CAJ | 학술논문

目的探讨Sonovue排泄性尿路超声造影（VUS）评估膀胱输尿管返流（VUR）的价值。方法纳入36例[共72个肾盂-输尿管单位（Pyelo-Ureter Units, PUUs）]临床疑为膀胱输尿管返流且同时进行了VUS和排泄性X线膀胱尿路造影（VCUG）的儿童病人。比较VUS和VCUG发现VUR的敏感性和一致性。根据返流分级标准比较两者判断返流分级的一致性。结果72个PPUs，VUS发现26个PUUs（36.1%，26/72），而VCUG发现21个PUUs（29.2%）存在返流，两者对返流检出率的差异无统计学意义（P=0.347）。65个PUUs（90.3%，65/72）的结果在两种方法完全一样（McNemar检验，Kappa值=0.843），表明两者的一致性较好。另外，VUS经会阴部观察还显示了2个病例的后尿道瓣膜。结论 Sonovue介导的VUS在检测和分级膀胱输尿管反流上不差于甚至优于VCUG，且更安全，应该作为膀胱输尿管返流的首选筛查和随访工具。另外，VUS经会阴部观察对评估后尿道病变也有一定帮助。
목적탐토Sonovue배설성뇨로초성조영（VUS）평고방광수뇨관반류（VUR）적개치。방법납입36례[공72개신우-수뇨관단위（Pyelo-Ureter Units, PUUs）]림상의위방광수뇨관반류차동시진행료VUS화배설성X선방광뇨로조영（VCUG）적인동병인。비교VUS화VCUG발현VUR적민감성화일치성。근거반류분급표준비교량자판단반류분급적일치성。결과72개PPUs，VUS발현26개PUUs（36.1%，26/72），이VCUG발현21개PUUs（29.2%）존재반류，량자대반류검출솔적차이무통계학의의（P=0.347）。65개PUUs（90.3%，65/72）적결과재량충방법완전일양（McNemar검험，Kappa치=0.843），표명량자적일치성교호。령외，VUS경회음부관찰환현시료2개병례적후뇨도판막。결론 Sonovue개도적VUS재검측화분급방광수뇨관반류상불차우심지우우VCUG，차경안전，응해작위방광수뇨관반류적수선사사화수방공구。령외，VUS경회음부관찰대평고후뇨도병변야유일정방조。
Objective To assess the value of voiding urosonography (VUS) with SonoVue in evaluation of vesicoureteral reflux. Methods Thirty-six pediatric patients (72 pyeloureter units [PUUs]) suspected of vesicoureteral reflux underwent both VUS and fluoroscopic voiding cystourethrography (VCUG). The sensitivity of VUS and VCUG and their consistency in detecting vesicoureteral reflux as well as in grading vesicoureteral reflux were compared. Results Vesicoureteral reflux was detected in 26 of the 72 PUUs (36.1%) by VUS while in 21 PUUs (29.2%) by VCUG (P=0.347). The two modalities yielded the same results for 65 PUUs (κ=0.843), showing a very good consistency between them. VUS also detected post-urethral valve in 2 patients via transperineal scans. Conclusion VUS with Sonovue has at least comparable, if not better, sensitivity in detecting vesicoureteral reflux with VCUG, and therefore should serve as the primary screening and follow-up modality for vesicoureteral reflux. In addition, transperineal VUS can be helpful in evaluation of post-urethral lesions.