Enhanced detection of vesicoureteric reflux with isotopic cystography

and fluoroscopic cystourethrography (FC) in detecting vesicoureteric reflux (VUR) in children. FC and IC were performed in 124 children, 56 boys and 6 8 girls, aged 1 month to 9.2 years (mean 2.1 years), admitted consecutively for suspected VUR over a 10-month period. VUR was diagnosed by one or both studies in 51 of 124 (41%) patients, The two methods were concordant for t he detection of VUR in 84% of kidney-ureter units and in 93% for the detect ion or exclusion of severe VUR, IC detected VUR more accurately than FC, bo th when all grades of VUR were considered together (P=0.00001) and when onl y severe reflux was considered (P=0.004). VUR was missed by FC in 23 of 51 (45%) subjects. Of these 23, 12 had seven VUR detect ed on one side at leas t by IC. VUR was missed by IC in 3 subjects. IC is significantly more accur ate than FC in the initial diagnosis of VUR, even of severe grade. IC is th e method of choice for the first diagnosis of VUR. Boys with VUR diagnosed by IC also need FC to investigate for posterior urethral valves.