Buradasınız

Vezikoüreteral Reflü Tanısında Miksiyosistoüretrografinin Güvenilirliği

The Reliability of Voiding Cystourethrography in the Diagnosis of Vesicoureteral Reflux

Journal Name:

Publication Year:

Abstract (2. Language): 
It is well known that the diagnosis of vesicoureteral reflux (VUR) in I children can be overlooked at voiding cystourethrography !VCUG}. In j this study we wanted to present the results of a second VCUG in : children with recurrent UTI and/or renal damage on DMSA-scan whose i findings at initial VCUG were normal. In this prospective study, 16 patients (15 girls, 1 boy] aged 3 to 14 j years (mean: 8.44±3.78 years} with recurrent UTI and/or renal damage | on DMSA-scan underwent repeat VCUG between April 1, 2001 and i January 31, 2003. All patients seemed normal on initial VCUG. The j average time interval between initial and second VCUG was 17.31+10.65 j months (range: 7-41 months}. An abnormal renal scan was observed in : 12 (75%) of 16 patients. All patients had had recurrent UTI during the j follow-up period. Among the 16 patients, 11 (68.75%) had an abnormal j repeat VCUG (Grade II VUR in 3 patients, Gr. Ill VUR in 3, Gr. IV VUR in '•• 4 patients and Gr. V in 1 patient). In conclusion, VUR sometimes can be overlooked by VCUG. Those j children who have normal VCUG with recurrent UTI and/or abnormal j scan should undergo a second VCUG.
Abstract (Original Language): 
idrar yolu enfeksiyonu (İVE) saptanan çocuklarda miksiyoststoüret-rografi (MSUG) İle vezikoüreteral reflülerin bîr kısmının saptanamadığı bilinmektedir. Bu çalışmada ilk MSUG'si normal saptanan ve izlemde yineleyen İYE ve/veya statik böbrek sintigrafisinde (DMSA) patoloji görülmesi nedeniyle MSUG'si tekrarlanan hastaların sonuçları verilmiştir. Bu prospektif çalışma Nisan 2001 ve Ocak 2003 tarihleri arasında hastanemiz Çocuk Nefroloji Polikliniğinde yineleyen İYE nedeniyle izlenen ve ilk MSUG'leri normal bulunan 16 çocuk üzerinde yapılmıştır. Hastaların 15'İ kız, Vî erkek olup; yaş ortalaması 8.44±3.78 (yaş dağılımı: 3¬14 yaş) yıldır. Bu hastalar, sık İYE görülmesi ve/veya DMSA'da enfeksiyon bulguları saptanması nedeniyle tekrar MSUG yapılmıştır. İlk MSUG ile ıekrarlanan MSUG arasındaki ortalama süre 17.31±10.65 aydır (en az 7, en çok 41 ay). Hastaların 12'sinde (%75) DMSA'da enfeksiyona ait değişiklikler saptanmıştır. MSUG'si tekrarlanan 16 hastanın 1 Tinde (%68} değişik derecelerde (3'ünde II.M, 3'ünde lll.o, 4'ünde IV.o, ve Tinde V.o} VUR saptanmıştır. Sonuç olarak, MSUG'si normal olan ve İzlemde yineleyen İYE ve/veya DMSA'da patoloji görülen İYE'li çocuklarda gözden kaçırılmış reflülerin saptanabilmesi için MSUG tekrarı akla getirilmelidir.
FULL TEXT (PDF): 
34-38

REFERENCES

References: 

1. Shaw KN, Gorelick M, McGowan KL, Yak.scoe NM, Schwartz S. Prevalence of urinary tract infection in febrile young children in the emergency department. Pediatrics 1998; 102:
2. Winiecka W, Zoch-Zwierz W, Wasilewska A. et al. Evaluation of bladder instability in Children with recurrent urinary trad infections. Med Sci Monk 2002;8:19 23¬3- Berrocal T, Gaya F, Arjonilla A, Loncrgan GJ. Vesicoureteral reflux; diagnosis and grading with echo-enhanced cystosonography versus voiding cystourethrography. Radiology 2001;221 :-359-36^.
4. Piaggio G. Degl ML, Toma IP, Calevo MG, Perfumo F. Cystoso-nography and voiding cystourethrography in the diagnosis of vesicoureteral reflux. Pediatr Nephrol 2003;18:lH-22.
# The Reliability of t aiding Cystourethrography in tbe Diagnosis of Vesianm'teml Refrwc
=i. Levari TK, Kenig A. Fettieh JJ, Kljucevsek D, Novljan G, Kenda KB. Sensitivity 6f ultrasonography in detecting renal parenchymal defects in children. Pediatr Nephrol 2002;17:1059-1062.
6. Riccabona M. Cystography in infants and children: a critical appraisal of the many forms with special regard to voiding cysto-uretlirogaphy. Eur Radiol 2002;12:2910-2918.
7. Polito C, Moggio G, Manna AL, Cioce F, Cappabianca S, Toro RD. Cyclic voiding cystourethrography in the diagnosis of occult ve-sicoureteric reflux. Pediatr Nephrol 2000;14:39-41.
8. Papadopoulou F. Efremidis SC. Economou A, ei al. Cyclic voiding cystourethrography: is vesicoureteral reflux missed with standard voiding cystourethrography? Eur Radiol 2002;12:666-670.
9- Lama G, Esposİto SM. Molecular basis of vesicoureteral reflux. Minerva Pediatr 2002;54:415-422.
10. Biggi A. Dardanelli L, Cussino P, et al. Prognostic value of the acute ÜMSA scan in children with first urinary tract infection. Pediatr Nephrol 2001;16:800-804.
11. Fricdland CiW, The voiding cystogram: an unreliable study.In:
Hodson J, Klncaid-Smith Keds), Reflux Nephropathy. New york:Masson, 1979, pp:93-99. 12. Jequier S. jequier JC. Reliability of voiding cystourethrography lo
detect reflux. AmJ Roentgenol 1989;15,3:807-810. 13- Muensterer OJ. Comprehensive ultrasound versus voiding cystourethrography in the diagnosis of vesicoureteral reflux. Fur J Pediatr 2002;161:435-437. i 14. McFwing RL, Anderson NG, Heilewell S, Mitchell J. Comparison of echo-enhanced ultrasound with fluoroscopic MCU for the detection of vesicoureteral reflux in neonates. Pediatr Radiol 2002;32:853-858.
: 15. Paltiel HJ, Rupich RC, Kiruiuta HG. Enhanced detection <•! vesicoureteral reflux in infants and children with the use of cyclic voiding cystourethrography. Radiology 1992.184: 753-755¬16. Shapiro E, Elder JS. The office management of recurrent urinan tract infection and vesicoureteral reflux in children. Urol Clin North Am 1998;25:725-734.
İ8

Thank you for copying data from http://www.arastirmax.com