609 COLOR DOPPLER SONOGRAPHIC EVALUATION OF URETERIC JET ANGLE IN DETECTING HIGH GRADE VESICOURETERAL REFLUX IN CHILDREN

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You have accessJournal of UrologyPediatrics: Imaging (Genital & Urinary Tract)/Infections and Vesicoureteral Reflux1 Apr 2012609 COLOR DOPPLER SONOGRAPHIC EVALUATION OF URETERIC JET ANGLE IN DETECTING HIGH GRADE VESICOURETERAL REFLUX IN CHILDREN Hiroshi Asanuma, Hiroyuki Satoh, Zenichi Matsui, Ryuichi Mizuno, Aya Masuda, Hidaka Kono, Kazunobu Shinoda, Eiji Kikuchi, Hirohiko Nagata, Akira Miyajima, Ken Nakagawa, and Mototsugu Oya Hiroshi AsanumaHiroshi Asanuma Tokyo, Japan More articles by this author , Hiroyuki SatohHiroyuki Satoh Fuchu-shi, Japan More articles by this author , Zenichi MatsuiZenichi Matsui Fuchu-shi, Japan More articles by this author , Ryuichi MizunoRyuichi Mizuno Tokyo, Japan More articles by this author , Aya MasudaAya Masuda Tokyo, Japan More articles by this author , Hidaka KonoHidaka Kono Tokyo, Japan More articles by this author , Kazunobu ShinodaKazunobu Shinoda Tokyo, Japan More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Hirohiko NagataHirohiko Nagata Tokyo, Japan More articles by this author , Akira MiyajimaAkira Miyajima Tokyo, Japan More articles by this author , Ken NakagawaKen Nakagawa Tokyo, Japan More articles by this author , and Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.687AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Vesicoureteral reflux (VUR) is a main course of urinary tract infection and a risk factor for renal scarring in children. Especially, high grade VUR is much more important because low grade reflux has high percentages of spontaneous resolution. Voiding cystourethrography (VCUG) is a gold standard tool to detect VUR, but invasive. So, a catheter-free and radiation-free procedure for VUR detection is needed. We supposed that a bolus of urine is ejected more perpendicularly to the bladder wall through the ureteric orifice in higher grade VUR, because higher grade VUR has shorter ureteral tunnel. The aim of this study was to evaluate color doppler sonographic ureteric jet angle (UJA) as a non-invasive screening tool to detect high grade VUR in children. METHODS We evaluated 65 pediatric patients, 130 renal units, aged 1 month to 14 years (mean 4 years), who presented with febrile urinary tract infection. All patients underwent VCUG and evaluation of UJA by transverse color doppler urtrasonography of the bladder within a maximum of 2 weeks. UJA was defined as the angle between ueteric jet and interureteric ridge (Figure). Receiver-operating characteristic plots were constructed to determine the best cut-off UJA, in order to detect high grade VUR. RESULTS Ureteric jets were visible in all 65 patients. VUR was detected in 40 patients (61.5%), 58 renal units (44.6%) by VCUG. The mean UJA was 46.6±18.1°, 57.5±13.2°, 63.1±13.1°, 67.8±25.2°, 80.5±12.5° in grade 0, I, II, III, IV/V VUR, respectively. The overall ability of UJA to detect grade III-V VUR or grade IV/V VUR, as given by the area under receiver-operating characteristic curve was 0.82, 0.80, respectively. Cut-off of UJA >55° was correctly detected grade III-V VUR with a sensitivity of 87.9%. Cut-off of UJA >70° was correctly detected grade IV/V VUR with a sensitivity of 83.3% and a specificity of 80.4%. CONCLUSIONS Color doppler urtrasonographic evaluation of UJA is an easy and non-invasive method that can be used as a screening tool to detect high grade VUR in the pediatric population. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e248 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hiroshi Asanuma Tokyo, Japan More articles by this author Hiroyuki Satoh Fuchu-shi, Japan More articles by this author Zenichi Matsui Fuchu-shi, Japan More articles by this author Ryuichi Mizuno Tokyo, Japan More articles by this author Aya Masuda Tokyo, Japan More articles by this author Hidaka Kono Tokyo, Japan More articles by this author Kazunobu Shinoda Tokyo, Japan More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Hirohiko Nagata Tokyo, Japan More articles by this author Akira Miyajima Tokyo, Japan More articles by this author Ken Nakagawa Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...