COLOR-FLOW DOPPLER SONOGRAPHY IN THE DIAGNOSIS OF VESICOURETERAL REFLUX

We describe an alternative technique using color flow Doppler sonograp hy (CFDS) for detection of vesicoureteric reflux (WR). Twenty-one chil dren, ages 2-16 years, were investigated for WR using Voiding cystoure thrography (VCU) and CFDS. Forty-two ureterovesical junctions were stu died and a total of 27 were found to be refluxing at VCU. Five of thes e 2 1 patients were operated for VUR and they were also reevaluated 3 and 6 months after the operation. With good diuresis ureteric jets cou ld easily be detected with CFDS and if there was a reflux of urine int o the ureter this could also be displayed. Afterwards, the patient was asked to urinate and if reflux into the ureter was detected, particul ar attention was paid to the detection of ureteral and pelvicalyceal d ilatation by conventional gray-scale sonography. Taking VCU as the gol d standard, CFDS revealed reflux in all cases except 1. There were 3 p atients who had only onesided reflux at VCU and bilateral reflux at CF DS examination (false-positive: 20%). Correlation of CFDS and VCU was 90, 100 and 75% in low grade, grade III and grade IV reflux, respectiv ely. The results of CFDS correlated well with the results of VCU durin g the follow-up of 5 patients who had antireflux operations. As a conc lusion, CFDS could be used as an adjunct to standard ultrasonography f or detection of VUR.