ผลการตรวจวินิจฉัยทางรังสีวิทยาในผู้ป่วยเด็กที่มีการติดเชื้อระบบทางเดินปัสสาวะที่มีไข้

บทคัดย่อ

          Objective: This study assessed the value of imaging studies, both renal ultrasonogram and voiding cystourethrogram, after the diagnosis of a febrile urinary tract infection in children age below 5 years.

          Materials and Method:  This study was prospective study in children age below 5 years involving 50 children who had the diagnosis of a febrile urinary tract infection. A renal ultrasonogram was performed within 2-3 days after diagnosis and voiding cystourethrogram was performed 4-6 weeks later.

          Results: The results of imaging studies were normal in 72% of the children (36 of 50). Ureteropelvic junction obstruction was diagnosed in one child. Veslcoureteral reflux (VUR) was diagnosed in 26% of the children (13 of 50, unilateral VUR in 6 children, bilateral VUR in 7 children). In total  20 kidneys of VUR, grade I VUR and grade ll VUR had 100% of normal renal ultrasonogram (4 of 4 kidneys), grade Ill VUR had 90% of normal renal ultrasonogram (9 of 10 kidneys), grade IV VUR had 67% of normal renal ultrasonogram (4 of 6 kidneys).

          Conclusion:  Renal ultrasonogram and voiding cystourethrogram should be performed after the diagnosis of a febrile urinary tract infection in children age below 5 years. However, a renal ultrasonogram is not sensitive enough to detect the presence of vesicoureteral reflux but it help us to diagnose ureteropelvic junction obstruction in some cases. Voiding cystourethrogram is useful for identify and grading of vesicoureteral reflux.