Korean J Nucl Med.  2000 Apr;34(2):135-143.

Pred ictive Efficacy of Radioisotope Voiding Cystography for Renal Outcome

• Kim SK
• Lee DS
• Kim KM
• Choi W
• Chung JK
• Lee MC

Abstract

PURPOSE: As vesicoureteral reflux (VUR) could lead to renal functional deterioration when combined with urinary tract infection, we need to decide whether operative anti-reflux treatment should be performed at the time of diagnosis of VUR. Predictive value of radioisotope voiding cystography (RIVCG) for renal outcome was tested.
MATERIALS AND METHODS
In 35 children (18 males, 17 females), radiologic voiding cystourethrography (VCU), RIVCG and DMSA scan were performed. Change in renal function was evaluated using the follow-up DMSA scan, ultrasonography, and clinical information. Discriminant analysis was performed using individual or integrated variables such as reflux amount and extent at each phase of voiding on RIVCG, in addition to age, gender and cortical defect on DMSA scan at the time of diagnosis. Discriminant function was composed and its performance was examined.
RESULTS
Reflux extent at the filling phase and reflux amount and extent at postvoiding phase had a significant prognostic value. Total reflux amount was a composite variable to predict prognosis. Discriminant function composed of reflux extent at the filling phase and reflux amount and extent at postvoiding phase showed better positive predictive value and specificity than conventional reflux grading.
CONCLUSION
RIVCG could predict renal outcome by disclosing characteristic reflux pattern during various voiding phases.

Keyword

vesicoureteral reflux; radioisotope voiding cystography; renal outcome

MeSH Terms

Child
Diagnosis
Follow-Up Studies
Humans
Male
Prognosis
Sensitivity and Specificity
Succimer
Ultrasonography
Urinary Tract Infections
Vesico-Ureteral Reflux
Succimer