Elucidation of Renal Scars in Children With Vesicoureteral Reflux Using Contrast-Enhanced Ultrasound: A Pilot Study

Overview

Journal Kidney Int Rep

Publisher Elsevier

Specialty Nephrology

Date 2017 Nov 17

PMID 29142969

Citations 10

Authors

David S Hains

Harris L Cohen

M Beth McCarville

Ellen E Ellison

Amy Huffman

Stacey Glass

Aslam H Qureshi

Keith R Pierce

Ashlyn L Cahill

Ashley Dixon

Noel DeLos Santos

Affiliations

Soon will be listed here.

Abstract

Introduction: Vesicoureteral reflux is a common disorder in children but can result in kidney scarring following acute pyelonephritis. The gold standard diagnostic to detect renal scars in children is Tc-dimercaptosuccinic acid (DMSA) scintigraphy. DMSA has a number of limitations including radiation exposure, need for sedation, and radiotracer supply shortages. Contrast-enhanced ultrasound (CEUS) is a technique whereby biocompatible microspheres of inert gas are administered i.v. that reflect ultrasonography sound waves and do not involve radiation. Because the contrast agent is rapidly cleared, contrast images must be obtained within minutes of administration. CEUS has been used in a variety of organ systems, but its use in pediatric kidney diseases is limited.

Methods: In this study, we performed CEUS in 7 children with documented renal scars by radiographic imaging consistent with reflux nephropathy.

Results: In all subjects, CEUS detected all previously known radiologic abnormalities as well as detecting new areas of hypoenhancing renal parenchyma. None of the patients experienced any serious adverse events.

Discussion: This study represents the first report of using CEUS to characterize renal scars in children with reflux nephropathy. We conclude that CEUS is a highly sensitive, rapid, and cost-effective diagnostic imaging modality for detecting and monitoring renal scars in children with vesicoureteral reflux.

Citing Articles

Contrast-enhanced ultrasound in detection and follow-up of focal renal infections in children.

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Microbubbles in the belly: optimizing the protocol for contrast-enhanced ultrasound of the pediatric abdomen.

Davis L, Back S Pediatr Radiol. 2022; 53(7):1224-1236.

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Contrast-enhanced ultrasound: a comprehensive review of safety in children.

Ntoulia A, Anupindi S, Back S, Didier R, Hwang M, Johnson A Pediatr Radiol. 2021; 51(12):2161-2180.

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Comparison of Urinary Tract Dilatation and Society of Fetal Urology systems in the detection of vesicourethral reflux and renal scar.

Dogan G, Sigirci A, Cengiz A, Tasolar S, Yildiz T, Tabel Y Pol J Radiol. 2021; 86:e449-e454.

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Contrast-enhanced ultrasound of the kidneys and adrenals in children.

Back S, Acharya P, Bellah R, Cohen H, Darge K, Deganello A Pediatr Radiol. 2021; 51(12):2198-2213.

PMID: 33978799 DOI: 10.1007/s00247-020-04849-0.

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