Studies comparing voiding urosonography (VUS) with voiding cystourethrography (VCUG) and direct radionuclide cystography (DRNC) were analyzed and detailed tables demonstrating the diagnostic values and grading of vesicoureteric reflux (VUR) are presented. Comparative studies of DRNC were too few and did not allow definite conclusions. Using VCUG as the reference, the results of VUS were as follows: sensitivity 57-100%, specificity 85-100%, positive/negative predictive values 58-100%/87-100%, respectively, and diagnostic accuracy 78-96%. With the exception of two studies the diagnostic accuracy reported was 90% and above. In 19% of pelviureteric units (PUUs) the diagnosis was made only by VUS and in 10% only by VCUG. Thus in 9% of PUUs more refluxes were detected using VUS. In 73.6% the reflux grades were concordant in VUS and VCUG. Reflux grade was found to be higher with VUS than with VCUG in 19.6% of PUUs. In 71.2% of PUUs with grade I reflux on VCUG, the reflux was found to be grade II and higher on VUS. The common selection criteria for VUS as the primary examination for VUR currently include (a) follow-up studies, (b) first examination for VUR in girls, and (c) screening high-risk patients.

译文

分析了排尿超声检查 (VUS) 与排尿膀胱尿道造影 (VCUG) 和直接放射性核素膀胱造影 (DRNC) 的比较研究,并给出了详细的表格,证明了膀胱输尿管反流 (VUR) 的诊断价值和分级。DRNC的比较研究太少,无法得出明确的结论。以VCUG为参照,VUS的结果如下: 敏感性57-100%,特异性85-100%,阳性/阴性预测值58-100%/87-100%,诊断准确性78-96%。除两项研究外,报告的诊断准确性90% 以上。在骨盆单位 (PUUs) 的19% 中,仅由VUS进行诊断,10% 仅由VCUG进行诊断。因此,在PUUs 9% 中,使用VUS检测到更多的回流。在73.6% 中,回流等级在VUS和VCUG中一致。发现19.6% PUUs时,VUS的回流等级高于VCUG。在VCUG上具有I级回流的PUUs 71.2% 中,发现回流为II级且在VUS上更高。VUS作为VUR主要检查的通用选择标准目前包括 (a) 随访研究,(b) 对女孩进行VUR的首次检查以及 (c) 筛查高危患者。

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