Diagnostic Accuracy of Ultrasound in Vesicoureteral Reflux in Children with Urinary Tract Infection at Nakornping Hospital
Keywords:
การติดเชื้อในทางเดินปัสสาวะ, ภาวะปัสสาวะไหลย้อนกลับ, อัลตราซาวด์, , การตรวจ Voiding cystourethrograhy HydronephrosisAbstract
The objective of this analytic study was to evaluate the accuracy of ultrasound in diagnosis of vesicoureteral reflux(VUR) compared to voiding cystourethrography (VCUG), taking both hydronephrosis and abnormal age-adjusted renal length into account. A retrospective review of 97 pedatric patients, age 0-15 years, 49 male and 48 female, with urinary tract infection (UTI) who underwent both ultrasound and VCUG in Nakornping Hospital from I October 2005 to 30 September 2008 was per formed.
Abnormal ultrasound findings suggesting VUR (Hydronephrosis and / or small size of one or both kidneys) were found in 38 patients (39.2%) and VUR (confirmed by VCUG) occurred in 11 out of these 38 patients (28.9%), and in 4 out of 59 patients (7.3%) with normal kidneys. The sensitivity, specificity, positive predictive value, negative predictive value and false negative rate of ultrasound in suggesting VUR were 73.3%, 67.1% , 28.9%, 93.2% and 26.7%, respectively. P-value-0.033
In conclusion, ultrasound could not accurately diagnose VUR because there was only 28.9% of reflux in the patient with abnormal renal ultrasound, however, the possibility of having reflux was quite low in normal renal ultrasound (Negative predictive value=93.2%) and would be useful for pediatricians and general practitioners in radiologic investigation.
References
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