Diagnostic imaging in the diagnosis of vesicoureteral reflux: from the beginning to the present

Abstract

Vesicoureteral reflux is commonly identifi ed in children and can be associated with reflux nephropathy. Some patients with reflux nephropathy develop chronic kidney disease, hypertension, and a small number of patients progress to end-stage renal disease. Identifi cation of patients with these clinical characteristics should be the goal of clinical, biochemical, and radiological evaluation of patients presenting with prenatal hydronephrosis or febrile urinary tract infection. The goals of imaging procedure in general are to confirm the diagnosis suspected with a high degree of sensitivity and specifi city, to aid treatment and allow prognosis. The diagnosis of vesicoureteral reflux is a relatively straightforward and well-established procedure. There is increasing awareness of the risks of radiation exposure and invasiveness of vesicoureteral refl ux investigation, which can be unpleasant experience for both the child and the parents. Therefore, it is an imperative for pediatric radiologist together with pediatric urologist and nephrologist to reevaluate the indications and goals for imaging for vesicoureteral refl ux, and to redefi ne the modalities used for diagnosis and follow up. This article reviews the available imaging modalities for evaluating vesicoureteral reflux, their characteristics, advantages and disadvantages.