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Keywords = contrast-enhanced urosonography (CE-VUS)

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12 pages, 2077 KiB  
Article
A Comparison of Contrast-Enhanced Voiding Urosonography (CE-VUS) and Contrast Retrograde Cystourethrography (RCUG) for the Detection of Vesicoureteral Reflux in Young Dogs
by Georgia Trikoupi, Paraskevi Papadopoulou, Katerina K. Adamama-Moraitou, Maria Eleni Filippitzi, Savvas Deftereos, Christos Koutinas, Michail Patsikas and Frederica Papadopoulou
Animals 2025, 15(13), 1918; https://doi.org/10.3390/ani15131918 - 29 Jun 2025
Viewed by 363
Abstract
The aim of this prospective study was to evaluate contrast-enhanced urosonography (CE-VUS) as an alternative to radiographic retrograde cystourethrography (RCUG) in the detection of vesicoureteral reflux (VUR) in young dogs. A total of 62 dogs, ranging in age from 6 weeks to 12 [...] Read more.
The aim of this prospective study was to evaluate contrast-enhanced urosonography (CE-VUS) as an alternative to radiographic retrograde cystourethrography (RCUG) in the detection of vesicoureteral reflux (VUR) in young dogs. A total of 62 dogs, ranging in age from 6 weeks to 12 months, and 124 ureterorenal units (UUs) were investigated for VUR using RCUG and CE-VUS. After a baseline gray-scale ultrasound (US) of the urinary tract, a second-generation ultrasound contrast agent (UCA), diluted in a bottle of normal saline, was instilled into the urinary bladder via a catheter and CE-VUS was performed. VUR was detected when microbubbles were observed in the ureter and/or in the renal pelvis. In addition, RCUG was performed on the same day. The findings obtained by CE-VUS and RCUG were concordant in 117/124 UUs (94.35%). No reflux was detected in 101/124 UUs (81.45%) using both methods. With RCUG as the standard of reference, the sensitivity of CE-VUS was 94.12%, and the specificity was 94.39%. The positive predictive value was 72.73%, and the negative predictive value was 99.02%. CE-VUS is highly sensitive for the detection of VUR in young dogs. Full article
(This article belongs to the Special Issue Imaging Techniques and Radiation Therapy in Veterinary Medicine)
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12 pages, 777 KiB  
Review
The Intrarenal Reflux Diagnosed by Contrast-Enhanced Voiding Urosonography (ceVUS): A Reason for the Reclassification of Vesicoureteral Reflux and New Therapeutic Approach?
by Marijan Saraga, Mirna Saraga-Babić, Adela Arapović, Katarina Vukojević, Zenon Pogorelić and Ana Simičić Majce
Biomedicines 2024, 12(5), 1015; https://doi.org/10.3390/biomedicines12051015 - 5 May 2024
Cited by 3 | Viewed by 1961
Abstract
Vesicoureteral reflux (VUR) is defined as the urine backflow from the urinary bladder to the pyelo-caliceal system. In contrast, intrarenal reflux (IRR) is the backflow of urine from the renal calyces into the tubulointerstitial space. VURs, particularly those associated with IRR can result [...] Read more.
Vesicoureteral reflux (VUR) is defined as the urine backflow from the urinary bladder to the pyelo-caliceal system. In contrast, intrarenal reflux (IRR) is the backflow of urine from the renal calyces into the tubulointerstitial space. VURs, particularly those associated with IRR can result in reflux nephropathy when accompanied by urinary tract infection (UTI). The prevalence of IRR in patients with diagnosed VUR is 1–11% when using voiding cystourethrography (VCUG), while 11.9–61% when applying the contrast-enhanced voiding urosonography (ceVUS). The presence of IRR diagnosed by VCUG often correlates with parenchymal scars, when diagnosed by a 99mTc dimercaptosuccinic acid scan (DMSA scan), mostly in kidneys with high-grade VURs, and when diagnosed by ceVUS, it correlates with the wide spectrum of parenchymal changes on DMSA scan. The study performed by both ceVUS and DMSA scans showed IRRs associated with non-dilated VURs in 21% of all detected VURs. A significant difference regarding the existence of parenchymal damage was disclosed between the IRR-associated and IRR-non-associated VURs. A higher portion of parenchymal changes existed in the IRR-associated VURs, regardless of the VUR grade. That means that kidneys with IRR-associated VURs represent the high-risk group of VURs, which must be considered in the future classification of VURs. When using ceVUS, 62% of places where IRR was found were still unaffected by parenchymal changes. That was the basis for our recommendation of preventive use of long-term antibiotic prophylaxis until the IRR disappearance, regardless of the VUR grade. We propose a new classification of VURs using the ceVUS method, in which each VUR grade is subdivided based on the presence of an IRR. Full article
(This article belongs to the Special Issue Recent Advances in Kidney Disease in Children)
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12 pages, 2422 KiB  
Article
Therapeutic Management of Children with Vesicoureteral Reflux
by Valeria Chirico, Filippo Tripodi, Antonio Lacquaniti, Paolo Monardo, Giovanni Conti, Giorgio Ascenti and Roberto Chimenz
J. Clin. Med. 2024, 13(1), 244; https://doi.org/10.3390/jcm13010244 - 31 Dec 2023
Cited by 6 | Viewed by 3402
Abstract
Contrasting data refer to therapies for vesicoureteral reflux (VUR), such as surgical treatments and continuous antibiotic prophylaxis (CAP). This study evaluated the effectiveness of these approaches in children with VUR, analyzing the recurrence of febrile urinary tract infections (UTIs) and the resolution of [...] Read more.
Contrasting data refer to therapies for vesicoureteral reflux (VUR), such as surgical treatments and continuous antibiotic prophylaxis (CAP). This study evaluated the effectiveness of these approaches in children with VUR, analyzing the recurrence of febrile urinary tract infections (UTIs) and the resolution of VUR after the treatment. A total of 350 pediatric patients underwent contrast-enhanced voiding urosonography (ceVUS) to diagnose a VUR, whereas renal scintigraphy evaluated potential scars. After 12 months from the treatment, the VUR, the relapse of febrile UTIs, and reflux-related nephropathy were analyzed. Twenty-seven children had recurrent febrile UTIs after surgical therapy, with a greater rate of relapses observed in III and V VUR grades. Thirteen patients who underwent surgery had scars, independently of VUR grades and gender, with evidence of chronic renal failure at the end of the follow-up period. A total of 140 subjects were treated with CAP, and 30% of them continued to suffer from febrile UTIs. Ninety-five patients with VUR underwent ceVUS after 12 months, with persistent reflux in fifty-two patients. All of them had severe VUR, correlating with the age at diagnosis and gender. CAP therapy prevented scarring better than surgery, especially in children with III and V grades of VUR. A late onset of VUR or VUR involving neonatal patients is rarely a reversible process. This study identified predictors of success or failure of surgical or CAP therapies, evaluating the relapse of UTIs or persistent reflux after the treatment and giving prognostic information in children with VUR. Full article
(This article belongs to the Section Clinical Pediatrics)
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10 pages, 1893 KiB  
Article
Evaluation of the Diagnostic Value of Contrast-Enhanced Voiding Urosonography with Regard to the Further Therapy Regime and Patient Outcome—A Single-Center Experience in an Interdisciplinary Uroradiological Setting
by Constantin A. Marschner, Vincent Schwarze, Regina Stredele, Matthias F. Froelich, Johannes Rübenthaler, Thomas Geyer and Dirk-André Clevert
Medicina 2021, 57(1), 56; https://doi.org/10.3390/medicina57010056 - 9 Jan 2021
Cited by 9 | Viewed by 3126
Abstract
Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1–2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, [...] Read more.
Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1–2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, is not yet widely used. In the present single-center study, subsequent therapeutic procedures and outcomes after ceVUS of 49 patients were investigated. The aim of the study is to investigate the efficacy of ceVUS with the intention of broader clinical implementation. Materials and Methods: Between 2016 and 2020, 49 patients were retrospectively included and received a ceVUS to evaluate VUR. With a distribution of 47:2 (95.9%), a clear female predominance was present. The age of the patients varied between 5 months and 60 years at the time of ceVUS. All examinations were all performed and subsequently interpreted by a single experienced radiologist (EFSUMB level 3). Results: Compared to intraoperative findings, ceVUS shows a sensitivity of 95.7% with a specificity of 100%. Allergic reactions to the contrast medium could not be observed. Conclusion: With its high sensitivity and intraoperative validation, ceVUS offers an excellent alternative to VCUG, the gold standard in the diagnosis of VUR. In addition, ceVUS is a radiation-free examination method with a low risk profile that offers an exceptional diagnostic tool in the diagnostic clarification of recurrent urinary tract infections with the suspected diagnosis of VUR and should also be included in the consideration of a diagnosis next to the established VCUG, especially in younger children. Full article
(This article belongs to the Special Issue Imaging of the Kidney and Urinary Tract)
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