Department of Pediatric Nephrology and Pediatric Radiology Unit (DK, AK), University Medical Center, Ljubljana, Slovenia.
J Urol. 2010 Jul;184(1):319-24. doi: 10.1016/j.juro.2010.01.057. Epub 2010 May 20.
We present different ultrasound techniques to detect vesicoureteral reflux in children with special emphasis on voiding urosonography.
Urinary tract infection is a common problem in children that may be related to vesicoureteral reflux. Currently there is no consensus on investigations in children after the first urinary tract infection. The least invasive imaging with the smallest radiation burden should be used in children. Ultrasound to detect reflux meets several of these criteria. The development of echo enhancing agents has markedly improved reflux visualization by ultrasound.
We discuss the clinical relevance of voiding urosonography. We reviewed the currently available literature and the results of our studies of this issue. We also describe our endeavors to avoid catheterization and detect vesicoureteral reflux based on various sonomorphological features, ie indirect voiding urosonography and ureteral jet Doppler waveform analysis, to avoid applying any substance into the bladder.
Voiding urosonography is safe and reliable to detect vesicoureteral reflux. When indicated, considerably decreased radiation exposure can be achieved by voiding urosonography instead of established cystography methods. Indirect voiding urosonography and ureteral jet Doppler waveform analysis could be an alternative to invasive voiding cystography, at least in children older than 3 years.
我们介绍了不同的超声技术来检测儿童的膀胱输尿管反流，特别强调了排尿性超声检查。
尿路感染是儿童常见的问题，可能与膀胱输尿管反流有关。目前对于首次尿路感染后的儿童，尚无一致的检查方法。对于儿童，应采用最具侵袭性、辐射负担最小的影像学方法。用于检测反流的超声检查符合这些标准。超声增强剂的发展显著提高了超声检查反流的可视化程度。
我们讨论了排尿性超声检查的临床相关性。我们复习了目前的文献资料和我们在这一问题上的研究结果。我们还描述了我们在避免使用导管和检测膀胱输尿管反流方面的努力，方法是根据各种声像图特征，即间接排尿性超声检查和输尿管射流多普勒波形分析，避免将任何物质注入膀胱。
排尿性超声检查是一种安全可靠的检测膀胱输尿管反流的方法。在有指征的情况下，与传统的膀胱造影方法相比，排尿性超声检查可显著降低辐射暴露。间接排尿性超声检查和输尿管射流多普勒波形分析可能是有创性排尿性膀胱造影的替代方法，至少对于 3 岁以上的儿童是如此。
