Papadopoulou Frederica, Tsampoulas Constantine, Siomou Ekaterini, Tzovara Joannie, Siamopoulou Antigoni, Efremidis Stavros C
Department of Clinical Radiology and Imaging, Ioannina University Hospital, Ioannina, 45110, Greece.
Eur Radiol. 2006 Nov;16(11):2521-6. doi: 10.1007/s00330-006-0253-y. Epub 2006 Apr 26.
The purpose of this study was to evaluate whether a second cycle of contrast-enhanced voiding urosonography (VUS) with no added contrast medium (CM) can increase the detection rate of vesicoureteral reflux (VUR). One hundred twelve consecutive children with a mean age of 2.9 years with 224 kidney-ureter units (KUU) underwent two cycles of contrast-enhanced harmonic VUS. The first cycle of VUS was performed with 3.5-12.5 ml of suspension 300 mg/ml SH U 508 A and was followed immediately by a second cycle with only saline without adding CM. VUR was detected in 57 KUU from 44 children (39%) at the first cycle of VUS. Eight of the remaining 68 non-refluxing children (12%) demonstrated VUR at the second cycle (P=0.045). Most cases of missed reflux at the first cycle were grade II (75%). However, in two KUU from two children missed reflux was grade III. In one child reflux (grade II) was missed on the second cycle. Comparing the second cycle of VUS with the first cycle, concordant findings regarding the presence or absence as well as the grade of reflux were found in 94% of KUU. A second cycle of contrast-enhanced harmonic VUS with no added CM discloses significantly more cases of VUR at no additional cost for the examination.
本研究的目的是评估不添加造影剂（CM）的第二轮对比增强排尿超声检查（VUS）是否能提高膀胱输尿管反流（VUR）的检出率。112例平均年龄2.9岁的连续儿童，共224个肾输尿管单位（KUU）接受了两轮对比增强谐波VUS检查。第一轮VUS检查使用3.5 - 12.5毫升300毫克/毫升的SH U 508 A混悬液，随后立即进行第二轮检查，仅使用生理盐水而不添加CM。在第一轮VUS检查中，44名儿童（39%）的57个KUU检测到VUR。其余68名无反流儿童中有8名（12%）在第二轮检查时出现VUR（P = 0.045）。第一轮检查中漏诊的反流大多数为Ⅱ级（75%）。然而，两名儿童的两个KUU漏诊的反流为Ⅲ级。有一名儿童在第二轮检查时漏诊了反流（Ⅱ级）。将VUS的第二轮检查与第一轮检查进行比较，94%的KUU在反流的有无以及反流分级方面结果一致。不添加CM的第二轮对比增强谐波VUS检查能显著发现更多VUR病例，且不增加检查成本。
