Abstract

Objectives: We aimed to explore the role and indication for the use of ultrasonography (US) in the vesico-ureteral reflux (VUR) disease and demonstrate the non – inferiority against the gold standard voiding cystourethrography (VCUG) for the screening in a certain group of patients.

Material and Methods: This is a retrospective analysis of 532 simultaneous VCUG and US examinations between April 2010 and March 2019, by a single radiologist in our hospital. Demographic characteristics, pelvic stasis, pelvi – calyxeal dilatation and hydro – uretero – nephrosis in the US, and reflux in the VCUG were recorded. ROC analysis was done for comparing the two tests.

Results: Among the cases between 5 months to 18 years of age, 342 (64.3 %) were female, and 190 (35.7 %) were male. The cases were divided into two groups below and after 6 years of age (N = 246 (46.2 %), and 286 (43.8%) respectively. There was a correlation between US and VCUG findings below the age of 6 (p<0.005, OR=6,977), but not in the cases over (p=0,539). In the ROC analysis of US in detection of VUR, compared to VCUG, sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) below 6 years age is 89,76 %, 47,86 %, 65,1 %, and 81,2 % (AUC= 0,688, p= 0,0001) respectively, and those above 6 years of age are 50,49 %, 53,55 %, 38,0 %, and 65,8 % (AUC=0,520, p= 0,5720).

Conclusion: US is easy, reproducible, safe and effective for diagnosis, and staging of the disease. Its high sensitivity (89.7 %), and negative predictive value (81.2 %), can make it an initial screening test in the patients below 6 years of age. VCUG as a gold standard modality can be reserved for definitive diagnosis in the suspected cases below the age of 6 and all of the cases after the age of 6.

Keywords: Vesicoureteral reflux, , Voiding cysto-urethrography, Ultrasonography, Pediatrics, Diagnosis, Screening

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How to cite

1.
Bayram Ilıkan G. How can we specify the role of ultrasonography in the vesico – ureteral reflux disease?. Turk J Pediatr Dis [Internet]. 2020 Jun. 26 [cited 2025 May 25];14(4):348-51. Available from: https://turkjpediatrdis.org/article/view/680