2023 THE EFFECTIVENESS OF DIFFERENT DIAGNOSTIC METHODS IN DETECTION OF VESICOURETERAL REFLUX IN CHILDREN

Abstract

INTRODUCTION AND OBJECTIVES: Evaluate the diagnostic value of direct radionuclide cystography, indirect radionuclide cystography dynamic nephroscintigraphy with voiding sample in comparing with “gold standard” micturation cystourethrography (MCUG) in the detecting of the vesicoureteral reflux (VUR). We assess three methods and made the indications for each of them. METHODS: Two groups of patients with VUR grade 2-4 were conducted. The first group included 72 patients (42 boys, 30 girls) in the age from 4 months to 18 years who were evaluated comparatively according to the results of indirect radionuclide cystography and MCUG; the second 20 patients in the age from 5 months to 8 years (5 girls, 15 boys) were evaluated with direct radionuclide cystography in comparing of MCUG. RESULTS: In the first group VUR was detected in 23 cases according to MCUG, in 33 according to indirect radionuclide cystography, in 16 by both methods. It should be noted that the discrepancy between the results was found in 59.7% of children aged from 6 months to 3 years with the VUR grade 2-3. In the second group 16 patients demonstrated matching results for both methods; 4 patients showed a discrepancy between the results: in 3 patients two-sided VUR was detected by direct radionuclide cystography but only one-side VUR by MCUG. CONCLUSIONS: Indirect radionuclide cystography is the method of choice in children elder than 3 years old. Direct radionuclide cystography in contrast to an indirect one provides a reliable and objective assessment of the presence of VUR in both filling and emptying phases of the bladder, as well as allowing to determine the functional capacity which causes VUR, its intensity and duration.