3D/4D contrast-enhanced urosonography (ceVUS) in children – is it superior to the 2D technique?

• Published in: Journal of ultrasonography Vol. 18; no. 73; pp. 120 - 125
• Main Authors: Woźniak, Magdalena Maria, Osemlak, Paweł, Ntoulia, Aikaterini, Borzęcka, Halina, Bieniaś, Beata, Brodzisz, Agnieszka, Jędrzejewski, Grzegorz, Drelich-Zbroja, Anna, Powerski, Maciej, Pech, Maciej, Wieczorek, Andrzej Paweł
• Format: Journal Article
• Language: English
• Published: Poland Sciendo 01.01.2018; Exeley Inc
• Subjects: children; contrast agents; Medicine; ultrasound; urinary tract infections; vesicoureteral reflux; children; contrast agents; vesicoureteral reflux; ultrasound; urinary tract infections
• ISSN: 2084-8404; 2451-070X
• DOI: 10.15557/jou.2018.0017

By now, two-dimensional contrast-enhanced voiding urosonography (ceVUS) has become a well-established method for the diagnosis and treatment monitoring of vesicoureteral reflux in children, particularly after the recent approval for this application in children in the USA and in Europe. The introduction of three-dimensional static (3D) and real-time (4D) techniques with ultrasound contrast agents opens up new diagnostic opportunities for this imaging modality. To analyze whether 3D and 4D ceVUS is a superior technique compared to standard 2D ceVUS in diagnosing vesicoureteral reflux in children. The study included 150 patients (mean age 3.7 years) who underwent 2D and 3D/4D ceVUS for the diagnosis and grading of vesicoureteral reflux. 2D ceVUS and 3D/4D ceVUS diagnosed the same number of vesicoureteral refluxes, however, there was a statistically significant difference in grading between the two methods. Performing 3D/4D ceVUS resulted in changing the initial grade compared to 2D ceVUS in 19 out of 107 refluxing units (17.76%) diagnosed. The 4D technique enabled a more conspicuous visualization of vesicoureteral reflux than the 3D technique. 2D ceVUS and 3D/4D ceVUS diagnosed the same number of vesicoureteral refluxes, however, there was a statistically significant difference in grading between the two methods. Thus 3D/4D ceVUS appears at least a valid, if not even a more conspicuous technique compared to 2D ceVUS.