Microvascular Doppler ultrasound in children with acute pyelonephritis

Gayoung Choi, Bo-Kyung Je, Doran Hong, Jaehyung Cha

Abstract


Aims: To compare the diagnostic performance of microvascular Doppler ultrasonography (MVUS) to B-mode and con-ventional colour Doppler US (CDUS) for detecting acute pyelonephritis (APN) lesions in children.

Material and methods: An IRB-approved retrospective study was performed. From July 2018 to January 2019, 41 APN lesions in 28 children (15 boys, 13 girls; age range, 1-196 months; mean age, 53 months) who underwent 99mTc‒dimercaptosuccinic acid renal scintig-raphy (DMSA) or contrast-enhanced computed tomography (CECT) and US including B-mode, CDUS, and MVUS were enrolled in this study. Three paediatric radiologists independently reviewed the B-mode, CDUS and MVUS images for the DMSA or CECT-proven APN lesions and evaluated the lesion visibility, lesion distinguishability and diagnostic confidence between the MVUS and CDUS images.

Results: A total 41 of APN lesions were verified by DMSA (41 lesions) or CECT (3 lesions) during the same hospitalization period with renal US. Among 41 APN lesions, 52.8% was visible on B-mode, 85.4% on CDUS, and 94.3% on MVUS (p<0.001). Comparing the extent and margins of the lesions, MVUS had better results than CDUS in 41.5% of the lesions, CDUS had better results in 6.5% and they were equal in 52% (p<0.001). The diagnostic con-fidence of the APN lesions was higher for MVUS than CDUS in 36.6%, higher for CDUS than MVUS in 4.9%, and equal in the remaining 58.5% (p<0.05). The interobserver agreement was fair to moderate.

Conclusions: MVUS showed improved detectability of hypoperfused areas in paediatric APN and provided higher diagnostic confidence.


Keywords


pyelonephritis; paediatrics; ultrasonography; colour Doppler; microvascular imaging

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DOI: http://dx.doi.org/10.11152/mu-2827

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