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Vezikoüreteral Reflü Tanısında Miksiyosistoüretrografinin Güvenilirliği

The Reliability of Voiding Cystourethrography in the Diagnosis of Vesicoureteral Reflux

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Abstract (2. Language): 
It is well known that the diagnosis of vesicoureteral reflux (VUR) in I children can be overlooked at voiding cystourethrography !VCUG}. In j this study we wanted to present the results of a second VCUG in : children with recurrent UTI and/or renal damage on DMSA-scan whose i findings at initial VCUG were normal. In this prospective study, 16 patients (15 girls, 1 boy] aged 3 to 14 j years (mean: 8.44±3.78 years} with recurrent UTI and/or renal damage | on DMSA-scan underwent repeat VCUG between April 1, 2001 and i January 31, 2003. All patients seemed normal on initial VCUG. The j average time interval between initial and second VCUG was 17.31+10.65 j months (range: 7-41 months}. An abnormal renal scan was observed in : 12 (75%) of 16 patients. All patients had had recurrent UTI during the j follow-up period. Among the 16 patients, 11 (68.75%) had an abnormal j repeat VCUG (Grade II VUR in 3 patients, Gr. Ill VUR in 3, Gr. IV VUR in '•• 4 patients and Gr. V in 1 patient). In conclusion, VUR sometimes can be overlooked by VCUG. Those j children who have normal VCUG with recurrent UTI and/or abnormal j scan should undergo a second VCUG.
Abstract (Original Language): 
idrar yolu enfeksiyonu (İVE) saptanan çocuklarda miksiyoststoüret-rografi (MSUG) İle vezikoüreteral reflülerin bîr kısmının saptanamadığı bilinmektedir. Bu çalışmada ilk MSUG'si normal saptanan ve izlemde yineleyen İYE ve/veya statik böbrek sintigrafisinde (DMSA) patoloji görülmesi nedeniyle MSUG'si tekrarlanan hastaların sonuçları verilmiştir. Bu prospektif çalışma Nisan 2001 ve Ocak 2003 tarihleri arasında hastanemiz Çocuk Nefroloji Polikliniğinde yineleyen İYE nedeniyle izlenen ve ilk MSUG'leri normal bulunan 16 çocuk üzerinde yapılmıştır. Hastaların 15'İ kız, Vî erkek olup; yaş ortalaması 8.44±3.78 (yaş dağılımı: 3¬14 yaş) yıldır. Bu hastalar, sık İYE görülmesi ve/veya DMSA'da enfeksiyon bulguları saptanması nedeniyle tekrar MSUG yapılmıştır. İlk MSUG ile ıekrarlanan MSUG arasındaki ortalama süre 17.31±10.65 aydır (en az 7, en çok 41 ay). Hastaların 12'sinde (%75) DMSA'da enfeksiyona ait değişiklikler saptanmıştır. MSUG'si tekrarlanan 16 hastanın 1 Tinde (%68} değişik derecelerde (3'ünde II.M, 3'ünde lll.o, 4'ünde IV.o, ve Tinde V.o} VUR saptanmıştır. Sonuç olarak, MSUG'si normal olan ve İzlemde yineleyen İYE ve/veya DMSA'da patoloji görülen İYE'li çocuklarda gözden kaçırılmış reflülerin saptanabilmesi için MSUG tekrarı akla getirilmelidir.
FULL TEXT (PDF): 
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REFERENCES

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