COMPARATIVE STUDY OF COLOR DOPPLER VOIDING UROSONOGRAPHY WITHOUT
CONTRAST ENHANCEMENT AND DIRECT RADIONUCLIDE VOIDING CYSTOGRAPHY FOR
THE DIAGNOSIS OF VESICOURETERIC REFLUX IN CHILDREN
M. Mohammadi fallah1, M. Falahati1, A. Mohammadi1, A.A. Nikibakhsh2, M. Ghasemi-Rad3
1Urmia University of Medical Sciences, 2Pediatric Nephrology, 3Student Research Committee, Urmia
University of Medical Sciences, Urmia, Iran
Objectives: We aimed to compare color DUS without the application of contrast enhancement and direct
radionuclide voiding cystography (DRC) to assess the capability of color DUS without contrast in the
detection and grading of VUR with respect to the sex and age of patients, as well as the severity of VUR.
Material and methods: In the 66 patients enrolled (56 girls, 10 boys), 132 reno-ureteral units were
investigated. All patients underwent DUS and DRC within 3 hours. DRC was used as the reference standard.
Results: Our results indicate a good overall sensitivity (83%) and specificity (77%) of color DUS without
contrast enhancement in comparison with DRC. As the age of the patients decreased, the sensitivity of DUS
increased, reaching 100% among patients below one year of age. Upon the comparison of different grades of
VUR severity, we found that sensitivity and specificity elevated as the grade increased (both parameters
reaching 100% in the most severe cases).
Conclusion: We have demonstrated that DUS is a comparably reliable method to DRVC in the detection and
grading of VUR especially at higher grades of VUR, even without the application of echo contrast agents. In
high grades of VUR, the diagnosis and follow-up can be safely and reliably performed without the
application of an US contrast medium. However, for an accurate diagnosis and grading, especially at lower
grades, the application of a contrast medium can be recommended when US is performed.