在小儿膀胱输尿管反流中,超声波是否增加了排尿膀胱尿道造影的价值?

Hamada Khater, Asmaa Abd El.Fattah ALi, Enas M. Sweed
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摘要

:背景:肾损伤是膀胱输尿管反流(VUR)的严重后果。虽然排尿膀胱输尿管造影术(VCUG)被认为是诊断的金标准程序,但它是一种创伤性技术,而且有很大的辐射风险。建议使用超声波检查作为筛查技术,以确定是否存在 VUR。本研究旨在评估超声波检查在 VUR 疾病中的适当作用和适应症,并将结果与金标准 VCUG 进行比较。方法和患者:这项横断面研究纳入了 2023 年 1 月至 2023 年 9 月期间转诊到本哈大学医院放射科和儿科医院的 100 名复发性尿路感染(UTI)患儿。每位患者都接受了完整的病史和影像学检查,以及包括超声波和 VCUG 在内的放射学评估。结果78%的病例通过超声波检查发现,而32%的VCUG升高型VUR患者未通过超声波检查发现。与低级别 VUR 相比,高级别 VUR 患者中肾脏体积增大、回声增强、输尿管扩张、输尿管壁变厚、肾盂突出和肾盂壁变厚的比例要高得多。使用接收器操作特征曲线(ROC)评估超声波的诊断潜力后发现,超声波在识别 VUR 方面具有 100% 的特异性和 78.5% 的敏感性。结论:超声波能更好地评估肾脏大小、实质厚度、疤痕和肾积水程度,并对治疗进行跟踪。
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Is Ultrasound Adding Values to Voiding Cystourethrogram In Pediatric Vesico Ureteric Reflux?
: Background: Renal injury is a severe consequence of vesicoureteral reflux (VUR). Although voiding cystoureterography (VCUG) is considered the gold standard procedure for diagnosis, it is too little concern invasive technique and has a significant radiation risk. It is recommended to use ultrasonography as a screening technique to determine whether VUR is present. The aim of this study was to estimate the appropriate role and indication for ultrasonography in the context of VUR disease and to compare the results with the gold standard, VCUG. Methods and patients: This cross-sectional study included 100 recurrent urinary tract infection (UTI) children who were referred to the radiology department, Benha University Hospital, and the pediatric hospital between January 2023 and September 2023. Every patient had a complete medical history and radiographic, as well as a radiological assessment that included an ultrasound and VCUG. Results: 78% of cases were identified by ultrasound, whereas 32% of patients with VUR in ascending VCUG were not identified by ultrasonography. Compared to low grade VUR, the percentage of high grade VUR patients with increased renal size, increased echogenicity, dilated ureters, thicker ureteral wall, prominent renal pelvis, and thicker pelvic wall was much higher. After evaluating ultrasound's diagnostic potential using receiver operating characteristic (ROC) curve, it was discovered that US had 100% specificity and 78.5% sensitivity for identifying VUR instances. Conclusion , ultrasound offer better evaluation renal size parenchymal thickness and scaring and degree of hydronephrosis and follow up with treatment.
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