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The ABCs of Voiding Cystourethrography

배뇨방광요도조영술의 기초

  • Yu Jin Kim (Department of Radiology, Chungbuk National University Hospital) ;
  • Bum Sang Cho (Department of Radiology, Chungbuk National University Hospital) ;
  • Junghwan Lee (Department of Radiology, Chungbuk National University Hospital) ;
  • Hyeonmi Ryu (Department of Radiology, Chungbuk National University Hospital) ;
  • Honggwon Byun (Department of Radiology, Chungbuk National University Hospital) ;
  • Miran Yeon (Department of Radiology, Chungbuk National University Hospital) ;
  • Yeongtae Park (Department of Radiology, Chungbuk National University Hospital) ;
  • Changhoon Oh (Department of Radiology, Chungbuk National University Hospital) ;
  • Younghun Jeon (Department of Radiology, Chungbuk National University Hospital)
  • 김유진 (충북대학교병원 영상의학과) ;
  • 조범상 (충북대학교병원 영상의학과) ;
  • 이정환 (충북대학교병원 영상의학과) ;
  • 류현미 (충북대학교병원 영상의학과) ;
  • 변홍권 (충북대학교병원 영상의학과) ;
  • 연미란 (충북대학교병원 영상의학과) ;
  • 박영태 (충북대학교병원 영상의학과) ;
  • 오창훈 (충북대학교병원 영상의학과) ;
  • 전영훈 (충북대학교병원 영상의학과)
  • Received : 2019.02.11
  • Accepted : 2019.07.31
  • Published : 2020.01.01

Abstract

Voiding cystourethrography (VCUG) demonstrates the anatomy of the urinary system and is used to detect the presence/absence of vesicoureteral reflux. It is the most important modality for urological fluoroscopic examination in children. For improved patient care, it is important to understand and perform VCUG appropriately. Therefore, an in-depth review of VCUG protocols and techniques has been presented herein. In addition, tips, tricks, and pitfalls associated with the technique have also been addressed.

배뇨방광요도조영술은 소아의 비뇨기과적 투시 검사에서 가장 중요한 검사이다. 배뇨방광요도조영술로 비뇨기계의 해부학적 구조와, 방광 요관 역류의 유무를 검사할 수 있다. 환자치료의 궁극적인 목표를 달성하려면 배뇨방광요도조영술을 적절하게 이해하고 수행하는 것이 중요하다. 이에, 심층적인 배뇨방광요도조영술의 술기 순서 및 기법에 대해 소개하였다. 또한, 배뇨방광요도조영술과 관련된 요령과 함정들을 다루었다.

Keywords

References

  1. Kirks DR, Griscom NT. Practical pediatric imaging: diagnostic radiology of infants and children. 3rd ed. Philadelphia: Lippincott-Raven 1998:1009-1160
  2. Swischuk LE. Imaging of the newborn, infant, and young child. 5th ed. Philadelphia: Lippincott Williams & Wilkins 2004:590-723
  3. Coley BD. Caffey's pediatric diagnostic imaging. 12th ed. Philadelphia: Saunders 2013:1243-1273
  4. American College of Radiology. ACR-SPR practice parameter for the performance of voiding cystourethrography in children. Available at. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/Voiding-Cysto.pdf. Published 1995. Accessed Jan 31, 2019
  5. Arena S, Iacona R, Impellizzeri P, Russo T, Marseglia L, Gitto E, et al. Physiopathology of vesico-ureteral reflux. Ital J Pediatr 2016;42:103
  6. Williams G, Fletcher JT, Alexander SI, Craig JC. Vesicoureteral reflux. J Am Soc Nephrol 2008;19:847-862 https://doi.org/10.1681/ASN.2007020245
  7. Brereton RJ, Narayanan R, Ratnatunga C. Ureteric re-implantation in the neuropathic bladder. Br J Surg 1987;74:1107-1110 https://doi.org/10.1002/bjs.1800741211
  8. Hernandez RJ, Goodsitt MM. Reduction of radiation dose in pediatric patients using pulsed fluoroscopy. AJR Am J Roentgenol 1996;167:1247-1253 https://doi.org/10.2214/ajr.167.5.8911190
  9. Hernanz-Schulman M, Goske MJ, Bercha IH, Strauss KJ. Pause and pulse: ten steps that help manage radiation dose during pediatric fluoroscopy. AJR Am J Roentgenol 2011;197:475-481 https://doi.org/10.2214/AJR.10.6122
  10. Lachenmyer LL, Anderson JJ, Clayton DB, Thomas JC, Pope JC 4th, Adams MC, et al. Analysis of an intervention to reduce parental anxiety prior to voiding cystourethrogram. J Pediatr Urol 2013;9:1223-1228 https://doi.org/10.1016/j.jpurol.2013.05.015
  11. Riccabona M. Pediatric urogenital radiology-medical radiology. Diagnostic imaging. 3rd ed. New York: Springer International Publishing 2018:20-23
  12. Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen-Mobius TE. International system of radiographic grading of vesicoureteric reflux. International reflux study in children. Pediatr Radiol 1985;15:105-109 https://doi.org/10.1007/BF02388714
  13. Ward VL. Patient dose reduction during voiding cystourethrography. Pediatr Radiol 2006;36 Suppl 2:168-172 https://doi.org/10.1007/s00247-006-0213-3
  14. Domina JG, Sanchez R, Meesa IR, Christodoulou E. Evaluation of pediatric VCUG at an academic children's hospital: is the radiographic scout image necessary? Pediatr Radiol 2015;45:855-861 https://doi.org/10.1007/s00247-014-3241-4
  15. Paltiel HJ, Rupich RC, Kiruluta HG. Enhanced detection of vesicoureteral reflux in infants and children with use of cyclic voiding cystourethrography. Radiology 1992;184:753-755 https://doi.org/10.1148/radiology.184.3.1509062
  16. Papadopoulou F, Efremidis SC, Oiconomou A, Badouraki M, Panteleli M, Papachristou F, et al. Cyclic voiding cystourethrography: is vesicoureteral reflux missed with standard voiding cystourethrography? Eur Radiol 2002;12:666-670 https://doi.org/10.1007/s003300101108
  17. Wyly JB, Lebowitz RL. Refluxing urethral ectopic ureters: recognition by the cyclic voiding cystourethrogram. AJR Am J Roentgenol 1984;142:1263-1267 https://doi.org/10.2214/ajr.142.6.1263
  18. Hodson CJ, Maling TM, McManamon PJ, Lewis MG. The pathogenesis of reflux nephropathy (chronic atrophic pyelonephritis). Br J Radiol 1975;Suppl 13:1-26
  19. Papachristou F, Printza N, Doumas A, Koliakos G. Urinary bladder volume and pressure at reflux as prognostic factors of vesicoureteral reflux outcome. Pediatr Radiol 2004;34:556-559 https://doi.org/10.1007/s00247-004-1211-y
  20. Alexander SE, Arlen AM, Storm DW, Kieran K, Cooper CS. Bladder volume at onset of vesicoureteral reflux is an independent risk factor for breakthrough febrile urinary tract infection. J Urol 2015;193:1342-1346 https://doi.org/10.1016/j.juro.2014.10.002
  21. Snyder EM, Nguyen RA, Young KJ, Coley BD. Vesicovaginal reflux mimicking obstructive hydrocolpos. J Ultrasound Med 2007;26:1781-1784 https://doi.org/10.7863/jum.2007.26.12.1781
  22. Maynard P. Drawing distinctions: the varieties of graphic expression. Ithaca: Cornell University Press 2005:22