Voiding Urosonography Multiple recent investigations evaluating real-time contrast-enhanced US techniques have demonstrated a high degree of diagnostic accuracy, and some demonstrated increased sensitivity as compared to fluoroscopic VCUG in the detection of VUR [41-45]. The main potential disadvantage of voiding urosonography is a lower anatomical detail of the bladder and urethra, and therefore it should not be used as the first study for male patients. Therefore, arguments for and against using voiding urosonography are similar to that of VCUG with the exception of male patients. Nuclear Medicine Cystography Some studies have suggested equal sensitivity for Tc-99m pertechnetate radionuclide cystography and VCUG [46], whereas others have indicated that radionuclide cystography has improved sensitivity for VUR in infants up to 1 year of age [47]. The main disadvantage of radionuclide cystography is that it does not provide anatomical details of the bladder and urethra and therefore should not be used as the first study for male patients. Therefore, arguments for and against using radionuclide cystography are similar to that of VCUG with the exception of male patients. DTPA Renal Scan There is no relevant literature to support the routine use of Tc-99m DTPA renal scan in the setting of a normal neonatal US. MAG3 Renal Scan There is no relevant literature to support the routine use of Tc-99m MAG3 diuretic renal scan in the setting of a normal neonatal US. MRI Abdomen and Pelvis There is no relevant literature to support the routine use of MRU in the in the setting of a normal neonatal US. Fluoroscopic Voiding Cystourethrography There is controversy regarding whether all children with antenatal hydronephrosis should undergo VCUG. A meta- analysis by the American Urology Association found that, on average, approximately 16% of neonates and infants with antenatal hydronephrosis will have VUR.
Antenatal Hydronephrosis Infant. Voiding Urosonography Multiple recent investigations evaluating real-time contrast-enhanced US techniques have demonstrated a high degree of diagnostic accuracy, and some demonstrated increased sensitivity as compared to fluoroscopic VCUG in the detection of VUR [41-45]. The main potential disadvantage of voiding urosonography is a lower anatomical detail of the bladder and urethra, and therefore it should not be used as the first study for male patients. Therefore, arguments for and against using voiding urosonography are similar to that of VCUG with the exception of male patients. Nuclear Medicine Cystography Some studies have suggested equal sensitivity for Tc-99m pertechnetate radionuclide cystography and VCUG [46], whereas others have indicated that radionuclide cystography has improved sensitivity for VUR in infants up to 1 year of age [47]. The main disadvantage of radionuclide cystography is that it does not provide anatomical details of the bladder and urethra and therefore should not be used as the first study for male patients. Therefore, arguments for and against using radionuclide cystography are similar to that of VCUG with the exception of male patients. DTPA Renal Scan There is no relevant literature to support the routine use of Tc-99m DTPA renal scan in the setting of a normal neonatal US. MAG3 Renal Scan There is no relevant literature to support the routine use of Tc-99m MAG3 diuretic renal scan in the setting of a normal neonatal US. MRI Abdomen and Pelvis There is no relevant literature to support the routine use of MRU in the in the setting of a normal neonatal US. Fluoroscopic Voiding Cystourethrography There is controversy regarding whether all children with antenatal hydronephrosis should undergo VCUG. A meta- analysis by the American Urology Association found that, on average, approximately 16% of neonates and infants with antenatal hydronephrosis will have VUR.