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    방광요관역류를 가진 소아에서의 신초음파 소견 = Ultrasonographic Findings in Children with Vesicoureteral Reflux

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    https://www.riss.kr/link?id=A101470753

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    Purpose: The aim of this study is to investigate the renal ultrasonographic findings in children with vesicoureteral reflux (VUR). Methods: We retrospectively reviewed the medical records of 83 patients who were diagnosed with VUR and underwent ultrasonography at Ilsan hospital between January 2000 and December 2010. Results: Among 166 renal units, 108 (65.0%) were found to have vesicoureteral reflux (VUR). Fifty-one (73.9%) had VUR in renal units with abnormal ultrasonography (USG), whereas 57 (58.7%) had VUR in renal units with normal USG. Abnormal USG findings were independent risk factors for VUR (Odds ratio, 1.98; 95% CI, 1.01-3.89; $P$=0.045). In renal units with VUR, the number of normal USG finding was 52.8%, and the abnormal findings were as follows; increased cortical echogenicity 16.7%, hydronephrosis 17.6%, megaureter or ureter dilatation 8.3%, hydronephrosis and ureter dilatation 1.9%, duplication of ureter 1.9%, and atrophic kidney 0.9%. The prevalence of VUR was relatively higher in renal units with hydronephrosis (23/19, 82.6%), ureter dilatation (9/9, 100%), duplication of ureter (2/3, 66.6%), and atrophic kidney (1/1, 100%). Conclusion: Our study indicates that VUR was associated with abnormal USG findings. When there are abnormal USG findings such as hydronephrosis, ureter dilatation, duplication of ureter, and atrophic kidney in children with UTI, VCUG is recommended to detect VUR after controlling UTI.
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    Purpose: The aim of this study is to investigate the renal ultrasonographic findings in children with vesicoureteral reflux (VUR). Methods: We retrospectively reviewed the medical records of 83 patients who were diagnosed with VUR and underwent ultras...

    Purpose: The aim of this study is to investigate the renal ultrasonographic findings in children with vesicoureteral reflux (VUR). Methods: We retrospectively reviewed the medical records of 83 patients who were diagnosed with VUR and underwent ultrasonography at Ilsan hospital between January 2000 and December 2010. Results: Among 166 renal units, 108 (65.0%) were found to have vesicoureteral reflux (VUR). Fifty-one (73.9%) had VUR in renal units with abnormal ultrasonography (USG), whereas 57 (58.7%) had VUR in renal units with normal USG. Abnormal USG findings were independent risk factors for VUR (Odds ratio, 1.98; 95% CI, 1.01-3.89; $P$=0.045). In renal units with VUR, the number of normal USG finding was 52.8%, and the abnormal findings were as follows; increased cortical echogenicity 16.7%, hydronephrosis 17.6%, megaureter or ureter dilatation 8.3%, hydronephrosis and ureter dilatation 1.9%, duplication of ureter 1.9%, and atrophic kidney 0.9%. The prevalence of VUR was relatively higher in renal units with hydronephrosis (23/19, 82.6%), ureter dilatation (9/9, 100%), duplication of ureter (2/3, 66.6%), and atrophic kidney (1/1, 100%). Conclusion: Our study indicates that VUR was associated with abnormal USG findings. When there are abnormal USG findings such as hydronephrosis, ureter dilatation, duplication of ureter, and atrophic kidney in children with UTI, VCUG is recommended to detect VUR after controlling UTI.

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    참고문헌 (Reference)

    1 오윤수, "영아 요로감염에서 배뇨방광요도조영술 시기에 따른 방광요관역류의 발생 빈도: 두 기관 비교 연구" 대한소아신장학회 15 (15): 163-171, 2011

    2 Hsieh MH, "Urologic diagnoses among infants hospitalized for urinary tract infection" 74 : 100-103, 2009

    3 Zamir G, "Urinary tract infection: is there a need for routine renal ultrasonography?" 89 : 466-468, 2004

    4 Pattaragarn A, "Urinary tract infection in childhood. Review of guidelines and recommendations" 54 : 401-413, 2002

    5 Novljan G, "Ultrasound detection of vesicoureteral reflux in children" 184 : 319-324, 2010

    6 Hiraoka M, "Ultrasonography for the detection of ureteric reflux in infants with urinary infection" 38 : 248-251, 1996

    7 Alshamsam L, "The value of renal ultrasound in children with a first episode of urinary tract infection" 29 : 46-49, 2009

    8 Glynn B, "The risk of infection of the urinary tract as a result of micturating cystourethrography in children" 13 : 283-287, 1970

    9 Lee HY, "The efficacy of ultrasound and dimercaptosuccinic acid scan in predicting vesicoureteral reflux in children below the age of 2 years with their first febrile urinary tract infection" 24 : 2009-2013, 2009

    10 Rachmiel M, "Symptomatic urinary tract infections following voiding cystourethrography" 20 : 1449-1452, 2005

    1 오윤수, "영아 요로감염에서 배뇨방광요도조영술 시기에 따른 방광요관역류의 발생 빈도: 두 기관 비교 연구" 대한소아신장학회 15 (15): 163-171, 2011

    2 Hsieh MH, "Urologic diagnoses among infants hospitalized for urinary tract infection" 74 : 100-103, 2009

    3 Zamir G, "Urinary tract infection: is there a need for routine renal ultrasonography?" 89 : 466-468, 2004

    4 Pattaragarn A, "Urinary tract infection in childhood. Review of guidelines and recommendations" 54 : 401-413, 2002

    5 Novljan G, "Ultrasound detection of vesicoureteral reflux in children" 184 : 319-324, 2010

    6 Hiraoka M, "Ultrasonography for the detection of ureteric reflux in infants with urinary infection" 38 : 248-251, 1996

    7 Alshamsam L, "The value of renal ultrasound in children with a first episode of urinary tract infection" 29 : 46-49, 2009

    8 Glynn B, "The risk of infection of the urinary tract as a result of micturating cystourethrography in children" 13 : 283-287, 1970

    9 Lee HY, "The efficacy of ultrasound and dimercaptosuccinic acid scan in predicting vesicoureteral reflux in children below the age of 2 years with their first febrile urinary tract infection" 24 : 2009-2013, 2009

    10 Rachmiel M, "Symptomatic urinary tract infections following voiding cystourethrography" 20 : 1449-1452, 2005

    11 American Academy of Pediatrics, Committee on Quality Improvement., "Subcommittee on Urinary Tract Infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children" 103 : 843-851, 1999

    12 Weinberg B, "Sonographic sign of intermittent dilatation of the renal collecting system in 10 patients with vesicoureteral reflux" 26 : 65-68, 1998

    13 Mahant S, "Renal ultrasound findings and vesicoureteral reflux in children hospitalized with urinary tract infection" 86 : 419-420, 2002

    14 Soylu A, "Predictive value of clinical and laboratory variables for vesicoureteral reflux in children" 22 : 844-848, 2007

    15 Zerin JM, "Postprocedural symptoms in children who undergo imaging studies of the urinary tract: is it the contrast material or the catheter?" 182 : 727-730, 1992

    16 Kass EJ, "Pediatric urinary tract infection and the necessity of complete urological imaging" 86 : 94-96, 2000

    17 Berrocal T, "Mild hydronephrosis in newborns and infants: can ultrasound predict the presence of vesicoureteral reflux" 22 : 91-96, 2007

    18 Kenney IJ, "Is sonographically demonstrated mild distal ureteric dilatation predictive of vesicoureteric reflux as seen on micturating cystourethrography?" 32 : 175-178, 2002

    19 Hannula A, "Imaging the urinary tract in children with urinary tract infection" 2011

    20 Foresman WH, "Does urinary tract ultrasonography at hospitalization for acute pyelonephritis predict vesicoureteral reflux?" 165 : 2232-2234, 2001

    21 Hansson S, "Dimercaptosuccinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infection" 172 : 1071-1073, 2004

    22 Smellie JM, "Development of new renal scars : a collaborative study" 290 : 1957-1960, 1985

    23 Salih M, "Color flow Doppler sonography in the diagnosis of vesicoureteric reflux" 26 : 93-97, 1994

    24 Ismaili K, "Characteristics of first urinary tract infection with fever in children: a prospective clinical and imaging study" 30 : 371-374, 2011

    25 Weiss R, "Characteristics at entry of children with severe primary vesicoureteral reflux recruited for a multicenter, international therapeutic trial comparing medical and surgical management. The international Reflux Study in children" 148 : 1644-1649, 1992

    26 강희경, "6개월 미만 영아 요로 감염의 특성과 재발의 위험인자" 대한소아신장학회 8 (8): 223-228, 2004

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