Safety assessment and diagnostic evaluation of patients undergoing contrast-enhanced urosonography in the setting of vesicoureteral reflux confirmation
Issue title: 40th Conference of the German Society for Clinical Microcirculation and Hemorheology, 5-6 November 2021, Senftenberg, Germany
Guest editors: J.-H. Küpper, A. Krüger-Genge and F. Jung
Affiliations: [a]
Department of Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
| [b]
Department of Urology, Ludwig-Maximilians-University Munich, Munich, Germany
| [c]
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany
Correspondence:
[*]
Corresponding author: Dr. med. Constantin Arndt Marschner, Department of Radiology, University Hospital, LMU Munich, Munich, Germany. Tel.: +49 89 4400 73620; E-mail: [email protected]. ORCID iD: 0000-0002-2042-7322.
Abstract: BACKGROUND:Vesicoureteral reflux (VUR) represents a common pediatric anomaly in children with an upper urinary tract infection (UTI) and is defined as a retrograde flow of urine from the bladder into the upper urinary tract. There are many diagnostic options available, including voiding cystourethrography (VCUG) and contrasted-enhanced urosonography (ceVUS). ceVUS combines a diagnostic tool with a high sensitivity and specificity which, according to previous study results, was even shown to be superior to VCUG. Nevertheless, despite the recommendation of the EFSUMB, the ceVUS has not found a widespread use in clinical diagnostics in Europe yet. MATERIALS AND METHODS:Between 2016 and 2020, 49 patients with a marked female dominance (n = 37) were included. The youngest patient had an age of 5 months, the oldest patient 60 years. The contrast agent used in ceVUS was SonoVue®, a second-generation blood-pool agent. All examinations were performed and interpreted by a single experienced radiologist (EFSUMB Level 3). RESULTS:The 49 patients included in the study showed no adverse effects. 51% of patients (n = 26) were referred with the initial diagnosis of suspected VUR, while 49% of patients (n = 23) came for follow-up examination or to rule out recurrence of VUR. The vast majority had at least one febrile urinary tract infection in their recent medical history (n = 45; 91,8%). CONCLUSION:ceVUS is an examination method with a low risk profile which represents with its high sensitivity and specificity an excellent diagnostic tool in the evaluation of vesicoureteral reflux, especially in consideration of a generally very young patient cohort.
