Abstract
ABSTRACT: Purpose. The purpose of this study was to
compare contrast-enhanced gray-scale voiding urosonography
(CE-VUS) and contrast-enhanced color
Doppler voiding urosonography (CE-CDVUS) with
voiding cystourethrography (VCUG) to verify whether
the use of color Doppler imaging improves the diagnosis
and grading of vesicoureteral reflux (VUR).
Methods. ln 74 patients, CE-VUS and CE-CDVUS
were compared with VCUG, which was used as the
gold standard. SHU 508 A (Levovist) was used as the
echo-enhancing contrast agent. VUR was diagnosed if
hyperechoic dots or color signals were visualized in
the ureter on sonograms. VUR grading was based on
morphologic and dynamic findings on CE-VUS and
morphologic and color findings on CE-CDVUS. VCUG
was performed conventionally, and grading by VCUG
was in accordance with the international system of
radiographic VUR grading. Patients who voided during
1 examination only (either CE-VUS and CE-CDVUS
or VCUG) were excluded from the study. Agreement
between the results of CE-VUS and VCUG and between
those of CE-CDVUS and VCUG in diagnosing
VUR was calculated by rc statistics. CE-VUS and CECDVUS
were compared for diagnostic accuracy by the
McNemar test.
Results. The agreement between CE-VUS and
VCUG in predicting VUR was 90% (rc score,0.77; p <
0.001). The agreement between CE-CDVUS and VCUG
was 96% (rc score, 0.91; p < 0.001). CE-CDVUS showed
a significantly higher diagnostic accuracy than did CEVUS
(96% versus 90% of cases correctly classified;
McNemar X2 = 4; p < 0.05). This was mainly related to
the lower number of false-negative results for grade I
and grade ll VUR when CE-CDVUS was used.
Conclusions. The use of color Doppler imaging significantly
improves the accuracy of contrast voiding
urosonography in the detection and grading of VUR.
Lingua originale | English |
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pagine (da-a) | 65-71 |
Numero di pagine | 6 |
Rivista | Journal of Clinical Ultrasound |
Volume | 29 |
Stato di pubblicazione | Pubblicato - 2001 |
Keywords
- cystourethrography
- vesicoureteral reflux