The appearance of dextranomer–hyaluronic acid copolymer implants on ultrasound may predict resolution of vesicoureteral reflux after injection therapy
| Autor: | Tae Yeon Jeon, Kyoung Doo Song, K.J. Park, Jong-Moon Kim, So-Young Yoo, Hong Eo |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Adolescent media_common.quotation_subject Urination Vesicoureteral reflux Injections Ureter Predictive Value of Tests Humans Medicine Radiology Nuclear Medicine and imaging Hyaluronic Acid Child Retrospective Studies Ultrasonography media_common Vesico-Ureteral Reflux medicine.diagnostic_test business.industry Ultrasound Reflux Infant Dextrans Cystoscopy Prostheses and Implants General Medicine medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Child Preschool Predictive value of tests Female Implant business Nuclear medicine |
| Zdroj: | Clinical Radiology. 69:939-944 |
| ISSN: | 0009-9260 |
| Popis: | Aim To investigate the correlation between implant appearance on ultrasound (US) and voiding cystourethrography (VCUG) results after dextranomer–hyaluronic acid copolymer (DxHA) injection in children with vesicoureteral reflux (VUR). Materials and methods Consecutive cases of primary VUR treated by endoscopic subureteral injection of DxHA were retrospectively reviewed. All children had postoperative bladder US and VCUG with a mean interval of 34 days and 47 days after injection, respectively. VUR resolution at postoperative VCUG was considered as treatment success. Implant appearance on US was graded according to the retained volume and its location by visual inspection; it was then correlated with VCUG results using the Spearman correlation coefficient. Results A total of 36 children (56 ureters) were identified in which 38 ureters (68%) had a clearly visualized implant on postoperative US and 40 ureters (71%) showed VUR resolution. The sensitivity of implant visualization on US for predicting reflux resolution was 73% (29/40), specificity 44% (7/16), positive predictive value 76% (29/38), and negative predictive value 39% (7/18). The grade 1, grade 2, and grade 3 implant appearances showed VUR resolution in 88% (22/25), 54% (7/13), and 61% (11/18), and showed persistent VUR in 8% (2/25), 15% (2/13), and 28% (5/18), respectively (p = 0.032). Conclusion The implant appearance on postoperative US showed good correlation with VCUG results in the early post-injection period. Large retained implants were associated with treatment success, while small or non-visualized implants were related to the persistent reflux. |
| Databáze: | OpenAIRE |
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