Novljan Gregor, Kenig Anton, Rus Rina, Kenda Rajko B
Department of Pediatric Nephrology, University Medical Center Ljubljana, Children's Hospital, Stare pravde 4, 1000 Ljubljana, Slovenia.
Pediatr Nephrol. 2003 Oct;18(10):992-5. doi: 10.1007/s00467-003-1228-8. Epub 2003 Jul 29.
Three methods are currently used to identify vesicoureteral reflux (VUR) in children, namely X-ray voiding cystourethrography (VCUG), radionuclide voiding cystography (RVC), and, recently, echo-enhanced voiding urosonography (VUS). It is known that the sensitivity of VCUG and RVC for detecting VUR can be improved by using cyclic procedures, such as repeated bladder filling and voiding. The purpose of our prospective study was to evaluate whether the cyclic procedure is superior to the conventional (one cycle only) procedure in VUS also. VUS was performed in 49 patients, aged 1.4-15.8 years (mean 4.1 years). After the first micturition, the catheter was left in place and the whole procedure was repeated under the same conditions. The results of the first and second cycles and the combined procedure were compared. In the initial cycle, 7 of 35 (20%) refluxing renal units that were detected in the second cycle and 4 of 26 (15%) children with at least unilateral VUR were missed. Cyclic VUS detected 25% more VURs than the conventional (one cycle only) VUS ( P=0.049) and revealed 50% more VUR III than the first cycle. Our results suggest that cyclic VUS is superior to conventional VUS.
目前有三种方法用于识别儿童膀胱输尿管反流（VUR），即X线排尿性膀胱尿道造影（VCUG）、放射性核素排尿膀胱造影（RVC），以及最近出现的超声增强排尿超声检查（VUS）。众所周知，通过采用循环程序，如反复膀胱充盈和排尿，可提高VCUG和RVC检测VUR的敏感性。我们前瞻性研究的目的是评估循环程序在VUS中是否也优于传统（仅一个周期）程序。对49例年龄在1.4至15.8岁（平均4.1岁）的患者进行了VUS检查。首次排尿后，留置导管，并在相同条件下重复整个检查过程。比较了第一个周期和第二个周期以及联合检查的结果。在初始周期中，第二个周期检测到的35个反流肾单位中有7个（20%）以及26例至少有单侧VUR的儿童中有4例（15%）被漏诊。循环VUS检测到的VUR比传统（仅一个周期）VUS多25%（P=0.049），且检测到的III级VUR比第一个周期多50%。我们的结果表明，循环VUS优于传统VUS。
