Author/Editor		Kopač, Matjaž
Title		Vloga indirektne mikcijske urosonografije v odkrivanju vezikoureternega refluksa pri otrocih
Type		monografija
Place		Ljubljana
Publisher		Univerza v Ljubljani, Medicinska fakulteta
Publication year		2005
Volume		str. 65
Language		slo
Abstract		Background The progress of diagnostics in medicine and particularly in pediatrics is directed towards finding diagnostic procedures that will diminish the radiation burden on the patient and other side effects without losing important data. The use of ultrasonography seemed to be a logical answer to this challenge. Purpose of the study The purpose of our prospective study was to determine the value of indirect voiding urosonography without the use of contrast-media and without filling the bladder through the catheter (IVUS) for detecting VUR in children in comparison with echo-enhanced voiding urosonography (VUS). Patients and methods Among 57 children (45 girls and 12 boys, aged 2.7 - 12.0 years) who were admitted for echo-enhanced VUS either as part of a routine evaluation after urinary tract infection (UTI) or as a follow-up of a previously detected VUR, IVUS was successfully performed in 47 children. The results were considered positive when there was any increase in pelvis size and/or ureter lumen with during voiding. Results The overall sensitivity of IVUS for the detection of VUR was 49%,specificity 75%. The best results were obtained with VUR grade III, where 6 out of 7 cases were detected with IVUS, thus giving a sensitivity of 86%. The average increase of AP pelvis diameter during voiding was highly significant only in uretero-renal units with VUR grade III. Conclusion Considering the difficult and often time-consuming performance of the investigation and its relatively low overall sensitivity and specificity,IVUS does not seem to have found its place in routinc clinical practicc, as it is not reliable enough to safely replace echo-enhanced VUS.
Descriptors		VESICO-URETERAL REFLUX CHILD PROSPECTIVE STUDIES