Department of Diagnostic Radiology, Inha University Hospital, Department of Pediatric2, Inha University Hospital
ABSTRACT
PURPOSE : To evaluate whether the presence of hydronephrosis or cortical irregularity on ultrasonogram (US) inchildren with urinary tract infection (UTI) predicts the vesicoureteral reflux on voiding cystourethrography(VCUG) or or associated renal scar on DMSA scan, and to assess the clinical value of US. MATERIAL & METHODS : Weanalyzed 90 kidneys of 45 children with UTI, and US, VCUG and DMSA scan were performed in all cases. We evaluatedthe presence of hydroneprhosis and cortical irregularity on US, vesicoureteral reflux on VCUG and cortical defecton DMSA scan. We analyzed the sensitivity, specificity and positive and negative predictive values of US findingsfor detection of vesicoureteral reflux and cortical defect. RESULTS : Hydronephrosis on US showed 28% sensitivityfor diagnosis of vesicoureteral reflux on VCUG, and was not significantly related with the grade of reflux.Cortical irregularity on US showed 31% sensitivity and 89% positive predictive value for cortical defect on DMSAscan. CONCLUSION : Hydronephrosis and cortical irregularity on US showed low sensitivities for diagnosis of refluxon VCUG and cortical defect on DMSA scan, however, ultrasonographic features of renal parenchyma were consideredto be useful for prediction of renal scar.
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