Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA.
Pediatr Radiol. 2009 Nov;39(11):1179-87. doi: 10.1007/s00247-009-1393-4. Epub 2009 Aug 29.
In accordance with ALARA, minimizing radiation exposure associated with voiding cystourethrograms (VCUG) is of critical importance. Advances in fluoroscopic technology might help achieve this goal.
To determine the efficacy of fluoroscopic image capture compared to conventional digital radiographic spot (DRS) images in voiding cystourethrograms (VCUG) for the evaluation of vesicoureteral reflux (VUR) in children.
The study was a retrospective review of 65 VCUG examinations (130 kidney/ureter units). Each examination consisted of fluoroscopically captured spot (FCS) images and the corresponding DRS images. Each set of images was evaluated by three pediatric radiologists for the diagnosis of VUR for a total of 390 kidney/ureter units reviewed. Using the DRS image set as the reference standard, the efficacy of the FCS images for diagnosing reflux was determined.
The diagnostic accuracy of the FCS images in terms of the binary characterization of reflux as negative or positive was 97.2% (379/390). The sensitivity of the FCS images was 92.6% (88/95); the specificity of the FCS images was 98.6% (291/295).
Fluoroscopically captured images are adequate in documenting absence of VUR on VCUG examinations, obviating the need for radiographic spot images and resulting in reduction in radiation exposure.
根据 ALARA 原则，尽量减少与排尿性膀胱尿道造影（VCUG）相关的辐射暴露至关重要。荧光透视技术的进步可能有助于实现这一目标。
确定与传统数字射线照相点（DRS）图像相比，荧光透视图像采集在评估儿童膀胱输尿管反流（VUR）中的排尿性膀胱尿道造影（VCUG）中的效果。
该研究是对 65 次 VCUG 检查（130 个肾/输尿管单位）的回顾性研究。每次检查均包括荧光透视捕获的点（FCS）图像和相应的 DRS 图像。共有 390 个肾/输尿管单位的 3 名儿科放射科医生对每组图像进行评估，以诊断 VUR。使用 DRS 图像集作为参考标准，确定 FCS 图像诊断反流的效果。
FCS 图像在反流的二进制特征（阴性或阳性）方面的诊断准确性为 97.2%（379/390）。FCS 图像的灵敏度为 92.6%（88/95）；FCS 图像的特异性为 98.6%（291/295）。
荧光透视采集的图像足以记录 VCUG 检查中是否存在 VUR，无需进行射线照相点图像，从而减少辐射暴露。
