However, VCUG is recommended for patients with a family history of VUR [16]. The NICE guidelines do not recommend VCUG for patients >3 years of age with first febrile UTI. The AAP guidelines suggest that VCUG should not be performed routinely after the first febrile UTI for patients 2 to 24 months of age but that VCUG is indicated if the renal and bladder US reveals hydronephrosis, scarring, or other findings that would suggest either high-grade VUR or obstructive uropathy. Furthermore, VCUG may be indicated in other atypical or complex clinical circumstances [41]. MRI Abdomen and Pelvis With IV Contrast There is no relevant literature to support the use of MRI abdomen and pelvis with IV contrast in the evaluation of a child 2 months to 6 years of age for the initial imaging of a first febrile UTI. MRI Abdomen and Pelvis Without IV Contrast There is no relevant literature to support the use of MRI abdomen and pelvis without IV contrast in the evaluation of a child 2 months to 6 years of age for the initial imaging of a first febrile UTI. MRU Without and With IV Contrast There is no relevant literature to support the use of MRU in the evaluation of a child 2 months to 6 years of age for the initial imaging of a first febrile UTI. Nuclear Medicine Cystography Good correlation has been shown between nuclear medicine cystography and VCUG for the detection of VUR [19]. Unlike in children AMAB, detailed urethral assessment in children AFAB is less necessary, so radionuclide cystography can be performed as an alternative for VCUG in patients AFAB [42,48]. A finding of VUR, especially high-grade VUR, may lead to a change in management [9]. Nuclear medicine cystography may reveal VUR despite a normal VCUG in children with recurrent febrile UTI [63]. For more information, please see the fluoroscopic VCUG section. US Kidneys and Bladder The main benefit of US is for the detection of underlying congenital renal anomalies [1,16].
Urinary Tract Infection Child. However, VCUG is recommended for patients with a family history of VUR [16]. The NICE guidelines do not recommend VCUG for patients >3 years of age with first febrile UTI. The AAP guidelines suggest that VCUG should not be performed routinely after the first febrile UTI for patients 2 to 24 months of age but that VCUG is indicated if the renal and bladder US reveals hydronephrosis, scarring, or other findings that would suggest either high-grade VUR or obstructive uropathy. Furthermore, VCUG may be indicated in other atypical or complex clinical circumstances [41]. MRI Abdomen and Pelvis With IV Contrast There is no relevant literature to support the use of MRI abdomen and pelvis with IV contrast in the evaluation of a child 2 months to 6 years of age for the initial imaging of a first febrile UTI. MRI Abdomen and Pelvis Without IV Contrast There is no relevant literature to support the use of MRI abdomen and pelvis without IV contrast in the evaluation of a child 2 months to 6 years of age for the initial imaging of a first febrile UTI. MRU Without and With IV Contrast There is no relevant literature to support the use of MRU in the evaluation of a child 2 months to 6 years of age for the initial imaging of a first febrile UTI. Nuclear Medicine Cystography Good correlation has been shown between nuclear medicine cystography and VCUG for the detection of VUR [19]. Unlike in children AMAB, detailed urethral assessment in children AFAB is less necessary, so radionuclide cystography can be performed as an alternative for VCUG in patients AFAB [42,48]. A finding of VUR, especially high-grade VUR, may lead to a change in management [9]. Nuclear medicine cystography may reveal VUR despite a normal VCUG in children with recurrent febrile UTI [63]. For more information, please see the fluoroscopic VCUG section. US Kidneys and Bladder The main benefit of US is for the detection of underlying congenital renal anomalies [1,16].