Ma. Dipietro et al., VESICOURETERAL REFLUX IN OLDER CHILDREN - CONCORDANCE OF US AND VOIDING CYSTOURETHROGRAPHIC FINDINGS, Radiology, 205(3), 1997, pp. 821-822
PURPOSE: To determine if a negative renal sonogram is reliably predict
ive of the absence of vesicoureteral reflux at voiding cystourethrogra
phy (VCUG) in children aged 5 years or older. MATERIALS AND METHODS: I
maging studies in 70 children aged 5 years or older who underwent rena
l ultrasound (US) and VCUG on the same day were reviewed. These childr
en had initially undergone evaluation because of a urinary tract infec
tion. RESULTS: Five of 70 children had abnormal sonograms; two (40%) O
f the five had reflux at VCUG. One had mild pelvicalyceal dilatation,
and one had a small kidney. The other three (without reflux) had a pel
vic kidney, a calyceal diverticulum, or a renal stone. Of 65 children
with a negative sonogram, 19 (29%) had reflux at VCUG; 46 (71%) did no
t. Altogether, of the 70 children, 21 had reflux, 19 (90%) of whom had
no sonographic abnormality. CONCLUSION: Children with abnormal screen
ing renal sonograms often have vesicoureteral reflux, but a normal son
ogram does not reliably exclude the condition even in children aged 5
years or older. Therefore, VCUG must be performed even in older childr
en, regardless of US findings, if clinical decisions are influenced by
documentation of the presence of VUR.