Department of Pediatrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
Acta Clin Croat. 2021 Jun;60(2):184-190. doi: 10.20471/acc.2021.60.02.03.
Vesicoureteral reflux (VUR) is one of the most common anomalies of the urinary system in children. Contrast-enhanced voiding urosonography (ceVUS) is one of the best methods in VUR diagnosis. This study compared characteristics associated with VUR specific images and categorized patients according to a particular VUR grade. The study included 183 children. VUR was detected in 38.9% of patients, mean age 1.7±1.1 years. Grade II VUR was most common (60.3%), followed by grade III (29.4%). Study results showed that VUR occurred irrespective of age, gender, previous ultrasound findings, causative agent, and severity of urinary tract infection (UTI). VUR was more common in children with recurrent UTI. In the group of children with the first UTI not caused by or with recurrent UTI, boys more commonly suffered from severe VUR (grade IV-V; 66.7%), while girls suffered from moderate VUR (grade II-III; 100%). In this study, the incidence of VUR in prenatally diagnosed hydronephrosis was 28.6%. It is necessary to develop an algorithm for the treatment of children after UTI in Croatia, which should include ceVUS. All children with possible VUR should be referred to a specialized center where it is possible to perform ceVUS.
膀胱输尿管反流(VUR)是儿童泌尿系统最常见的异常之一。增强超声静脉尿路造影(ceVUS)是 VUR 诊断的最佳方法之一。本研究比较了与 VUR 特定图像相关的特征,并根据特定的 VUR 分级对患者进行分类。该研究纳入了 183 名儿童。38.9%的患者检测到 VUR,平均年龄 1.7±1.1 岁。最常见的是 II 级 VUR(60.3%),其次是 III 级(29.4%)。研究结果表明,VUR 的发生与年龄、性别、先前的超声检查结果、病原体以及尿路感染(UTI)的严重程度无关。VUR 在反复发生 UTI 的儿童中更为常见。在首次 UTI 不是由 引起或反复发生 UTI 的儿童组中,男孩更常患有严重的 VUR(IV-V 级;66.7%),而女孩患有中度 VUR(II-III 级;100%)。在本研究中,产前诊断为肾积水的 VUR 发生率为 28.6%。有必要制定克罗地亚儿童 UTI 后治疗的算法,该算法应包括 ceVUS。所有疑似 VUR 的儿童都应转介至可进行 ceVUS 的专门中心。