Ultrasound vs Direct Radionuclide Cystography in Infants: Diagnosis of High-Grade Vesicoureteral Reflux during First Febrile Urinary Tract Infection

Introduction: Renal damage caused by infantile Urinary Tract Infection has led to various imaging techniques being proposed for the early diagnosis of Vesicoureteral Reflux. The goal of this study is to determine the possibility of Ultrasound replacing more invasive and costly methods for diagnosing high-grade vesicoureteral reflux in infants with their first febrile urinary tract infection. Material & Methods Infants with their first febrile Urinary Tract Infection underwent Sonography and Radionuclide Cystography. The evidence of high-grade Vesicoureteral Reflux obtained from these two imaging methods was compared and contrasted. Results A total of 175 patients, 70.3% of which were female, were included in this study, with an average age of 7.2 months. USG was normal in 98 (56%) patients, with 59 patients (33.7%) having signs of severe hydronephrosis. DRNC showed that most patients (64.6%) were devoid of VUR, however among those diagnosed most were of high-grade. Abnormal USG findings were statistically significant compared to VUR and high-grade VUR (P-value = 0.0001), especially in the presence of hydronephrosis. Conclusion This study shows that pathological findings in USG are significantly correlated to VUR diagnosis, and can be used as an alternative in resource-poor settings.