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

The diagnostic accuracy of contrast-enhanced voiding urosonography (ce-VUS) in the diagnosis and grading of vesicoureteral reflux (VUR) is high compared to voiding cystourethrography. However, its reliability has not been yet adequately evaluated. The purpose of this study is to assess the reliability of ce-VUS in VUR detection and grading by estimating the inter- and intra- οbserver agreement of two pediatric radiologists.  

Two hundred ten children (86 boys/124 girls, mean-age 2.7y) with 421 pelvi-ureteral-units underwent ce-VUS examination with a second-generation contrast-agent to assess possible (180) or follow-up known (30) VUR. The video-clips of all ce-VUS examinations were twice independently assessed by two pediatric radiologists 4-6 weeks apart. The inter- and intra-observer agreement was estimated by kappa statistic.

The inter- and intra-observer agreement of both radiologists regarding the presence or grading of VUR was excellent (k>0.94). There were only two disagreements regarding the presence of VUR (grade Ι and ΙΙ false-negative and false-positive respectively). There were 5 cases of disagreement in VUR grading: three cases of VUR grade II-III and two cases grade III-IV. VUR was detected in 123(29%) pelvi-ureteral-units of 87 (41.4%) children and it was more common in completely duplicated ureters (6/7) than in single ones (p=0.03). The rate of VUR was independent of sex, age and presence or side of hydronephrosis (p>0.05). 

The reliability of ce-VUS with a second generation ultrasound contrast-agent in VUR detection and grading is high. Ce-VUS could be used as a radiation-free alternative.

To demonstrate the reliability of ceVUS for vesicoureteral reflux detection in children

Papadopoulou, F, Ntoulia, A, Edgar, J, Darge, K, Reliability of Contrast-enhanced Voiding Urosonography with a Second Generation Ultrasound Contrast-agent in the Diagnosis and Grading of Vesicoureteral Reflux .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018775.html