Comparison of X-ray VCUG with RI VCUG for Diagnosing VUR in Children

Hong, Hyun-Soook; Choi, Deuk-Lin; Kim, Eun-Mi; Kim, Sung-Jun

J Korean Soc Pediatr Nephrol > Volume 3(2); 1999 > Article

Journal of the Korean Society of Pediatric Nephrology 1999;3(2): 187-195.

소아의 방광 요관 역류 진단시 X-ray 배뇨성 방광 요도 조영술(X-ray VCUG)과 방사성 동위원소 배뇨성 방광 요도 조영술(RI VCUG)의 비교

홍현숙, 최득린, 김은미, 김성준

¹순천향 병원 방사선과학 교실
²순천향 병원 방사선과학 교실
³순천향 병원 소아과학 교실
⁴순천향 병원 소아과학 교실

Comparison of X-ray VCUG with RI VCUG for Diagnosing VUR in Children

Hyun-Soook Hong, Deuk-Lin Choi, Eun-Mi Kim, Sung-Jun Kim

¹Department of Radiology, Soonchunhyang University, College of Medicine
²Department of Radiology, Soonchunhyang University, College of Medicine
³Department of Pediatrics, Soonchunhyang University, College of Medicine
⁴Department of Pediatrics, Soonchunhyang University, College of Medicine

ABSTRACT

Purpose : VUR is state where urine regurge from bladder to ureter and kidney. It is shown in about 1/3 of urinary tract infection patients and it is classified as grade I to V. We compared results from RI VCUG(Radiisotope voiding cystourethrography) and X-ray VCUG which used in diagnosing VUR in children, to evaluate which is better in diagnosing VUR in children.
Methods : 41 Patients(19 males, 21 females), who visited Pediatric department, Soonchunhyang university Hospital from peroid of 1991. January to 1998. July for recurrent urinary tract infection or abnormalities in ultrasonogams, were enrolled in the study. The age ranged from 9 months to 17 years and mean age was 5 1/2 years. Both RI VCUG and X-ray VCUG were done and follow-up test of urine culture, renal ultrasonogram and RI VCUG were done every month, every 3 month and every 6 month, respectively to observe the disappearance of VUR and evaluated the prognosis.
Results : 24 patients had taken RI VCUG and 17(70.1%) patients showed positive result. 22 patients had taken X-ray VCUG and 9(40.1%) patients showed findings of VUR. 17 patients had taken both tests and 14 patients showed positive result in RI VCUG and 6 of these patients also showed reflux in X-ray VCUG. 3 patients who showed negative in RI VCUG, showed negative also in X-ray VCUG. For prognosis, resolution and scar formation was shown in 8 patients each. Persistent VUR was shown in 6 patients and 2 of these patients VUR was corrected by operation, 1 patient showed decreased renal function, and 1 patient was not follwed up. 8 of 9 patients who showed findings of VUR on DMSA scan formed a scar and 8 patients who showed no findings of VUR didn't form a scar. Urine culture was positive in 17 of 19 patients with VUR. Positive rate in urine culture was higher than that of patients with no VUR who showed positivity in 15 of 21 patients for urine culture. E. coli was most common organism and the period free of UTI was 14 months in VUR patients and it was shorter compared to patients without VUR which was 26 months.
Conclusion : In diagnosing VUR in children, the positive rate was higher in RI VCUG than X-ray VCUG. Therefore, in early diagnosis when VUR is suspicious but not shown in X-ray VCUG, RI VCUG should be done and it will help to make accurate diagnosis.