Contrast ultrasound in diagnosis of intrarenal reflux in children

Vesicoureteral reflux (VUR) is one of the most common urinary tract anomalies in children and may be associated with reflux nephropathy (RN). Many studies have shown that intrarenal reflux (IRR) is an important risk factor for febrile urinary tract infections (UTI) and renal scarring and consequentl...

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Autores principales:	Andrea Cvitković Roić, Iva Palčić, Alemka Jaklin Kekez, Goran Roić
Formato:	article
Lenguaje:	EN HR
Publicado:	Hrvatski liječnički zbor 2021
Materias:	vesico-ureteral reflux – complications diagnostic imaging; kidney – diagnostic imaging pathology; cicatrix – diagnostic imaging etiology; urinary tract infections – diagnostic imaging; diagnostic techniques Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/faef361a88ef4798b909d079d2c27910
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spelling	oai:doaj.org-article:faef361a88ef4798b909d079d2c279102021-12-01T13:38:23ZContrast ultrasound in diagnosis of intrarenal reflux in children10.26800/LV-143-1-2-60024-34771849-2177https://doaj.org/article/faef361a88ef4798b909d079d2c279102021-02-01T00:00:00Zhttps://lijecnicki-vjesnik.hlz.hr/lijecnicki-vjesnik/kontrastni-ultrazvuk-u-dijagnostici-intrarenalnog-refluksa-u-djece/https://doaj.org/toc/0024-3477https://doaj.org/toc/1849-2177Vesicoureteral reflux (VUR) is one of the most common urinary tract anomalies in children and may be associated with reflux nephropathy (RN). Many studies have shown that intrarenal reflux (IRR) is an important risk factor for febrile urinary tract infections (UTI) and renal scarring and consequently, later, the development of hypertension and/or renal failure. The incidence of IRR diagnosed by fluoroscopic voiding cystourethrography (VCUG) ranges below 1% to a maximum of 10%. The diagnostic criterion for IRR in contrast-enhanced voiding urosonography (ceVUS) is the appearance of contrast microbubbles outside the contours of the renal collecting system and the entry of contrast into the renal parenchyma. Numerous studies have demonstrated the high diagnostic accuracy of ceVUS compared to VCUG in the detection of VUR. We have been using ultrasound methods for the diagnosis of VUR in our institution since 2006, and ceVUS was accepted and included in the Algorithm of diagnostic procedures for children with UTI by the Croatian Pediatric Nephrology Society in 2018. Initially, we detected IRR in only 2.3% of children with VUR, and since 2013, when we applied contrast-enhanced voiding urosonography, IRR has been detected in 11.9% of children with VUR. To date, there are no studies investigating the incidence of IRR with this method. The aim of this paper is to present the possibility of diagnosing IRR using contrast ultrasound, to describe the technique of performance and our vast personal experience.Andrea Cvitković RoićIva Palčić Alemka Jaklin KekezGoran RoićHrvatski liječnički zborarticlevesico-ureteral reflux – complicationsdiagnostic imaging; kidney – diagnostic imagingpathology; cicatrix – diagnostic imagingetiology; urinary tract infections – diagnostic imaging; diagnostic techniquesMedicine (General)R5-920ENHRLiječnički vjesnik, Vol 143, Iss 1-2, Pp 35-41 (2021)
institution	DOAJ
collection	DOAJ
language	EN HR
topic	vesico-ureteral reflux – complications diagnostic imaging; kidney – diagnostic imaging pathology; cicatrix – diagnostic imaging etiology; urinary tract infections – diagnostic imaging; diagnostic techniques Medicine (General) R5-920
spellingShingle	vesico-ureteral reflux – complications diagnostic imaging; kidney – diagnostic imaging pathology; cicatrix – diagnostic imaging etiology; urinary tract infections – diagnostic imaging; diagnostic techniques Medicine (General) R5-920 Andrea Cvitković Roić Iva Palčić Alemka Jaklin Kekez Goran Roić Contrast ultrasound in diagnosis of intrarenal reflux in children
description	Vesicoureteral reflux (VUR) is one of the most common urinary tract anomalies in children and may be associated with reflux nephropathy (RN). Many studies have shown that intrarenal reflux (IRR) is an important risk factor for febrile urinary tract infections (UTI) and renal scarring and consequently, later, the development of hypertension and/or renal failure. The incidence of IRR diagnosed by fluoroscopic voiding cystourethrography (VCUG) ranges below 1% to a maximum of 10%. The diagnostic criterion for IRR in contrast-enhanced voiding urosonography (ceVUS) is the appearance of contrast microbubbles outside the contours of the renal collecting system and the entry of contrast into the renal parenchyma. Numerous studies have demonstrated the high diagnostic accuracy of ceVUS compared to VCUG in the detection of VUR. We have been using ultrasound methods for the diagnosis of VUR in our institution since 2006, and ceVUS was accepted and included in the Algorithm of diagnostic procedures for children with UTI by the Croatian Pediatric Nephrology Society in 2018. Initially, we detected IRR in only 2.3% of children with VUR, and since 2013, when we applied contrast-enhanced voiding urosonography, IRR has been detected in 11.9% of children with VUR. To date, there are no studies investigating the incidence of IRR with this method. The aim of this paper is to present the possibility of diagnosing IRR using contrast ultrasound, to describe the technique of performance and our vast personal experience.
format	article
author	Andrea Cvitković Roić Iva Palčić Alemka Jaklin Kekez Goran Roić
author_facet	Andrea Cvitković Roić Iva Palčić Alemka Jaklin Kekez Goran Roić
author_sort	Andrea Cvitković Roić
title	Contrast ultrasound in diagnosis of intrarenal reflux in children
title_short	Contrast ultrasound in diagnosis of intrarenal reflux in children
title_full	Contrast ultrasound in diagnosis of intrarenal reflux in children
title_fullStr	Contrast ultrasound in diagnosis of intrarenal reflux in children
title_full_unstemmed	Contrast ultrasound in diagnosis of intrarenal reflux in children
title_sort	contrast ultrasound in diagnosis of intrarenal reflux in children
publisher	Hrvatski liječnički zbor
publishDate	2021
url	https://doaj.org/article/faef361a88ef4798b909d079d2c27910
work_keys_str_mv	AT andreacvitkovicroic contrastultrasoundindiagnosisofintrarenalrefluxinchildren AT ivapalcic contrastultrasoundindiagnosisofintrarenalrefluxinchildren AT alemkajaklinkekez contrastultrasoundindiagnosisofintrarenalrefluxinchildren AT goranroic contrastultrasoundindiagnosisofintrarenalrefluxinchildren
_version_	1718405152998686720

Contrast ultrasound in diagnosis of intrarenal reflux in children

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