University of Iowa, Division of Pediatric Urology, Iowa City, IA, USA.
J Pediatr Urol. 2011 Aug;7(4):462-6. doi: 10.1016/j.jpurol.2010.07.003. Epub 2010 Aug 14.
In a group of children diagnosed with vesicoureteral reflux (VUR) we evaluated renal ultrasound findings, associated findings on renal scan, and prognostic impact on VUR resolution.
Medical records were reviewed for children with primary reflux and no history of antenatal hydronephrosis who underwent an initial renal ultrasound. Abnormal renal ultrasound was defined as hydronephrosis or relative difference in renal size ≥1 cm. Reflux resolution was evaluated at 2 years post diagnosis.
In 129 children with VUR (111 girls, 18 boys), 39 (30%) had an abnormal renal ultrasound. Two-year VUR resolution in the abnormal renal ultrasound group was 21% versus 46% in the group with normal renal ultrasound (P = 0.01). Combining grade II and III reflux, an abnormal ultrasound was associated with a statistically significantly lower resolution rate (grade II-III 23% vs 47%, P = 0.049). For children with moderate hydronephrosis, 8/9 (89%) had abnormal initial renal scans and all failed to achieve resolution of reflux at 2 years.
In this cohort of children with VUR, 30% had abnormalities on renal ultrasound. The presence of moderate hydronephrosis on ultrasound may indicate a high likelihood of abnormality on renal scan and failure to achieve early resolution of VUR.
在一组被诊断为膀胱输尿管反流（VUR）的儿童中，我们评估了肾脏超声检查结果、肾扫描的相关发现以及对 VUR 缓解的预后影响。
回顾了一组无产前肾积水病史且初次接受肾超声检查的原发性反流儿童的病历。异常肾脏超声定义为肾积水或肾脏大小差异≥1cm。在诊断后 2 年评估反流缓解情况。
在 129 例 VUR 患儿（111 名女孩，18 名男孩）中，39 例（30%）存在异常肾脏超声。异常肾脏超声组的 2 年 VUR 缓解率为 21%，而肾脏超声正常组为 46%（P=0.01）。合并 II 级和 III 级反流时，异常超声与缓解率显著降低相关（II-III 级 23%对 47%，P=0.049）。对于中度肾积水的患儿，9/9（89%）例初始肾扫描存在异常，且所有患儿在 2 年内均未缓解反流。
在本队列的 VUR 患儿中，30%存在肾脏超声异常。超声检查存在中度肾积水可能表明肾扫描异常的可能性较大，且早期缓解 VUR 的可能性较低。
