SONOGRAPHIC DETECTION OF VESICOURETERAL REFLUX WITH FLUID AND AIR CYSTOGRAPHY - COMPARISON WITH VCUG

Purpose: Attempt to find out an effective and reliable alternative met hod for the diagnosis of vesicoureteral reflux (VUR), without irradiat ion, in children, and the comparison of its results with those of void ing cystourethrography (VCUG). Methods: In a prospective comparative s tudy we examined 88 children (176 units) (average age = 2.8 years) son ographically and with VCUG, in order to detect VUR. First we examined sonographically the kidney's morphology on an empty bladder. Then we e xamined them sonographically after filling the urinary bladder with fl uid (fluid-cystorenography, fluid-CRG), and after filling it with air (air cystorenography, air CRG). Within the following 2-5 days the stan dard VCUG was performed. We compared the results of these three method s. Results: Fluid CRG showed fluid reflux to the pelvicalyceal system in 25/176 kidneys (sensitivity = 94.4%, specificity = 94.9%, accuracy = 94.9%). Air CRG showed air reflux in 19/176 kidneys (sensitivity = 8 3.3%, specificity = 96.8%, accuracy = 95.4%). VCUG showed VUR in 18/17 6 pelvicalyceal systems and/or ureters. Conclusion: Fluid CRG and/or a ir CRG can be used as complementary methods to the VCUG, or during the follow up of patients with known VUR: VCUG cannot be replaced complet ely by fluid CRG or air CRG, especially the first and the last one, be cause of the false negative results of these methods and because none of them can show the renal collecting system, the urinary bladder and the urethra in the standard way.