Viability of contrast-enhanced voiding urosonography as an alternative to fluoroscopy during video urodynamics

Pediatr Radiol. 2023 Jul;53(8):1713-1719. doi: 10.1007/s00247-023-05619-4. Epub 2023 Mar 7.

Abstract

Pediatric urodynamic studies are performed to evaluate bladder function, commonly in conjunction with a voiding cystourethrogram (VCUG). Contrast-enhanced voiding urosonography (CeVUS) has been approved in the evaluation of vesicoureteral reflux and has been shown to have equal or superior diagnostic value to VCUG. In this technical innovation, we have shown that ultrasound contrast agent microbubbles are compatible with the equipment used for urodynamic evaluation. We have also shown that it is feasible to use contrast ultrasound in pediatric urodynamic examinations. The purpose of our study was to assess the technical feasibility of CeVUS during urodynamics with an in vitro test followed by a vivo evaluation. This single-center prospective study enrolled 25 patients aged 0-18 years who underwent CeVUS instead of VCUG at their regularly scheduled appointment. During the in vitro saline experiment, the radiologic and urologic equipment were found to be compatible. Microbubbles were observed at flow rates of 10 and 20 ml/min.

Keywords: Bladder dysfunction; Children; Contrast-enhanced ultrasound; Fluoroscopy; Urodynamics.

MeSH terms

  • Child
  • Contrast Media
  • Cystography
  • Fluoroscopy
  • Humans
  • Infant
  • Prospective Studies
  • Ultrasonography
  • Urodynamics*
  • Vesico-Ureteral Reflux* / diagnostic imaging

Substances

  • Contrast Media