What is voiding urosonography?
Pediatric imagers are currently looking to offer voiding urosonography as an alternative to fluoroscopic or radionuclide voiding cystography. With this technique, which avoids the use of ionizing radiation, fluid containing microbubbles is instilled into the urinary bladder; VUR reaching the kidneys can be readily detected utilizing US.
What are the pros and cons of a radionuclide cystography or voiding urosonography compared with fluoroscopic VCUG?
Fluoroscopic VCUG provides anatomic detail but at a much higher radiation dose. Voiding urosonography does not require radiation and may also detect low-grade VUR not clearly identifiable fluoroscopically. Radionuclide cystography is highly sensitive for detecting reflux because the child is continuously monitored by the gamma camera but at the expense of good anatomic detail. Radionuclide cystography is particularly useful for follow-up studies that assess for resolution of previously detected VUR and is useful for screening siblings of patients with known VUR.