Validity of the Ultrasonography Findings for Screening Vesicoureteral Reflux in Children With Urinary Tract Infection Publisher



Pournasiri Z¹ ; Mirmohammadkhani M² ; Pourpashang P^{3, 4}
Source: Journal of Pediatrics Review Published:2025

Abstract

Background: Rapid diagnosis and treatment of urinary tract infection (UTI) in children are mandatory. One of the main causes of vesicoureteral reflux (VUR) is UTI. The primary diagnostic procedure for evaluating VUR in children is voiding cystourethrography (VCUG). Radionuclide cystography (RNC) is an alternative sensitive method. Objectives: This study aimed to evaluate the validity of ultrasonography (US) for screening and predicting VUR in children with UTI. Methods: This cross-sectional study was conducted in Loghman Hakim and Mofid hospitals, Tehran City, Iran, in 2024. We analyzed the data of children with UTI who had a US with or without VUR based on VCUG or RNC. Sensitivity and specificity were calculated to evaluate the diagnostic validity of the US in determining VUR. Kappa statistic was used to examine the agreement between the two methods. The chi-square test was used to compare the proportions. P<0.05 was considered significant in statistical tests. Results: In this study, 183 children (119 girls [65%] and 64 boys [35%]) with a Mean±SD age of 6.98±4.07 years were assessed. Of 183 eligible children examined by the US, 80(43.7%) were reported as normal, 63(34.4%) and 82(44.8%) were reported to have abnormalities in their right and left urinary systems, respectively. Also, 42 children (23%) had abnormalities on both sides. Regarding VUR, 39 children (21.3%) were normal, and the rest had some reflux. The sensitivity and specificity of US were 60.4% and 58.9%, respectively. The level of agreement between the two methods in terms of kappa was “none” to “slight” (k=0.14, P=0.003). Conclusions: Despite all the advantages, US is not suitable for a definitive diagnosis of VUR and lacks a proper diagnostic sensitivity. So, VCUG is still preferable despite its disadvantages. © 2025 The Author(s);.