All issues > Volume 33(3); 1990

Original Article

J Korean Pediatr Soc. 1990;33(3):332-340. Published online March 31, 1990.

Comparison of the 3-Imaging Procedures (IVP,VCUG & USG) on Children with Urinary Tract Infection.

Min Hee Yeo¹, Won Yeob Kim¹, Jee Sung Kim¹, Sang Geel Lee¹, Im Ju Kang¹

¹Department of Pediatrics, Tagu Fatima Hospital, Taegu, Korea

Received: July 4, 1989;  Accepted: October 10, 1989.

Abstract

This study was performed in 106 childrens with urinary tract infection who were admitted to Pediatric Department of Fatima Hospital during 2 1/2 years period from January 1986 to June 1988. Each patient was evaluated in three imaging procedures: intravenous pyelography (IVP), voiding cystourethrography (VCUG) and ultrasonography (USG). 1) Of 106 cases, 59 cases (55.7%) were normal on the three imaging procedures (IVP, VCUG, USG), whereas abnormality was seen in 47 cases (44.3%) detected by any of the three imaging procedures. Of the 47 cases, 31 cases were abnormal demonstrated on USG, 33 cases on IVP, 31 cases on VCUG respectively. 2) Renal ultrasonography and IVP correlated well in 80 of the 106 patients. One by one analysis of the 26 patients in where there was discrepancy between the two diagostic modes indicates the following, one case of hydronephrosis, 5 cases of double collecting system, 5 cases of ureteral dilatation, 7 cases of renal scar, one case of ureterocele and 2 cases of ureteral stone were not detected on the ultrasonography. And 5 cases of hydronephrosis and one cases of renal carbuncle were not shown of IVP. 3) Of 31 cases of vesicoureteral reflux detected on VCUG, 54.8% was also demonstrated on IVP. 4) Ultrasonography combined with VCUG did not disclose only 2 cases of ureteral stone and 2 cases of double collecting system which were detected on IVP. 5 cases of hydronephrosis combined with vesicoureteral reflux were not demonstrated on IVP which were also detected on the VCUG & USG. In summary, the present study confirms the observation that ultrasonography can usefully replace IVP as a screening imaging procedure in the initial radiologic evaluation of children with urinary tract infection, althrough renal ultrasonography may be inferior to IVP in imaging some details such as double collecting system and renal scarring. By this approach, the need for IVP in children with urinary tract infection will be reduced. For detecting the presence of reflux which can cause renal scarring, we recommand that VCUG should be the essential radiologic study performed on young children with urinary tract infection.

Keywords :IVP, VCUG, USG, Urinary tract infection