Radiology reporting of micturating cystourethrograms (MCUGs): What the paediatric urologists want to know

Abstract

Micturating cystourethrograms (MCUGs) are commonly requested to exclude vesicoureteric reflux (VUR) and bladder outlet obstruction (BOO). Useful additional information including timing and bladder volume at the start of reflux, urethral anomalies and post-void drainage can be obtained from the cystograms, but are not routinely reported by radiologists. The study aim was to retrospectively review MCUG reports against a proposed reporting proforma, and then re-analyse the effect of the proforma on report quality. A retrospective analysis of paediatric MCUG reports was undertaken from two patient cohorts. Cohorts A (41 reports) and B (51 reports) comprised reports written before (2011-12) and following (2016-17) distribution of the standardised reporting proforma, respectively. Reports were assessed with respect to the parameters outlined on the standardised MCUG reporting proforma, including presence, grade and timing of VUR amongst others. Findings from both cohorts were compared and statistically analysed (p<0.05 significant) to establish if the proforma influenced the content of reports. Statistically significant improvements were demonstrated in the reporting of: bladder outline normal/abnormal - reported in 92% after the proforma vs 56% before (p<0.001); urethra normal/abnormal - 87% vs 68% (p=0.033); contrast volume instilled - 84% vs 61% (p=0.011); bladder emptying - 69% vs 17% (p<0.001). In patients with VUR, reporting of VUR timing - 96% vs 33% (p<0.001) and VUR grade - 91% vs 40% (p=0.002) were also significantly improved. Implementation of a standardised MCUG reporting proforma produced substantial improvements in report quality and consistency, with statistically significant improvements noted in six of seven key features.