for the evaluation of children with urinary tract infection, the effective diagnostic approach with appropriate maging studies may be one of the most important process. But there is no definitely standardized method to evaluate these children.
The
author analysed the radiologic finddings ofn 88 consecutivve chioldren with recurrent urinary tract infection to investigate the diagnostic efficacy of abdominal ultrasonography compared to conventional excretory urography and determine logical
sequence
of uroradiologic study in children with urinary tract infection.
@ES The results were as follows:
@EN 1. Of all the children studied, there were 37 cases of vesicoureteral reflux (VUR) with or without another urologic abnormalities such as posterior urethral valve and double collecting syste, 32 cases of ureteropelvic junction obstruction
(UPJ
obstruction) and 1 case of multicystic kidney.
2. All cases with UPJ obstruction and multicystic kidney were diagnosed with abdominal ultrasonography. But excretory urography did not detect 2 cases of mild UPJ obstruction due to intermittent hydronephrosis.
3. Of 37 cases with VUR, 3 cases were not detected with abdominal ultrasonography and 5 cases were not detected with excretory urography.
4. Of all the cases studied, 18 cases did not have any anatomical abnormalities. In these cases, abnormal findings on excretory urography and ultrasonography were detected in 2 and 3 cases, respectively.
5. In the evaluation of anatomical abnormalities in the patient of recurrent UTI, combined radiologic study of ultrasonography and voiding cystourethrography has the same efficacy as excretory urography and voiding cystourethrography.
These results suggest that abdominal ultrasonography may be more effective than excretory urography in the evaluation of children with urinary tract infection. And both ultrasonography and excretory urography are relatively insensitive for
detecting
reflux and its sequale. So in the evaluation of children with urinary tract infection, voiding cystourethrography and ultrasonography should be performed initially. And excretory urography could be performed for selected cases.
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