Author/Editor		Kmetec, Andrej; Bren, Andrej F; Kandus, Aljoša; Fettich, Jurij; Buturović-Ponikvar, Jadranka
Title		Contrast-enhanced ultrasound voiding cystography as a screening examination for vesicoureteral reflux in the follow-up of renal transplant recipients: a new approach
Type		članek
Source		Nephrol Dial Transplant
Vol. and No.		Letnik 16
Publication year		2001
Volume		str. 120-3
Language		eng
Abstract		Background. The aim of the study was to evaluate a new diagnostic procedure. ultrasound contrastenhanced voiding cystography ( USVC ). for vesicoureteral reflux (VUR) in renal transplant recipients and to compare it with radionuclide voiding cystography (RVC). Methods. Twenty-three renal transplant recipients with recurrent urinary tract infection were investigated simultaneously by RVC and USVC. After catheterization. the empty bladder was filled with normal saline (mean 250+-30 ml ) and 30-45 mBq of 99m Tc-lubelled colloid. At the end of filling the bladder, 19,5 ml of galactosebased, microbubble-containing echo-enhancing agent, at a concentration of 200 mg/ml, was, instlled. During the filling and voiding phases the movement of the radiotracer was recorded by a gamma camera and the presence of microbubbles in the urinary tract by ultrasound. RVC was used to detecte and grade the degree of VUR. Results. Nuclear studies identified VUR in IG (69,6%) of 23 recipients with recurrent urinary tract infection: VUR grade I in three ( l3%) recipients, grade II in eight (34,8%) and grade III in five (21,7%) using a simplified grading system USVC with contrastenhancement detected VUR in 14 (60.9%) recipients. Overall sensitivity and specificity of contrast-enhanced USVC was 75 and 71%, respectively. Statistical analysis showed that the accuracy of this procedure incrased with higher grades of VUR and its sensitivity reached 100%, for detection of VUR grade III. Conclusion. In our preliminary study. contrastenhanced USVC has proved to be un effective examination, with the same accuracy rate as RVC in detending grade III VUR episodes with low diagnostic accuracy for low reflux grades.
Descriptors		VESICO-URETERAL REFLUX KIDNEY TRANSPLANTATION BLADDER URINARY TRACT INFECTIONS SENSITIVITY AND SPECIFICITY