经皮肾盂造影膀胱造影：其在复发性发热性尿路感染治疗方案中的地位
The PIC cystogram: its place in the treatment algorithm of recurrent febrile UTIs.
作者信息
Hagerty Jennifer A, Maizels Max, Cheng Earl Y
机构信息
Department of Pediatric Urology, Children's Memorial Hospital, 2300 Children's Plaza, Box 24, Chicago, IL 60614, USA.
出版信息
Adv Urol. 2008;2008:763620. doi: 10.1155/2008/763620.
PURPOSE
A common pediatric dilemma involves management of children with recurrent febrile urinary tract infections (UTIs) who have normal voiding cystourethrograms. Vesicoureteral reflux (VUR) has been demonstrated in such cases by performing a cystogram which positions the instillation of contrast (PIC) at the ureteral orifice. We describe the evidence supporting this diagnostic test.
MATERIALS AND METHODS
The literature was searched to identify and subsequently evaluate all studies investigating PIC cystography.
RESULTS
In patients with febrile UTIs and negative VCUGs, the PIC cystogram has been demonstrated to identify occult reflux (PIC-VUR). When identified and treated, these patients have a significant reduction in the incidence of febrile UTIs.
CONCLUSIONS
Although the current literature on PIC cystography is limited, it appears to be a clinically useful test in a select group of patients with recurrent febrile UTIs, that are not found to have VUR on a conventional VCUG. A prospective randomized trial is underway to further define its role in the treatment algorithm of febrile UTIs.
目的
儿科常见的一个难题是如何处理反复发热性尿路感染（UTI）且排尿性膀胱尿道造影正常的儿童。通过进行一种将造影剂注入置于输尿管口处的膀胱造影（PIC），已证实在此类病例中存在膀胱输尿管反流（VUR）。我们描述支持这种诊断测试的证据。
材料与方法
检索文献以识别并随后评估所有研究PIC膀胱造影的研究。
结果
在发热性UTI且排尿性膀胱尿道造影（VCUG）结果为阴性的患者中，PIC膀胱造影已被证明确认隐匿性反流（PIC-VUR）。当识别并治疗这些患者时，发热性UTI的发生率显著降低。
结论
尽管目前关于PIC膀胱造影的文献有限，但它似乎是一组反复发热性UTI患者的临床有用测试，这些患者在传统的VCUG上未发现VUR。一项前瞻性随机试验正在进行，以进一步确定其在发热性UTI治疗方案中的作用。
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