Pediatric Radiology

, Volume 35, Issue 1, pp 73–78 | Cite as

Diagnosis of vesicoureteric reflux with low-dose contrast-enhanced harmonic ultrasound imaging

  • Kassa DargeEmail author
  • Richard-Tobias Moeller
  • Andreas Trusen
  • Felix Butter
  • Nader Gordjani
  • Hubertus Riedmiller
Original Article


Background: Harmonic US imaging has been shown to be better than conventional US for the detection and visualisation of microbubbles in contrast-enhanced voiding urosonography (VUS). Objective: To determine the diagnostic efficacy of VUS using a reduced dose of the US contrast medium in comparison to voiding cystourethrography (VCUG). Materials and methods: Fifty-five children (17 boys, 38 girls; mean age 4 years) were recruited. All patients underwent VUS by harmonic imaging followed by VCUG. The dose of the US contrast medium (Levovist) administered intravesically was half of the recommended dose i.e. 5% of the bladder filling volume. Results: A total of 114 kidney-ureter (K-U) units were available for evaluation. Vesicoureteric reflux (VUR) was detected in 29 K-U units by one or both examination modalities. There was a 91.2% concordance rate between VUS and VCUG. VUR in seven and three K-U units were detected only by VUS and VCUG, respectively. Taking VCUG as the reference method, VUS had the following diagnostic results: 86.4% sensitivity, 92.4% specificity, positive and negative predictive values of 73.1 and 96.6%, respectively. Conclusions: Even when the dose of US contrast medium is halved, the diagnostic efficacy of harmonic VUS is comparable to VCUG. Consequently, we recommend an US contrast medium dose of 5% of the bladder filling volume for the diagnosis of VUR using contrast-enhanced harmonic VUS.


Kidney Ureter Vesico-ureteric reflux Ultrasound Harmonic imaging Contrast medium Children 



We are very thankful to Mr. Arne Schaefer for the comprehensive statistical analysis and expert advice.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Kassa Darge
    • 1
    Email author
  • Richard-Tobias Moeller
    • 1
  • Andreas Trusen
    • 1
  • Felix Butter
    • 1
  • Nader Gordjani
    • 2
  • Hubertus Riedmiller
    • 3
  1. 1.Department of Paediatric RadiologyUniversity Hospital WuerzburgWuerzburgGermany
  2. 2.Department of Paediatric NephrologyUniversity Children’s Hospital WuerzburgWuerzburgGermany
  3. 3.Department of UrologyUniversity Hospital WuerzburgWuerzburgGermany

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