Efficacy of cyclic voiding cystourethrography in detection of vesicoureteral reflux in young children

To evaluate the efficacy of cyclic voiding cystourethrography (VCUG) for the detection of vesicoureteral reflux (VUR) in young children. Two cycles of cyclic VCUG were performed in 119 kidney-ureter units (KUUs) of 60 children (mean age; 9 months, range; 5 days-2 years). Spot radiographs and fluoroscopic-image captures were obtained. We analyzed the presence of VUR and the grade of VUR according to the standards of the international grading system. We recorded the amount of total contrast material on each cycle and the total fluoroscopic time. VUR was present in 21 (17.6%) KUUs of 13 (21.7%) children. On the first and second cycle, the reflux occurred in 9 (15.0%) children and 13 (12.6%) KUUs. In one hundred-four KUUs of 51 children whose VCUG results were negative on the first cycle, the reflux occurred in 4 (7.8%) children and 6 (5.8%) KUUs during the second cycle. The grading of the reflux was upgraded during a second cycle in one case. A new detection and upgrade of VUR by the second cycle was observed in 5 (9.8%) children and 7 (6.7%) KUUs. In 4 KUUs (53%) of these 7 KUUs, the VUR was higher than grade II. The mean amounts of contrast solution were 28 cc (range; 5-100 cc) on the first cycle and 39 cc (range; 10-100 cc) on the second cycle. The mean of the total fluoroscopic time was 147 seconds (range; 59--338 seconds). Cyclic VCUG can enhance the ability of the method to detect and grade VUR in children under 2 years of age