Echocontrast cystosonography versus micturating cystourethrography in the detection of vesicoureteric reflux

Faizah Mohd Zaki, Kanaheswari P. Yoganathan, C. R. Thambidorai, M. A. Zulfiqar

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR). Materials and methods: This was a prospective study of 25 children, who had MCU between 2007 and 2009. ECS was performed and findings documented prior to MCU. Baseline renal and bladder sonograms were obtained. The bladder was filled with normal saline followed by introduction of 10-20 mls of air to generate microbubbles. Detection of VUR was based on two sonographic criteria: (1) presence of microbubbles in the pelvicaliceal system (PCS), and (2) increase in dilatation of the PCS. VUR was graded as (1) Grade I: microbubbles seen in ureter only; (2) Grade II: microbubbles seen in non-dilated PCS; and (3) Grade III-V: microbubbles seen in dilated PCS. The ECS findings were compared using MCU as the gold standard. Results: Of the 50 kidney-ureter (K-U) units studied, ECS detected 9 of 10 K-U units with VUR on MCU. ECS did not detect a Grade II VUR. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for criterion 1 was 90%, 87.5%, 88%, 64.3% and 97%, respectively, compared to criterion 2 which was 70%, 90%, 86%, 64% and 92%, respectively. The grading of VUR was similar on both ECS and MCU except for one case. Conclusion: ECS using agitated saline was a sensitive technique for the detection of VUR. ECS grading was comparable with MCU grading of VUR.

Original languageEnglish
JournalBiomedical Imaging and Intervention Journal
Volume7
Issue number1
DOIs
Publication statusPublished - Jan 2011

Fingerprint

Microbubbles
Ureter
Kidney
Urinary Bladder
Dilatation
Air
Prospective Studies
Sensitivity and Specificity

Keywords

  • Echocontrast cystosonography
  • Micturating cystourethrography
  • Sensitivity
  • Specificity
  • Vesicoureteric reflux

ASJC Scopus subject areas

  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Echocontrast cystosonography versus micturating cystourethrography in the detection of vesicoureteric reflux. / Mohd Zaki, Faizah; P. Yoganathan, Kanaheswari; Thambidorai, C. R.; Zulfiqar, M. A.

In: Biomedical Imaging and Intervention Journal, Vol. 7, No. 1, 01.2011.

Research output: Contribution to journalArticle

@article{5d97b64ad4b747d88d23582f21e16da5,
title = "Echocontrast cystosonography versus micturating cystourethrography in the detection of vesicoureteric reflux",
abstract = "Purpose: To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR). Materials and methods: This was a prospective study of 25 children, who had MCU between 2007 and 2009. ECS was performed and findings documented prior to MCU. Baseline renal and bladder sonograms were obtained. The bladder was filled with normal saline followed by introduction of 10-20 mls of air to generate microbubbles. Detection of VUR was based on two sonographic criteria: (1) presence of microbubbles in the pelvicaliceal system (PCS), and (2) increase in dilatation of the PCS. VUR was graded as (1) Grade I: microbubbles seen in ureter only; (2) Grade II: microbubbles seen in non-dilated PCS; and (3) Grade III-V: microbubbles seen in dilated PCS. The ECS findings were compared using MCU as the gold standard. Results: Of the 50 kidney-ureter (K-U) units studied, ECS detected 9 of 10 K-U units with VUR on MCU. ECS did not detect a Grade II VUR. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for criterion 1 was 90{\%}, 87.5{\%}, 88{\%}, 64.3{\%} and 97{\%}, respectively, compared to criterion 2 which was 70{\%}, 90{\%}, 86{\%}, 64{\%} and 92{\%}, respectively. The grading of VUR was similar on both ECS and MCU except for one case. Conclusion: ECS using agitated saline was a sensitive technique for the detection of VUR. ECS grading was comparable with MCU grading of VUR.",
keywords = "Echocontrast cystosonography, Micturating cystourethrography, Sensitivity, Specificity, Vesicoureteric reflux",
author = "{Mohd Zaki}, Faizah and {P. Yoganathan}, Kanaheswari and Thambidorai, {C. R.} and Zulfiqar, {M. A.}",
year = "2011",
month = "1",
doi = "10.2349/biij.7.1.e7",
language = "English",
volume = "7",
journal = "Biomedical Imaging and Intervention Journal",
issn = "1823-5530",
publisher = "University of Malaya",
number = "1",

}

TY - JOUR

T1 - Echocontrast cystosonography versus micturating cystourethrography in the detection of vesicoureteric reflux

AU - Mohd Zaki, Faizah

AU - P. Yoganathan, Kanaheswari

AU - Thambidorai, C. R.

AU - Zulfiqar, M. A.

PY - 2011/1

Y1 - 2011/1

N2 - Purpose: To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR). Materials and methods: This was a prospective study of 25 children, who had MCU between 2007 and 2009. ECS was performed and findings documented prior to MCU. Baseline renal and bladder sonograms were obtained. The bladder was filled with normal saline followed by introduction of 10-20 mls of air to generate microbubbles. Detection of VUR was based on two sonographic criteria: (1) presence of microbubbles in the pelvicaliceal system (PCS), and (2) increase in dilatation of the PCS. VUR was graded as (1) Grade I: microbubbles seen in ureter only; (2) Grade II: microbubbles seen in non-dilated PCS; and (3) Grade III-V: microbubbles seen in dilated PCS. The ECS findings were compared using MCU as the gold standard. Results: Of the 50 kidney-ureter (K-U) units studied, ECS detected 9 of 10 K-U units with VUR on MCU. ECS did not detect a Grade II VUR. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for criterion 1 was 90%, 87.5%, 88%, 64.3% and 97%, respectively, compared to criterion 2 which was 70%, 90%, 86%, 64% and 92%, respectively. The grading of VUR was similar on both ECS and MCU except for one case. Conclusion: ECS using agitated saline was a sensitive technique for the detection of VUR. ECS grading was comparable with MCU grading of VUR.

AB - Purpose: To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR). Materials and methods: This was a prospective study of 25 children, who had MCU between 2007 and 2009. ECS was performed and findings documented prior to MCU. Baseline renal and bladder sonograms were obtained. The bladder was filled with normal saline followed by introduction of 10-20 mls of air to generate microbubbles. Detection of VUR was based on two sonographic criteria: (1) presence of microbubbles in the pelvicaliceal system (PCS), and (2) increase in dilatation of the PCS. VUR was graded as (1) Grade I: microbubbles seen in ureter only; (2) Grade II: microbubbles seen in non-dilated PCS; and (3) Grade III-V: microbubbles seen in dilated PCS. The ECS findings were compared using MCU as the gold standard. Results: Of the 50 kidney-ureter (K-U) units studied, ECS detected 9 of 10 K-U units with VUR on MCU. ECS did not detect a Grade II VUR. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for criterion 1 was 90%, 87.5%, 88%, 64.3% and 97%, respectively, compared to criterion 2 which was 70%, 90%, 86%, 64% and 92%, respectively. The grading of VUR was similar on both ECS and MCU except for one case. Conclusion: ECS using agitated saline was a sensitive technique for the detection of VUR. ECS grading was comparable with MCU grading of VUR.

KW - Echocontrast cystosonography

KW - Micturating cystourethrography

KW - Sensitivity

KW - Specificity

KW - Vesicoureteric reflux

UR - http://www.scopus.com/inward/record.url?scp=79954488954&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79954488954&partnerID=8YFLogxK

U2 - 10.2349/biij.7.1.e7

DO - 10.2349/biij.7.1.e7

M3 - Article

C2 - 21655116

AN - SCOPUS:79954488954

VL - 7

JO - Biomedical Imaging and Intervention Journal

JF - Biomedical Imaging and Intervention Journal

SN - 1823-5530

IS - 1

ER -