Abstract
Purpose: The aim of this study is to compare the results of direct radionuclide cystography (DRNC) and voiding cystourethrography (VCUG) in a group of children with a high suspicion of vesicoureteral reflux (VUR).Methods: For this purpose, 25 children were studied with both VCUG and DRNC. Among 50 ureter units able to be compared 39 ureter units did not show any VUR on either study. Eleven ureter units (10 children) had VUR either on one study or on both (VCUG and DRNC). In the children who had VUR on either study, a dimercaptosuccinic acid scintigraphy (DMSA) was performed to determine their cortical function.Results: We identified the following four patterns: 1) Five ureter units (five children) read positive on DRNC who were negative on VCUG and four of these children had positive findings on DMSA; 2) Four ureter units (four children) read positive on VCUG who were negative on DRNC, and two of them had positive findings on DMSA; 3) Two ureters (one child) read positive in both studies and also had abnormal DMSA findings; 4) Thirtynine ureter units read as negative on both studies.Conclusion: Although the results of these two methods did not show a significant difference, DRNC offers a high sensitivity in the younger age group whereas VCUG seems to be more sensitive in the older age group. DRNC also offers continuous recording during the study, ease of assessment and lower radiation dose to the gonads, which makes it a preferable method for the initial diagnosis and follow-up of VUR.
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References
Gibson HM. Ureteral reflux in the normal child.J Urol 1949; 60: 40–49.
Treves ST, Gelfand M, Willi UV. Vesicoureteric reflux and radionuclide cystography. In: Treves ST (ed),Pediatric Nuclear Medicine, New York; Springer Verlag, 1994: 411–427.
Treves ST. The ongoing challenge of Diagnosis and Treatment of Urinary Tract Infection, Vesicoureteral Reflux and Damage in Children.J Nucl Med 1994; 35: 1608–1611.
Polito C, Rambaldi PF, La Manna A, Mansi L, Di Toro R. Enhanced detection of vesicoureteric reflux with isotopic cystography.Pediatr Nephrol 2000; 14: 827–830.
Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen-Mobius TE. International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children.Pediatr Radiol 1985; 15: 105–109.
Fettich JJ, Kenda RB. Cyclic direct radionuclide voiding cystography. Increasing reliability detecting vesico-ureteral reflux in children.Pediatr Radiol 1992; 22: 337–338.
Guillet J, Catalinat B, Christophe E. La cystographie isotopique retrograde-son application dans le diagnostic des reflux vesico-ureteraux de l’enfant.Nouv Presse Med 1982; 11: 3831–3834.
Lebowitz RL. The detection and characterization of vesicoureteral reflux in the child.J Urol 1992; 148 (5 Pt 2): 1640–1642.
Conway JJ, King LR, Belman AB, Thorson T. Detection of vesico-ureteral reflux with radionuclide cystography.AJR 1972; 115: 720–727.
Bower G, Lovegrove F, Gensel H, Schall A, Guelfi G. Comparison of “Direct” and “Indirect” Radionuclide Cystography.J Nucl Med 1994; 26: 465–468.
Rothwell DL, Constasle AR, Alberchton M. Radionuclide cystography in the investigation of vesico-ureteric reflux in children.Lancet 1977; 8021: 1072–1075.
Dikshit MP, Acharya VN, Shikare S, Merchant S, Pardanani DS. Comparison of direct radionuclide cystography with micturating cysto-urethrography for the diagnosis of vesicoureteric reflux, and its correlation with cystoscopic appearances of the ureteric orifices.Nephrol Dial Transplant 1993; 8: 600–602.
Salom MG, Nunez F, Hernadez R, Fons J, Lara A, Brines J. Valor de la cistografia isotopica en el diagnostico del reflujo vesicoureterera en la infancia.Actas Uro Esp 1989; 13: 339–342.
Poli-Merol ML, Francois S, Pfliger F, Lefebvre F, Roussel B. Interest of Direct Radionuclide Cystography in Repeated Urinary Tract Infection Exploration in Childhood.Eur J Surg 1998; 8: 339–342.
Andrich MP, Massoud M. Diagnostic Imaging in the Evaluation of the First Urinary Tract Infection in Infants and Young Children.Pediatrics 1992; 90: 992.
Eggli F, Tulchinsky M. Scintigraphic evaluation of pediatric urinary tract infection.Sem Nucl Med 1993; 199–218.
Merrick MV, Notghi A, Chalmers N, Wilkonson AG. Long term follow-up to determine the prognostic value of imaging after urinary tract infections. Part I: Reflux.Arch Dis Child 1995; 72: 338–392.
Kleiman PK, Diamond DA, Karellas A, Spevak MR, Nimkin K, Belanger P. Tailored low dose fluoroscopic voiding cystourethrography for the re-evaluation of the vesicoureteral reflux in girls.AJR 1994; 162: 1151–1154.
Bjorgvinsson E, Majd M, Eggli KD: Diagnosis of acute pyelonephritis in children: comparison of sonography and99mTc-DMSA scintigraphy.AJR 1991; 157: 539–543.
Rushton HG, Majd M, Chandra R, Yim D. Evaluation of 99m-technetium-dimercaptosuccinic acid renal scans in experimental acute pyelonephritis in piglets.J Urol 1988; 140: 1169–1174.
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Sükan, A., Bayazit, A.K., Kibar, M. et al. Comparison of direct radionuclide cystography and voiding direct cystography in the detection of vesicoureteral reflux. Ann Nucl Med 17, 549–553 (2003). https://doi.org/10.1007/BF03006667
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DOI: https://doi.org/10.1007/BF03006667