排泄性尿路超声造影在儿童膀胱输尿管返流诊断中的应用

Contrast-enhanced Voiding Urosonography with Intravesical Administration of Ultrasound Contrast Agent for Diagnosis of Pediatric Vesicoureteral Reflux

目的探讨排泄性尿路超声造影(CeVUS)在儿童膀胱输尿管返流(VUR)诊断中的临床应用。方法华中科技大学同济医学院附属同济医院儿科肾病中心2016年8月~2016年12月收治的VUR高危风险患儿,使用超声造影剂SonoVue经导尿管膀胱内给药进行CeVUS检查,分析CeVUS在VUR诊断中的应用情况。结果纳入38例患儿,共77个肾盂-输尿管单位(PUUs)。经CeVUS检查,38例患儿中诊断VUR 18例(47.4%)。77个PUUs中诊断VUR27个(35.1%),其中Ⅰ度VUR 3个(11.1%),Ⅱ度3个(11.1%),Ⅲ度7个(25.9%),Ⅳ度7个(25.9%),Ⅴ度7个(26.0%)。无不良事件发生。结论 CeVUS检查安全、准确且阳性率高,CeVUS可作为包括新生儿在内的儿童VUR筛查和随访的首选检查。

Objective To analyze clinical application of contrast-enhanced voiding urosonography(CeVUS)in the diagnosis of pediatric vesicoureteric reflux(VUR).Methods From August to December in 2016 in Pediatric Nephrology Center of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology,children with high risk of VUR underwent CeVUS using ultrasound contrast agent(SonoVue)administered intravesically through transurethral bladder catheterization.CeVUS and VUR results were analyzed.Results Thirty-eight children and 77 pelvi-ureter units(PUUs)were included.VUR was detected in 18 of the 38 pediatric patients(47.4%)and 27 of the 77 PUUs(35.1%)by CeVUS.VUR grade distribution of the 27 PUUs were as follows:gradeⅠ=3(11.1%),gradeⅡ=3(11.1%),gradeⅢ=7(25.9%),gradeⅣ=7(25.9%),grade Ⅴ =7(26.0%).No adverse events occurred.Conclusion CeVUS is safe and accurate with high positive rate.CeVUS can be used as the primary screening and follow-up examination for VUR diagnosis of children including neonates.