The growing role of ultrasonography in evaluating children after urinary tract infection

Abstract

The purpose of this review is to advocate the use of ultrasonography (US) techniques in the work-up of children after a urinary tract infection (UTI). Currently, two major approaches are recognized. The first approach recommends looking for vesicoureteral reflux (VUR) in all children following a UTI. New techniques have been developed where, in the majority of cases, x-ray voiding cystourethrography (VCUG) is first substituted with radionuclide voiding cystography, and finally with echo-enhanced voiding urosonography, and this presented a significant improvement in diminishing the radiation burden on patients; yet there remained the drawback that catheterization is still necessary with all of these techniques. The introduction of catheter-free procedures would be a ‘final solution’, but these are yet to be validated. The second approach recommends screening for scars (mostly using a dimercaptosuccinic acid renal scan), while cystographies (preferably VCUG) are only performed in cases in which renal scarri...