SONOGRAPHIC SIGN OF INTERMITTENT DILATATION OF THE RENAL COLLECTING SYSTEM IN 10 PATIENTS WITH VESICOURETERAL REFLUX

Purpose. Renal sonography is an accepted primary imaging modality for evaluating the pediatric urinary tract. We report a new sonographic fi nding associated with vesicoureteral reflux (VUR). Methods. Ten patien ts underwent sonographic evaluation of the kidneys and were noted to h ave intermittent renal collecting system dilatation that expanded and contracted during real-time scanning. These patients were further eval uated with voiding cystourethrography. Results. All 10 patients were p roven to have VUR on the side of the sonographic abnormality. Four pat ients had bilateral VUR for a total of 14 refluxing renal units. Of th ese 14 renal units, 1 was sonographically normal. Five of the 14 renal units had grade V VUR that required surgical reimplantation of the ur eter. Conclusions. This new finding of intermittent renal collecting s ystem dilatation may become an important predictor of VUR. The finding warrants further evaluation even when detected in patients not suspec ted of having VUR who are undergoing renal sonography for other reason s. (C) 1998 John Wiley & Sons, Inc.