Renal bladder ultrasound in children with urinary tract infection

Abstract

Introduction. Urinary tract infections (UTI) are a common problem in the pediatric age patients. They can represent the first sign of congenital anomaly of the kidney or urinary tract (CAKUT) in children younger than 2 years, vesicoureteral reflux being the most frequent. Renal bladder ultrasound (RBUS) is the most utilized imaging modality in children with UTI. RBUS is a non-invasive, non-radiating and the least expensive imaging test available. Materials and methods. The present study is a retrospective analysis of patients admitted for UTI in “Grigore Alexandrescu” Clinical Emergency Hospital for Children between 1st January 2015 and 31st December 2017. Results. RBUS was performed in 310/359 cases. Urinary tract anomalies were found in 108 patients. In 67/108 cases upper urinary tract dilations were identified. 31/191 patients (16%) under 2 years of age had upper urinary tract dilations on RBUS, while 36/119 patients (30%) older than 2 years had positive RBUS for upper urinary tract dilations. In 61 cases both RBUS and VCUG were available. 11/29 patients with upper urinary tract dilations on RBUS had VUR on VCUG (8 patients with high grade VUR). 8 patients with normal RBUS had VUR on VCUG (5 patients with high grade VUR). Conclusions. Although RBUS is a non-invasive and non-radiating imaging test, its value when used alone in children with UTI is limited in diagnosing CAKUT, especially VUR.