超声造影对小儿膀胱输尿管反流诊断价值的初步探讨

Evaluation of contrast-enhanced ultrasound in the diagnosis of vesicoureteral reflux in children

目的评价排尿膀胱尿道超声造影检查小儿膀胱输尿管反流（VUR）的诊断价值。方法应用对比脉冲序列超声造影技术对53例反复尿路感染的患儿进行超声造影检查，观察膀胱、输尿管及肾的声像图表现，用五级法分析评价，并以排尿膀胱尿道造影术（VUCG）对照。结果53例患者中超声造影检出19例（36个肾输尿管单位），VCUG检出18例（34个肾输尿管单位），超声造影及VCUG对VUR的分级检出一致性为31个肾输尿管单位，阴性检出一致性为69个肾输尿管单位。超声造影和VCUG对VUR的检查有很高的一致性（Kappa值=0．909）。结论超声造影能敏感检测出VUR，同时无放射性，重复性好，可作为VUR的首选检查方法之一。

Objective To evaluate the usefulness of contrast-enhanced ultrasonography （CEUS） in diagnosing and grading vesicoureteral reflux （VUR）. Methods Fifty three children who had recurrent urinary tract infections were prospectively examined using CEUS with contrast pulse sequence mode via intravesical administration of the contrast agent （SonoVue）. The CEUS findings of bladder,retrovesical space and each kidney were observed,graded in five steps, which were compared with voiding cytourethrography （VCUG）. Results Ninteen cases（36 reno-ureteral units） was confirmed the presence of VUR by CEUS and 18 cases（34 reno-ureteral units） were confirmed by VCUG. CEUS and VCUG results were in agreement in 31 reno-ureteral units with VUR and 69 reno-ureteral units without VUR. A high agreement was seen between CEUS and VCUG （Kappa =0.909）. Conclusions CEUS is a sensitive and easy technique for the evaluation of VUR and can avoid the radiation using by VCUG.