Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Voiding urosonography (VUS) with ultrasonography contrast medium is a new modality in the detection of vesicoureteral reflux (VUR) in children. The purpose of this study was to evaluate the diagnostic accuracy of VUS compared with voiding cystourethrography (VCUG) in the detection of VUR. One hundred and eighteen patients, aged 3 weeks to 16 years, with 234 ureterorenal units, were investigated by VUS with ultrasonography contrast medium and radiographic VCUG in one session. The indications were predominantly urinary tract infection and follow-up of previously detected VUR. During the sonographic examination, the bladder was filled with saline solution and an ultrasonography contrast medium (Levovist) was administered through a catheter. Reflux was diagnosed when echogenic bubbles were observed in the ureter or in the renal pelvis. Afterwards, conventional VCUG was performed. Concordant findings were obtained in 210 of 224 ureterorenal units (93.7%). Reflux was excluded by both methods in 174 units (77.7%). With the VCUG as the reference, the sensitivity of VUS was 90%, the specificity 94.6%, the positive predictive value 78.3%, and the negative predictive value 97.8%. The accuracy was 93.7%. In conclusion, VUS with ultrasonography contrast medium is a reliable diagnostic tool for the detection of VUR in children.
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PMID:Voiding urosonography with ultrasonography contrast medium in children. 1195 81

Voiding cystourethrography (VCUG) has long been the method of choice for the diagnosis of vesicoureteral reflux (VUR). Especially in the course of conservative treatment, the radiation dose involved might become quite high over the years. Since the development of such ultrasound echo-enhancing agents as Levovist (Schering, Germany), we now have the ability to assess the diagnostic efficacy of this agent in the evaluation of VUR with a view to replacing VCUG with the radiation-free ultrasound methodology. A total of 104 children with a mean age of 5.4 years were examined using echo-enhancing ultrasound after informed consent had been obtained from their parents. For control purposes, all children were examined by standard VCUG as well. The diagnosis of VUR was judged to be positive when microbubbles appeared in the ureter or renal pelvis. Correlations were sought between the sonographic findings and those obtained by standard VCUG. In 76 (37%) of the 208 ureter-kidney units investigated, VUR was detected by both technologies. VUR was diagnosed by ultrasonography only in 5 units and by VCUG only only in 3 units. All reflux grades (I-V) were identified. The specificity and sensitivity of the contrast reflux ultrasound were significantly high. The long contrast time of up to 30 min combined with the high contrast effect resulted in convincing images with high levels of diagnostic confidence. Our results clearly demonstrate that the safety and accuracy of the diagnosis of VUR by means of contrast-enhanced ultrasound is statistically comparable to those of standard radiologic VCUG. Therefore, this methodology is an exceptional approach to reducing the number of children being exposed to ionising radiation especially during conservative follow-up of children with reflux.
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PMID:[Contrast-medium enhanced reflux ultrasound in children. A comparison with radiologic imaging up to now]. 1252 41

Voiding urosonography (VUS) using a microbubble contrast agent has been introduced as an alternative technique in the diagnosis of vesicoureteral reflux (VUR). This study was undertaken to assess if phase inversion ultrasound (PIUS), a recent microbubble specific imaging technique, has advantages over fundamental in VUS and if it allows a reduction of contrast agent dose. Forty-three children with suspected VUR (aged 3 days-12 years, average of 3.9 years) with 92 kidney-ureter units (KUU) were included. Everyone obtained a baseline US scan that was followed by VUS using Levovist as the contrast agent. Constant switching between fundamental and PIUS performed the enhanced part for comparison. Every child underwent VCUG immediately afterwards. Contrast enhancement was stronger and longer lasting on PIUS than on fundamental US in all 43 cases. Reflux was detected in a total of 21 KUU, out of 92 KUU (23%). PIUS revealed VUR in 18; fundamental in 14 KUU and VCUG depicted 16 cases of reflux (p> or =0.29). The mean volume of Levovist dose administered to the bladder was 7.4+/-3.4% of the bladder volume. VUS using PI mode provided considerably stronger and longer enhancement and slightly improved the detection of VUR. It allowed a reduction of contrast dose and cost by approximately 35% over current dose recommendations for fundamental US.
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PMID:Low contrast dose voiding urosonography in children with phase inversion imaging. 1523 11