Reflux in Young Patients: Comparison of Voiding US of the Bladder and Retrovesical Space with Echo Enhancement versus Voiding Cystourethrography for Diagnosis

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Abstract
PURPOSE: To compare the usefulness of voiding US of the bladder and retrovesical space with echo enhancement with that of voiding cystourethrography (VCUG) for diagnosis of vesicoureteral reflux (VUR) and to assess patient tolerance of the echo-enhancing agent. MATERIALS AND METHODS: One hundred eighty-eight patients (aged 5 days to 20 years) referred for investigation of VUR underwent voiding US with echo enhancement, which was followed by VCUG in 110 patients (226 kidney-ureter units). After US of the renal tract, the bladder was filled with normal saline solution. Then SH U 508 A, a galactose-based, microbubble-containing echo-enhancing agent, was administered. Reflux was diagnosed when microbubbles appeared in the ureter or pelvicalyceal system. RESULTS: VUR was detected in 80 of the units with one (n = 18) or both (n = 62) methods. All grades of reflux were identified. In 15 units, reflux diagnosed at voiding US was not observed at VCUG; the reverse was true in three units. In 208 (92%) of the 226 ki...