Document Detail


Contrast-enhanced gray-scale and color Doppler voiding urosonography versus voiding cystourethrography in the diagnosis and grading of vesicoureteral reflux.
MedLine Citation:
PMID:  11425090     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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: In 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 kappa statistics. CE-VUS and CE-CDVUS were compared for diagnostic accuracy by the McNemar test. RESULTS: The agreement between CE-VUS and VCUG in predicting VUR was 90% (kappa score, 0.77; p < 0.001). The agreement between CE-CDVUS and VCUG was 96% (kappa score, 0.91; p < 0.001). CE-CDVUS showed a significantly higher diagnostic accuracy than did CE-VUS (96% versus 90% of cases correctly classified; McNemar chi2 = 4; p < 0.05). This was mainly related to the lower number of false-negative results for grade I and grade II 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.
Authors:
A L Valentini; E Salvaggio; C Manzoni; C Rendeli; C Destito; V Summaria; P Campioni; P Marano
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of clinical ultrasound : JCU     Volume:  29     ISSN:  0091-2751     ISO Abbreviation:  J Clin Ultrasound     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-06-26     Completed Date:  2001-07-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401663     Medline TA:  J Clin Ultrasound     Country:  United States    
Other Details:
Languages:  eng     Pagination:  65-71     Citation Subset:  IM    
Affiliation:
Department of Radiology, Università Cattolica del Sacro Cuore, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Contrast Media
Humans
Infant
Infant, Newborn
Polysaccharides / diagnostic use
Ultrasonography, Doppler, Color
Vesico-Ureteral Reflux / radiography*,  ultrasonography*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Polysaccharides; 127279-08-7/SHU 508

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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