Comparison of direct radionuclide cystography and voiding cystourethrography in detecting vesicoureteral reflux
Comparison of direct radionuclide cystography and voiding cystourethrography in detecting vesicoureteral reflux
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DOI：
10.1111/j.1442-200x.2006.02206.x
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发表时间：
2006-06-01
影响因子：
1.4
通讯作者：
Ones, Tunc
中科院分区：
文献类型：
--
作者：
Unver, Tamer;Alpay, Harika;Ones, Tunc
荧光尿路造影术(VCUG)是诊断膀胱输尿管反流(VUR)的一种广泛应用的影像检查。然而，VCUG的主要缺点是性腺高辐射和间歇性成像。直接放射性核素膀胱造影术(DRC)具有灵敏度高、辐射剂量低等优点，但其缺点是不能提供更多的尿路解剖细节。本研究对41例(82个肾输尿管单位，KUU)1个月-126个月(中位数，15个月)的儿童进行了DRC和VCUG检查。观察尿路感染29例，随访8例，产前扩张史4例。DRC检出18条返流输尿管，VCUG检出22条返流输尿管，两种方法均检出14条返流输尿管。在85%的KUU患者中，两种方法检测和排除VUR的符合率为100%。VCUG漏诊VUR 4例(重度3例，轻度1例)，DRC漏诊8例(I级4例，III级4例)，DRC与VCUG对VUR的评价具有较好的相关性。DRC提供持续监测和低性腺辐射暴露。DRC可用于VUR的诊断，在部分病例中可替代VCUG。
Fluoroscopic voiding cystourethrography (VCUG) is a widely used imaging test for the diagnosis of vesicoureteral reflux (VUR). However, high gonadal radiation and intermittent imaging are the main disadvantages of VCUG. Direct radionuclide cystography (DRC) has been advocated for the detection of VUR with increased sensitivity and low radiation doses, however, having the disadvantage of providing less anatomical details for urethral evaluation. In this study, DRC has been compared with standard fluoroscopic VCUG for detection of VUR.A total of 41 children (82 kidney ureter units, KUU) aged 1 month-126 months (median, 15 months) were studied sequentially using DRC and VCUG. The indications of VUR studied were urinary tract infection in 29 children, VUR follow up in eight children and antenatal dilatation history in four children.A total of 18 refluxing ureters were detected by DRC, 22 refluxing ureters by VCUG and 14 refluxing ureters by both methods. The two methods were concordant for the detection and exclusion of VUR in 85% of KUU. VUR was missed by VCUG in four KUU (three severe, one mild) whereas VUR was missed by DRC in eight KUU (four grade I, four grade III).There was a good correlation between DRC and VCUG in the evaluation of VUR. DRC provides continuous monitoring and low gonadal radiation exposure. DRC can be used in the diagnosis of VUR as an alternative to VCUG in selected cases.