Discover the recommended diagnostic approach by learning more about the steps that can put you on the right path towards a proper VUR diagnosis.

Diagnosis steps

Types of Imaging Tests

Renal bladder ultrasound is the most common imaging modality to evaluate the urinary tract in children.

The use of VCUG is recommended in patients with US findings of:

  • Bilateral high-grade hydronephrosis
  • Duplex kidneys with hydronephrosis
  • Ureterocele
  • Ureteral dilatation
  • Abnormal bladders

UTI may present with fever or nonspecific signs such as failure to thrive, vomiting, diarrhea, poor oral intake, or lethargy.

  • Grade 1: reflux limited to the ureter
  • Grade 2: reflux up to the renal pelvis
  • Grade 3: mild dilatation of ureter and pelvicalyceal system
  • Grade 4: tortuous ureter with moderate dilatation blunting of fornices but preserved papillary impressions 
  • Grade 5: tortuous ureter with severe dilatation of ureter and pelvicalyceal system loss of fornices and papillary impressions 

Dimercaptosuccinic acid is the best nuclear agent for visualising the cortical tissue and differential function between both kidneys.
Dimercaptosuccinic acid is taken up by proximal renal tubular cells and is a good indicator of renal parenchyma function.
In areas of acute inflammation or scarring, DMSA uptake is poor and appears as cold spots.
DMSA scans are therefore used to detect and monitor renal scarring.

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