Sensitivity and Safety of Contrast-enhanced cystosonography in diagnosis of pediatric vesicoureteral reflux after urinary tract infection

Abstract

Objective: To investigate the sensitivity and safety of contrast-enhanced cystosonography in the diagnosis of primary vesicoureteral reflux (VUR) after urinary tract infection (UTI) in infants.

Methodology: This was a retrospective study. Infants diagnosed with VUR after UTI in Baoding Hospital, Beijing Children’s Hospital Affiliated to Capital Medical University were selected from July 2019 to May 2024. All the infants were subjected to contrast-enhanced cystosonography and voiding cystourethrography (VCUG). The detection rate of VUR by contrast-enhanced cystosonography and VCUG, as well as the consistency of VUR classification were analyzed.

Results: The proportion of VUR diagnosed by contrast-enhanced ultrasonography (CEUS) was 32.00%, which was significantly higher than 18.00% by VCUG (P < 0.05). The incidence of VUR was 38.23% and 43.75% in male and female infants, respectively, without statistically significant differences (P > 0.05). Among the male infants, the proportion of VUR diagnosed by CEUS was 20.58%, while the proportion by VCUG was 17.65% (P > 0.05). In the female infants, the proportion of VUR diagnosed by CEUS was 50.00%, which was significantly higher than 18.75% by VCUG (P < 0.05). VUR was diagnosed in 31.00% (31/100) pyelo-ureter units (PUUs) by CEUS, and in 18.00% (18/100) PUUs by VCUG, with good consistency (Kappa value, 0.547). The consistency of both methods in diagnosing VUR at different degrees was good, with higher diagnostic rates of Grade-II and III VUR.

Conclusion: Both contrast-enhanced cystosonography and VCUG have high diagnostic value in the detection of infants with VUR after UTI. The value of contrast-enhanced cystosonography in the diagnosis of infants with UTI and VUR is higher.