Frederica Papadopoulou MD, Presenter: Nothing to Disclose

Aikaterini Ntoulia MD, PhD, Abstract Co-Author: Nothing to Disclose

J. Christopher Edgar PhD, Abstract Co-Author: Nothing to Disclose

Kassa Darge MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the diagnostic performance and safety of intravesical administration of a-second-generation ultrasound contrast-agent (UCA) for the diagnosis of vesicoureteral reflux (VUR) in children. 

1350 children (587 boys/763 girls, mean-age 2.6y, range 15d-17y) with 2720 pelvi-ureter-units, underwent contrast-enhanced voiding urosonography (ceVUS) to rule out VUR and/or urethral pathology. A second-generation UCA (SonoVue®, Bracco, Milan) was administered intravesically through 5-8F feeding-tube at a dose of 0.5 ml/bladder filling. Possible adverse-events were monitored during the examination and followed-up 7 days after the ceVUS by phone-calls. Urine analysis and culture were performed 3-5d before ceVUS in all children and 24-48h in any patient reported with adverse-events. 

VUR was detected in 450/1350 (33%) patients (162 boys/288 girls). This was in 653 (24%) pelvi-ureter-units. The distribution of grade of reflux was: grade I=1, grade II=276, grade III=266, grade IV=100, grade V=10). The urethra was imaged in 1300 (96%) children and it was of normal morphology in all but one case of an infant with posterior urethral valves. Mean duration of examination was 14±7 min, including urethral imaging. Minor adverse-events were reported in 45 (3.3%) children. These included dysuria (n=40), abdominal pain (n=1), increased frequency of micturition (n=1), vomiting (n=1), perineal irritation (n=1), and urinary-tract-infection after ceVUS (n=1). The onset of adverse-events was sub-acute in 92% and delayed in 8% of cases and the symptoms were self-limited non-requiring hospitalization. 

Ce-VUS with intravesical administration of a second-generation UCA was capable to detect and grade VUR and urethral morphology. There were no serious adverse-events with intravesical use of SonoVue®. Only a few minor adverse-events were reported during ceVUS most likely due to catheterization process. 

Ce-VUS with intravesical administration of a second-generation UCA is a safe and highly sensitive imaging modality for vesicoureteral reflux detection and urethral imaging in children. 

Papadopoulou, F, Ntoulia, A, Edgar, J, Darge, K, Diagnostic Performance and Safety of Contrast-enhanced Voiding Urosonography with a Second-generation Ultrasound Contrast Agent for the Diagnosis of Vesicoureteral Reflux: The Experience of a Single Center in 1350 Children.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016359.html