Diagnostik des vesikoureterorenalen Refluxes – MUS vs. MCU

ZUSAMMENFASSUNG

Zur Diagnose eines vesikoureterorenalen Reflux existieren verschiedene bildgebende Verfahren. Ziel des Beitrages ist es, das Vorgehen bei der Miktionsurosonografie (MUS) und der Miktionszysturethrografie (MCU) aufzuzeigen und ihre jeweiligen Vor- bzw. Nachteile beim Einsatz im Kindes- und Jugendalter darzulegen.

ABSTRACT

There are various imaging modalities for the diagnosis of vesicoureterorenal reflux. Aim of this paper is to present voiding urosonography (VUS) and voiding cysturethrography (VCUG) and to discuss their advantages and disadvantages in children.

Schlüsselwörter

Vesikoureterorenaler Reflux - Miktionsurosonografie - Miktionszysturethrografie - Harnwegsinfektion - subvesikale Obstruktion - Strahlenexposition

Keywords

Vesicoureterorenal reflux - voiding urosonography - voiding cysturethrography - urinary tract infection - subvesical obstruction - ionizing radiation

Publication History

Received: 16 July 2020

Accepted: 03 August 2020

Article published online:
25 February 2021

• Literatur

• 1 Lebowitz RL, Olbing H, Parkkulainen KV. et al International system of radiographic grading of vesicoureteric reflux. Pediatr Radiol 1985; 15: 105-109
• 2 Shaikh N, Spingarn RB, Hum SW. Dimercaptosuccinic acid scan or ultrasound in screening for vesicoureteral reflux among children with urinary tract infections. Cochrane Database Syst Rev 2016: 7
• 3 Edwards A, Peters CA.. Managing vesicoureteral reflux in children: making sense of all data. F1000 Research. 2019
• 4 Asanuma H, Matsui Z, Satoh H. et al Color Doppler ultrasound evaluation of ureteral jet angle to detect vesicoureteral reflux in children. J Urol 2016; 195: 1877-1882
• 5 Alzen G, Wildberger JE, Müller-Leisse C. et al Ultrasound screening of vesico-uretero-renal reflux. Klin Pediatr 1994; 206: 178-180
• 6 Darge K, Dütting T, Zieger B. et al Diagnosis of vesicoureteral reflux with echo-enhanced micturition urosonogaphy. Radiologe 1998; 38: 405-409
• 7 Mentzel HJ, Vogt S, Patzer L. et al Contrast-enhanced sonography of vesicoureterorenal reflux in children: preliminary results. Am J Roentgenol 1999; 173: 737-740
• 8 https://www.ema.europa.eu/en/documents/product-information/sonovue-epar-product-information_en.pdf
• 9 Waginger M, Mentzel HJ. Refluxdiagnostik – Pro MUS. Akt Urol 2020; 51: 145-150
• 10 Darge K. Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children. I. Procedure. Pediatr Radiol 2008; 38: 40-53
• 11 Darge K, Troeger J. Vesicoureteral reflux grading in contrast-enhanced voiding urosonography. Eur J Radiol 2002; 43: 122-128
• 12 Riccabona M, Vivier PH, Ntoulia A. et al ESPR Uroradiology Task Force. ESPR uroradiology task force imaging recommendations in paediatric uroradiology part VII. Standardized terminology, impact of existing recommendations, and update on contrast-enhanced ultrasound of the paediatric urogenital tract. Pedidatr Radiol 2014; 44: 1478-1484
• 13 Duran C, Beltrán VP, González A. et al Contrast-enhanced voiding urosonography for vesicoureteral reflux diagnosis in children. Radiographics 2017; 37: 1854-1869
• 14 Papadopoulou F, Ntoulia A, Siomou E. et al Contrast-enhanced voiding urosonography with intravesical administration of a second-generation ultrasound contrast agent for diagnosis of vesicoureteral reflux: prospective evaluation of contrast safety in 1,010 children. Pediatr Radiol 2014; 44: 719-728
• 15 Chua ME, Mendoza JS, Ming JM. et al Diagnostic accuracy of contrast-enhanced voiding urosonogram using second-generation contrast with harmonic imaging (CEVUS-HI) study for assessment of vesicoureteral reflux in children: a meta-analysis. World J Urol 2019; 37: 2245-2255
• 16 Riccabona M, Avni FE, Blickman JG. et al Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography. Barcelona, Spain, June 2007. Pediatr Radiol 2008; 38: 138-145
• 17 Beetz R. Refluxdiagnostik – Stellenwert des Miktionszystourethrogramms. Akt Urol 2020; 51: 137-144
• 18 Schaeffer AJ, Greenfield SP, Ivanova A. et al Reliability of grading of vesicoureteral reflux and other findings in voiding cystourethrography. J Pediatr Urol 2017; 13: 192-198
• 19 https://www.bfs.de/SharedDocs/Downloads/BfS/DE/fachinfo/ion/drw-roentgen.pdf
• 20 Schultz F, Geleijns J, Holscher H. et al Radiation burden to paediatric patients due to micturationg cystourethrography examinations in a Dutch children’s hospital. Br J Radiol 1999; 72: 763-772
• 21 Linke SYS, Tsiflikaas I, Herz K. et al Ultra low-dose VCUG in children using a modern flat detector unit. Eur Radiol 2016; 26: 1678-1685
• 22 Kopac M, Riccabona M, Haim M. Contrast-enhanced voiding urosonography and genitography in a baby with ambiguous genitalia and urogenital sinus. Ultraschall in Med 2009; 30: 299-300
• 23 Velasquez M, Emerson MG, Diaz E. et al The learning curve of contrast-enhanced ‚microbubble‘ voiding urosonography – validation study. J Pediatr Urol 2019: 15
• 24 Sauer A, Wirth C, Platzer I. et al Off-label use of sulfur-hexafluoride in voiding urosonography for diagnosis of vesicoureteral reflux in children: A survey on adverse events. World J Clin Pediatr 2017; 6: 52-59