RENAL SONOGRAPHY IS NOT A RELIABLE SCREENING EXAMINATION FOR VESICOURETERAL REFLUX

A retrospective analysis of 493 infants and children was performed to determine the reliability of renal sonography for identifying vesicour eteral reflux. Sonography was done in all cases within 8 hours of a vo iding cystourethrogram. Vesicoureteral reflux was documented in 272 of 986 kidneys on voiding cystourethrography and -there were 201 refluxi ng kidneys with normal ultrasound (25 with grade I reflux, 119 with gr ade II, 50 with grade III, 6 with grade IV and 1 with grade V). In 71 of the refluxing kidneys the ultrasound was abnormal due to pelvicalic eal dilatation in 45, a duplication anomaly in 6 and renal fossae abno rmality in 20. Of the kidneys with vesicoureteral reflux 74% were sono graphically normal. Sonography was not sufficiently sensitive or speci fic for detecting vesicoureteral reflux, since 28% of the missed reflu xing kidneys had grade III or higher reflux.