Ureteral Jet Flow Angle: An Ultrasonographic Diagnostic Tool in Vesicoureteral Reflux in Children

Abstract

Objective: Vesicoureteral reflux (VUR) is the most common urinary system anomaly in childhood. The gold standard method in diagnosis is voiding cystourethrography (VCUG). However, this method is invasive and requires the use of contrast media. The aim of our study is to investigate the diagnostic value of the ureteral jet flow angle determined in color Doppler ultrasound as a noninvasive method in diagnosing VUR in children. Material-Method: In this prospective cohort study, 63 pediatric cases scheduled for VCUG were evaluated to confirm the diagnosis of VUR. Patients not having VUR on both sides included in the control group (n=32), while patients with VUR at least on one side formed the VUR group (n=31). VCUG and ureteral jet flow angle measurement with Doppler ultrasound were performed in all patients. Baseline descriptive data and ureteral jet flow angles were compared. Results: There was no significant difference between VUR and control groups in terms of age (p=0.287), gender (p=0.889), and bladder volume (p=0.211). Ureteral jet flow angle was higher in the VUR group on the right side (p=0.001) and on the left side (pl0.001) compared to the control group. Conclusion: Ureteral jet flow angle can provide clues that can help diagnose VUR. However, more multicenter studies are needed to confirm this new sonographic marker’s validity.