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Abstract

Background: Urinary tract infections (UTIs) are prevalent bacterial diseases in children, often linked to vesicoureteral reflux (VUR), a common underlying cause. Traditionally, the diagnosis of VUR has relied on invasive micturating cystourethrography (MCU).
Objectives: to assess the accuracy of ultrasonography (USG) for predicting and grading VUR in pediatric patients with UTIs.
Methodology: The present study was conducted in the Department of (Radiology) Radio- diagnosis, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum (Belagavi) from January 2023 to December, 2023.
Results: It was a one-year observational study where in a cohort of 42 pediatric patients, predominantly in early to mid-childhood (54.7%), underwent evaluation, with a male-to-female ratio of 6:1. USG identified 38 true positive cases of VUR and 4 false negatives, while both USG and MCU showed no false positives or true negatives. Among the findings, bilateral Grade IV VUR was most prevalent, followed by bilateral Grade V VUR, 90.4 % of all grade VUR were accurately diagnosed and 68.4% cases were graded accurately, 75% of the low-grade being diagnosed on USG and 44% of cases were accurately graded 96.6 % of the high-grade cases were accurately diagnosed on USG with 75.8 % of them accurately graded In addition to VUR grading, USG provided insights into kidney size, shape, signs of chronic pyelonephritis, ureteric characterization, intrapelvic echoes indicating persistent infection, poor urine emptying due to reflux, and dynamic reflux assessment. Furthermore, USG detected renal scarring, atrophic changes, and intrapelvic echogenicities, facilitating comprehensive management decisions. Conclusion: Ultrasonography emerges as a promising non-invasive tool for assessing VUR in pediatric UTI patients, offering reliable diagnostic accuracy and additional parameters for comprehensive clinical management.