Division of Pediatric Urology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
J Urol. 2011 Jun;185(6 Suppl):2536-41. doi: 10.1016/j.juro.2011.01.026. Epub 2011 Apr 28.
We determined whether the presence or absence of dextranomer-hyaluronic acid copolymer mounds on bladder ultrasound coincides with voiding cystourethrogram results after injection therapy in children with primary vesicoureteral reflux.
We retrospectively reviewed consecutive cases of dextranomer-hyaluronic acid copolymer injection for primary vesicoureteral reflux. The primary outcome investigated was the appearance of dextranomer-hyaluronic acid copolymer mounds on ultrasound and their association with voiding cystourethrogram results postoperatively. An intramural dextranomer-hyaluronic acid copolymer mound on ultrasound was considered a negative test result for vesicoureteral reflux.
A total of 187 cases were identified, of which 132 had imaging available for evaluation. Intramural mounds were seen on ultrasound in 86 cases postoperatively, of which 34 (40%) had a positive voiding cystourethrogram. Of 46 cases in which no mound was identified 21 (46%) had a positive voiding cystourethrogram. The sensitivity of ultrasound to determine the presence or absence of vesicoureteral reflux was 38%, specificity was 67%, accuracy was 55%, the positive predictive value was 46% and the negative predictive value was 60%.
Our results indicate poor correlation of dextranomer-hyaluronic acid copolymer mound appearance on ultrasound with voiding cystourethrogram results after injection. To adequately evaluate for the resolution of vesicoureteral reflux a voiding cystogram or nuclear medicine cystogram needs to be performed after injection therapy.
我们旨在确定在儿童原发性膀胱输尿管反流注射治疗后，膀胱超声上是否存在葡聚糖-透明质酸共聚体丘是否与排尿性膀胱尿道造影结果一致。
我们回顾性分析了连续接受葡聚糖-透明质酸共聚体注射治疗的原发性膀胱输尿管反流病例。主要研究结果是超声上葡聚糖-透明质酸共聚体丘的出现及其与术后排尿性膀胱尿道造影结果的关系。超声上发现的壁内葡聚糖-透明质酸共聚体丘被认为是膀胱输尿管反流的阴性试验结果。
共确定了 187 例病例，其中 132 例有影像学评估资料。术后超声检查发现 86 例存在壁内丘，其中 34 例（40%）排尿性膀胱尿道造影阳性。46 例未发现丘的病例中，21 例（46%）排尿性膀胱尿道造影阳性。超声检测膀胱输尿管反流存在或不存在的敏感性为 38%，特异性为 67%，准确性为 55%，阳性预测值为 46%，阴性预测值为 60%。
我们的结果表明，超声上葡聚糖-透明质酸共聚体丘的出现与注射后排尿性膀胱尿道造影结果相关性较差。为了充分评估膀胱输尿管反流的缓解情况，需要在注射治疗后进行排尿性膀胱造影或核医学膀胱造影。
