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目的探讨超声造影技术(contrast-enhanced ultrasonography,CEUS)在小儿膀胱输尿管反流(vesicoureteral reflux,VUR)中的临床诊断价值。方法本试验选择46例临床可疑VUR患儿,应用对比脉冲序列超声造影技术(contrastpulsed sequence,CPS),经膀胱腔注入SonoVue造影剂后,实时观察造影剂微泡在反流病例中尿路的流动过程,分析评价反流程度,并与排泄性膀胱尿路造影技术(voiding cystoureterogram,VCUG)进行对照。结果 46例患儿CEUS检出VUR19例33支输尿管反流,VCUG检出17例30支输尿管反流。CEUS对VUR检出准确率为94.5%,敏感性和特异性分别为96.7%、93.5%。两种检查方法对VUR的分级评价一致性较高(Kappa值=0.83)。结论 CEUS对VUR检测的敏感性及特异性均较高,与VCUG方法具有较好的一致性,对小儿VUR的诊断、筛查及随访具有重要临床意义。
Objective To investigate the clinical value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of vesicoureteral reflux (VUR) in children. Methods 46 cases of clinically suspected VUR were selected in this study. Contrast pulse sequence contrast-enhanced ultrasound (CPS) was performed. After injection of SonoVue contrast medium into the bladder cavity, the urinary tract flow was observed in real time The extent of regurgitation was analyzed and compared with the voiding cystoureterogram (VCUG). Results In 46 cases, 33 patients with VUR were retrospectively analyzed and 33 patients with VUR were retrospectively analyzed. VCUG detected 17 patients with ureter reflux. CEUS VUR detection accuracy was 94.5%, sensitivity and specificity were 96.7%, 93.5%. The consistency of the ratings of the two methods for VUR was high (Kappa = 0.83). Conclusion CEUS has high sensitivity and specificity for detecting VUR. It has good consistency with VCUG and has important clinical significance for the diagnosis, screening and follow-up of VUR in children.