of age) with urinary tract infections who underwent renal US and VCUG. The incidences of decreased or increased renal size, increased renal parenchymal echogenicity, ureteral dilation, ureteral wall thickening, renal pelvic dilation, pelvic wall thickening, and accentuated pelvic dilation in the prone position were compared. Grade 3 or higher VUR was classified as “high-grade.” A total of 138 patients (109 males; mean age, 3 months) were included. Multivariate logistic regression analysis was performed, and diagnostic accuracy was calculated.
Results: Fifty-three (38.4%) and 43 (31.2%) patients exhibited all-grade and high-grade VUR. Decreased renal size was significantly related to all-grade [odds ratio (OR): 16.6; 95% confidence interval (CI): 3.4?81.3; p = 0.001) and high-grade VUR (OR: 29.7; 95% CI: 5.7?155.3; p < 0.001). Accentuated pelvic dilation in the prone position, increased renal parenchymal echogenicity, and ureteral dilation were related to all-grade and high-grade VUR.
Conclusion: Decreased renal size showed the highest diagnostic accuracy for US-based diagnosis of all-grade and high-grade VUR. Accentuated pelvic dilation in the prone position, increased renal parenchymal echogenicity, and ureteral dilation may aid in the diagnosis of high-grade VUR.
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KEYWORD
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Vesico-Ureteral Reflux, Ultrasonography, Urinary Tract Infections
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