Color Doppler Ultrasound Evaluation of Ureteral Jet Angle to Detect Vesicoureteral Reflux in Children.
Color Doppler Ultrasound Evaluation of Ureteral Jet Angle to Detect Vesicoureteral Reflux in Children.
复制标题
彩色多普勒超声评估输尿管射流角度以检测儿童膀胱输尿管反流。
DOI：
10.1016/j.juro.2016.01.055
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
M. Oya
中科院分区：
文献类型：
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作者：
H. Asanuma;Z. Matsui;H. Satoh;Nobuyoshi Asai;Chizuko Nukui;Y. Aoki;R. Mizuno;M. Oya
目的膀胱输尿管反流是儿童最常见的泌尿系统疾病。虽然排尿性膀胱尿道造影是诊断反流的金标准，但这种方法是有创的。我们评估了彩色多普勒超声测量输尿管喷射角作为一种非侵入性的筛选工具检测reflux.Materials和MethodsWe回顾性评价了125名儿童（250肾单位）谁提出了尿路感染或肾积水。所有患者均行彩色多普勒超声检查和排尿性膀胱尿道造影。输尿管喷射角测量为输尿管喷射方向与输尿管间嵴之间的夹角。结果80例患者（117个肾单位）被诊断为反流。输尿管喷射角的平均值±标准差（67.9 ± 18.7度）显著大于非输尿管喷射角（47.8 ± 17.3度，p <0.0001）。各反流级别的角度值随级别的增加而显著增大（p <0.0001）。输尿管喷射角检测III至V级和IV/V级反流的总体能力（由受试者工作特征曲线下面积给出）分别为0.81和0.88。55度或更大的截止角检测III至V级和IV/V级反流，灵敏度分别为85.5%和94.7%。结论彩色多普勒超声检测输尿管喷射角是一种简便、无创的方法，可作为儿童重度膀胱输尿管反流的筛查工具。
PurposeVesicoureteral reflux is the most common urinary tract abnormality in children. Although voiding cystourethrography is the gold standard for diagnosing reflux, this approach is invasive. We evaluated color Doppler ultrasound measurement of ureteral jet angle as a noninvasive screening tool for detecting reflux.Materials and MethodsWe retrospectively evaluated 125 children (250 renal units) who presented with urinary tract infections or hydronephrosis. All patients underwent color Doppler ultrasonography and voiding cystourethrography. Ureteral jet angle was measured as angle between the direction of the ureteral jet and interureteral ridge.ResultsReflux was diagnosed in 80 patients (117 renal units). Mean ± SD ureteral jet angle was significantly greater in refluxing units (67.9 ± 18.7 degrees) than in nonrefluxing units (47.8 ± 17.3 degrees, p <0.0001). Angle value in each reflux grade became significantly greater according to grade (p <0.0001). Overall ability of ureteral jet angle to detect grade III to V and grade IV/V reflux, as given by the area under the receiver operating characteristic curve, was 0.81 and 0.88, respectively. A cutoff angle of 55 degrees or greater detected grade III to V and grade IV/V reflux with a sensitivity of 85.5% and 94.7%, respectively. A cutoff angle of 70 degrees or greater diagnosed grade IV/V reflux with a sensitivity of 81.6% and a specificity of 82.7%.ConclusionsColor Doppler ultrasound measurement of ureteral jet angle represents a simple and noninvasive method that is applicable as a screening tool to detect high grade vesicoureteral reflux in children.