The Diagnostic Efficacy of Abdominal Ultrasonography for Evaluation of Children with Urinary Tract Infection

Moon, Hong Sang; Woo, Young Nam

Abstract

For the evaluation of children with urinary tract infection, the effective diagnostic approach with appropriate imaging studies may be one of the most important process. But there is no definitely standardized method to evaluate these children. The author analysed the radiologic findings on 88 consecutive children with recurrent urinary tract infection to investigate the diagnostic efficacy of abdominal ultrasonography compared to conventional excretory urography and determine logical sequence of uroradiologic study in children with urinary tract infection. The results were as follows: 1 Of all the children studied, there were 37 cases of vesicoureteral reflux (VUR) with or without another urologic abnormalities such as posterior urethral valve and double collecting system, 32 cases of ureteropelvic junction obstruction (UPJ obstruction) and 1 case of multicystic kidney. 2. All cases with UPJ obstruction and multicystic kidney were diagnosed with abdominal ultrasonography. But excretory urography did not detect 2 cases of mild UPJ obstruction due to intermittent hydronephrosis 3. Of 37 cases with VUR, 3 cases were not detected with abdominal ultrasonography and 5 cases were not detected with excretory urography 4. Of all the cases studied, 18 cases did not have any anatomical abnormalities. In these cases, abnormal findings on excretory urography and ultrasonography were detected in 2 and 3 cases, respectively 5. In the evaluation of anatomical abnormalities in the patient of recurrent UTI, combined radiologic study of ultrasonography and voiding cystourethrography has the same efficacy as excretory urography and voiding cystourethrography. These results suggest that abdominal ultrasonography may be more effective than excretory urography in the evaluation of children with urinary tract infection. And both ultrasonography and excretory urography are relatively insensitive for detecting reflux and its sequel. So in the evaluation of children with urinary tract infection, voiding cystourethrography and ultrasonography should be performed initially. And excretory urography could be performed for selected cases.