{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:49:52Z","timestamp":1790693392515,"version":"4.1.0"},"reference-count":37,"publisher":"Scientific Foundation Spiroski (publications)","issue":"2","license":[{"start":{"date-parts":[[2017,4,11]],"date-time":"2017-04-11T00:00:00Z","timestamp":1491868800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Open Access Maced J Med Sci"],"abstract":"<jats:p>BACKGROUND: Vesicoureteric reflux (VUR) is an important association of paediatric urinary tract infection (UTI) found in 30-50% of all children presenting with first UTI. Contrast-enhanced voiding ultrasonography (ceVUS) has become an important radiation-free method for VUR detection in children. Its sensitivity in detecting VUR has greatly improved due to the development of the contrast-specific ultrasound techniques and the introduction of the second-generation ultrasound contrast agent, superseding the diagnostic accuracy of standard radiological procedures.AIM: This article aimed to summarise the current literature and discuss the first local pilot study performed in our institution on detection of vesicoureteric reflux by contrast-enhanced voiding ultrasonography with second- generation agent (SonoVue, Bracco, Italy).MATERIAL AND METHODS: Retrospective review of the first 31 ceVUS (24 girls, 7 boys) was presented.\u00c2\u00a0 Age range was 2 months to 18 years (mean = 6.4 \u00c2\u00b1 4.9).RESULTS:\u00c2\u00a0 All examinations were well tolerated without any adverse incident. VUR was shown in 20 (64.5%) children in 32\/62 (51.6) nephroureteral units (NUUs). In 18 NUUs, VUR was grade II\/V, in 11 Grade III\/V and in 3 grade IV\/V, respectively. Urethra was shown in 19\/31 children and in all boys, without pathological finding. In two girls spinning top urethra has been detected. Subsequent urodynamic studies revealed functional bladder problem in both.\u00c2\u00a0CONCLUSIONS: Contrast-enhanced voiding urosonography using intravesical second generation ultrasound contrast agent could be recommend\u00c2\u00a0 as a valid alternative diagnostic modality for detecting vesicoureteral reflux and evaluation of the distal urinary tract in children, based on its radiation-free, highly efficacious, reliable, and safe characteristics.<\/jats:p>","DOI":"10.3889\/oamjms.2017.055","type":"journal-article","created":{"date-parts":[[2017,4,12]],"date-time":"2017-04-12T05:00:55Z","timestamp":1491973255000},"page":"215-221","source":"Crossref","is-referenced-by-count":10,"title":["Voiding Urosonography with Second-Generation Ultrasound Contrast Agent for Diagnosis of Vesicoureteric Reflux: First Local Pilot Study"],"prefix":"10.3889","volume":"5","author":[{"given":"Dafina","family":"Kuzmanovska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar","family":"Risteski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Kambovska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tase","family":"Trpcevski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilija","family":"Sahpazova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mile","family":"Petrovski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"52292","published-online":{"date-parts":[[2017,4,11]]},"reference":[{"key":"31321","doi-asserted-by":"crossref","unstructured":"Diamond DA, Mattoo TK. Endoscopic treatment of primary vesicoureteral reflux. N Engl J Med. 2012;366(13):1218-26. https:\/\/doi.org\/10.1056\/NEJMct1108922 PMid:22455416","DOI":"10.1056\/NEJMct1108922"},{"key":"31322","doi-asserted-by":"crossref","unstructured":"Sargent MA. What is the normal prevalence of vesicoureteral reflux? Pediatr Radiol. 2000;30(9):587-93. https:\/\/doi.org\/10.1007\/s002470000263 PMid:11009294","DOI":"10.1007\/s002470000263"},{"key":"31323","doi-asserted-by":"crossref","unstructured":"Venhola M, Hannula A, Huttunen NP, Renko M, Pokka T, Uhari M. Occurrence of vesicoureteral reflux in children. Acta Paediatr. 2010;99(12):1875-8. https:\/\/doi.org\/10.1111\/j.1651-2227.2010.01909.x PMid:20545929","DOI":"10.1111\/j.1651-2227.2010.01909.x"},{"key":"31324","doi-asserted-by":"crossref","unstructured":"Greenfield SP, Wan J. Vesicoureteral reflux: practical aspects of evaluation and management. Pediatr Nephrol. 1996;10(6):789-94.","DOI":"10.1007\/s004670050218"},{"key":"31325","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1007\/s004670050218","DOI":"10.1007\/s004670050218"},{"key":"31326","doi-asserted-by":"crossref","unstructured":"Skoog SJ, Peters CA, Arant BS Jr, Copp HL, Elder JS, Hudson RG, Khoury AE, Lorenzo AJ, Pohl HG, Shapiro E, Snodgrass WT, Diaz M. Pediatric Vesicoureteral Reflux Guidelines Panel Summary Report: Clinical Practice Guidelines for Screening Siblings of Children With Vesicoureteral Reflux and Neonates\/Infants With Prenatal Hydronephrosis. J Urol. 2010;184(3):1145-51. https:\/\/doi.org\/10.1016\/j.juro.2010.05.066 PMid:20650494","DOI":"10.1016\/j.juro.2010.05.066"},{"key":"31327","doi-asserted-by":"crossref","unstructured":"Koff SA, Wagner TT, Jayanthi VR. The relationship among dysfunctional elimination syndromes, primary vesicoureteral reflux and urinary tract infections in children. J Urol. 1998; 160:1019-22. https:\/\/doi.org\/10.1016\/S0022-5347(01)62686-7","DOI":"10.1097\/00005392-199809020-00014"},{"key":"31328","unstructured":"Bailey RR. The relationship of vesico-ureteric reflux to urinary tract infection and chronic pyelonephritis\u00e2\u20ac\u201dreflux nephropathy. Clin Nephrol. 1973; 1:132-41. PMid:4783715"},{"key":"31329","doi-asserted-by":"crossref","unstructured":"Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011; 128:595-610. https:\/\/doi.org\/10.1542\/peds.2011-1330 PMid:21873693","DOI":"10.1542\/peds.2011-1330"},{"key":"31330","doi-asserted-by":"crossref","unstructured":"Radmayr C, Klauser A, Pallwein L, Zurnedden D, BartschG, Frauscher F. Contrast enhanced reflux sonography in children: a comparison to standard radiological imaging. J Urol. 2002; 167:1428-30. https:\/\/doi.org\/10.1016\/S0022-5347(05)65335-9","DOI":"10.1016\/S0022-5347(05)65335-9"},{"key":"31331","doi-asserted-by":"crossref","unstructured":"Escape I, Martinez J, Bastart F, Solduga C, Sala P. Usefulness of echocystography in the study of vesicoureteral reflux. J Ultrasound Med. 2001; 20:145-9. https:\/\/doi.org\/10.7863\/jum.2001.20.2.145 PMid:11211135","DOI":"10.7863\/jum.2001.20.2.145"},{"key":"31332","doi-asserted-by":"crossref","unstructured":"Bosio M. Cystosonography with echocontrast: a new imaging modality to detect vesicoureteric reflux in children. Pediatr Radiol. 1998; 28:250-5. https:\/\/doi.org\/10.1007\/s002470050343 PMid:9545481","DOI":"10.1007\/s002470050343"},{"key":"31333","doi-asserted-by":"crossref","unstructured":"Darge K, Bruchelt W, Roessling G et al. Interaction of normal saline solution with ultrasound contrast medium: significant implication for sonographic diagnosis of vesicoureteral reflux. Eur Radiol. 2003;13:213\u00e2\u20ac\u201c218. PMid:12541132","DOI":"10.1007\/s00330-002-1495-y"},{"key":"31334","doi-asserted-by":"crossref","unstructured":"Papadopoulou F, Anthopoulou A, Siomou E, Efremidis S, Tsamboulas C, Darge K. Harmonic voiding urosonography with a second-generation contrast agent for the diagnosis of vesicoureteral reflux. Pediatr Radiol. 2009; 39:239-44. https:\/\/doi.org\/10.1007\/s00247-008-1080-x PMid:19096835","DOI":"10.1007\/s00247-008-1080-x"},{"key":"31335","doi-asserted-by":"crossref","unstructured":"Papadopoulou F, Tsampoulas C, Siomou E et al. Cyclic contrast-enhanced harmonic voiding urosonography for the evaluation of reflux. Can we keep the cost of the examination low? Eur Radiol. 2006; 16:2521\u00e2\u20ac\u201c2526. https:\/\/doi.org\/10.1007\/s00330-006-0253-y PMid:16639494","DOI":"10.1007\/s00330-006-0253-y"},{"key":"31336","doi-asserted-by":"crossref","unstructured":"Berrocal T, Gay\u00c3\u00a1 F, Arjonilla A. Vesicoureteral reflux: can the urethra be adequately assessed by using contrast-enhanced voiding US of the bladder? Radiology. 2005;234(1):235-41. https:\/\/doi.org\/10.1148\/radiol.2341031503 PMid:15618383","DOI":"10.1148\/radiol.2341031503"},{"key":"31337","doi-asserted-by":"crossref","unstructured":"Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen- Moebius TE. International system of radiographic grading of vesicoureteric reflux. Pediatr Radiol. 1985; 15:105\u00e2\u20ac\u201c9. https:\/\/doi.org\/10.1007\/BF02388714 PMid:3975102","DOI":"10.1007\/BF02388714"},{"key":"31338","doi-asserted-by":"crossref","unstructured":"Perisinakis K, Raissaki M, Damilakis J, Stratakis J,Neratzoulakis J, Gourtsoyiannis N. Fluoroscopy-controlled voiding cystourethrography in infants and children: are the radiation risks trivial? Eur Radiol. 2006; 16:846-51. https:\/\/doi.org\/10.1007\/s00330-005-0072-6 PMid:16328446","DOI":"10.1007\/s00330-005-0072-6"},{"key":"31339","doi-asserted-by":"crossref","unstructured":"Unver T, Alpay H, Biyikli NK, Ones T. Comparison of direct radionuclide cystography and voiding cystourethrography in detecting vesicoureteral reflux. Pediatr Int. 2006; 48:287-291. https:\/\/doi.org\/10.1111\/j.1442-200X.2006.02206.x PMid:16732797","DOI":"10.1111\/j.1442-200X.2006.02206.x"},{"key":"31340","unstructured":"Kuzmanovska D, Tasik V, Sahpazova E. Detection of vesicoureteral reflux with radionuclide cystography. Srpski arhiv za celokupno lekarstvo. 1996; 124(Suppl 1):78-81. PMid:9102939"},{"key":"31341","doi-asserted-by":"crossref","unstructured":"Fettich J, Colarinha P, Fischer S, et al. Guidelines for direct radionuclide cystography in children. Eur J Nucl Med MolImaging. 2003; 30:39-44. https:\/\/doi.org\/10.1007\/s00259-003-1137-x PMid:12692686","DOI":"10.1007\/s00259-003-1137-x"},{"key":"31342","doi-asserted-by":"crossref","unstructured":"Bosio M. Cystosonography with echocontrast: a new imaging modality to detect vesicoureteric reflux in children. Pediatr Radiol. 1998; 28:250-5. https:\/\/doi.org\/10.1007\/s002470050343 PMid:9545481","DOI":"10.1007\/s002470050343"},{"key":"31343","doi-asserted-by":"crossref","unstructured":"Tranquart F, Grenier N, Eder V, Pourcelot L. Clinical use of ultrasound tissue harmonic imaging. Ultrasound Med Biol. 1999; 25:889-94. https:\/\/doi.org\/10.1016\/S0301-5629(99)00060-5","DOI":"10.1016\/S0301-5629(99)00060-5"},{"key":"31344","doi-asserted-by":"crossref","unstructured":"Schneider M. SonoVue, a new ultrasound contrast agent. Eur Radiol. 1999; 9(Suppl 3):347S-348S. https:\/\/doi.org\/10.1007\/PL00014071","DOI":"10.1007\/PL00014071"},{"key":"31345","doi-asserted-by":"crossref","unstructured":"Shapiro RS, Wagreich J, Parsons RB, Stancato-Pasik A,Yeh HC, Lao R. Tissue harmonic imaging sonography:evaluation of image quality compared with conventional sonography. Am J Roentgenol. 1998; 171:1203-6. https:\/\/doi.org\/10.2214\/ajr.171.5.9798848 PMid:9798848","DOI":"10.2214\/ajr.171.5.9798848"},{"key":"31346","doi-asserted-by":"crossref","unstructured":"Darge K, Troeger J. Vesicoureteral reflux grading in contrast enhanced voiding urosonography. Eur J Radiol. 2002; 43:122\u00e2\u20ac\u201c128. https:\/\/doi.org\/10.1016\/S0720-048X(02)00114-6","DOI":"10.1016\/S0720-048X(02)00114-6"},{"key":"31347","doi-asserted-by":"crossref","unstructured":"Darge K. Voiding urosonography with US contrast agents for the diagnosis of vesicoureteric reflux in children. II.Comparison with radiological examinations. Pediatr Radiol. 2008; 38:54\u00e2\u20ac\u201c63. https:\/\/doi.org\/10.1007\/s00247-007-0528-8 PMid:17639371","DOI":"10.1007\/s00247-007-0528-8"},{"key":"31348","doi-asserted-by":"crossref","unstructured":"Klju\u00c4\u008dev\u00c5\u00a1ek D, Battelino N, Toma\u00c5\u00bei\u00c4\u008d M, Kersnik Levart T. A comparison of echo-enhanced voiding urosonography with X-ray voiding cystourethrography in the first year of life. Acta Paediatr. 2012; 101:e235-9. https:\/\/doi.org\/10.1111\/j.1651-2227.2011.02588.x PMid:22211993","DOI":"10.1111\/j.1651-2227.2011.02588.x"},{"key":"31349","doi-asserted-by":"crossref","unstructured":"Ascenti G, Zimbaro G, Mazziotti S, et al. Harmonic US imaging of vesicoureteric reflux in children: usefulness of a second generation US contrast agent. Pediatr Radiol. 2004; 34:481-487. https:\/\/doi.org\/10.1007\/s00247-004-1190-z PMid:15107964","DOI":"10.1007\/s00247-004-1190-z"},{"key":"31350","doi-asserted-by":"crossref","unstructured":"Kis E, Nyitrai A, Varkonyi I, et al. Voiding urosonographywith second-generation contrast agent versus voiding cystourethrography. Pediatr Nephrol. 2010; 25:2289-93. https:\/\/doi.org\/10.1007\/s00467-010-1618-7 PMid:20686902","DOI":"10.1007\/s00467-010-1618-7"},{"key":"31351","unstructured":"Darge K, Beer M, Gordjani N, Riedmiller H. Contrast enhanced voiding urosonography with the use of a 2nd generation US contrast medium: preliminary results. Pediatr Radiol. 2004; 34:97S."},{"key":"31352","doi-asserted-by":"crossref","unstructured":"Robrecht J, Darge K. In-vitro comparison of a 1st and a 2nd generation US contrast agent for reflux diagnosis. Rofo. 2007;179:818\u00e2\u20ac\u201c82532. https:\/\/doi.org\/10.1055\/s-2007-963312 PMid:17638173","DOI":"10.1055\/s-2007-963312"},{"key":"31353","unstructured":"Kljucevsek D. Echo-encanced voiding urosonography in children: state of the art. Paediatr Croat. 2012; 56 (Supl 1]: 147-150."},{"key":"31354","doi-asserted-by":"crossref","unstructured":"Darge K, Moeller RT, Trusen A et al. Diagnosis of vesicoureteric reflux with low-dose contrast-enhanced harmonic ultrasound imaging. Pediatr Radiol. 2005; 35:73\u00e2\u20ac\u201c78. https:\/\/doi.org\/10.1007\/s00247-004-1317-2 PMid:15448949","DOI":"10.1007\/s00247-004-1317-2"},{"key":"31355","doi-asserted-by":"crossref","unstructured":"Duran C, Valera A, Alguersuari A, et al. Voiding urosonography: the study of the urethra is no longer a limitation of the technique. Pediatr Radiol. 2009; 39:124-31. https:\/\/doi.org\/10.1007\/s00247-008-1050-3 PMid:19002449","DOI":"10.1007\/s00247-008-1050-3"},{"key":"31356","doi-asserted-by":"crossref","unstructured":"Riccabona M, Avni FE, Blickman JG, et al. Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol. 2008;38:138-45. https:\/\/doi.org\/10.1007\/s00247-007-0695-7 PMid:18071685","DOI":"10.1007\/s00247-007-0695-7"},{"key":"31357","doi-asserted-by":"crossref","unstructured":"Riccabona M, Avni FE, Damasio MB, et al. ESPR Uroradiology Task Force and ESUR Paediatric Working Group\u00e2\u20ac\u201dImaging recommendations in paediatric uroradiology, part V: childhood cystic kidney disease,childhood renal transplantation and contrast-enhanced ultrasonography in children. Pediatr Radiol. 2012; 42:1275-83. https:\/\/doi.org\/10.1007\/s00247-012-2436-9 PMid:23001574","DOI":"10.1007\/s00247-012-2436-9"}],"container-title":["Open Access Macedonian Journal of Medical Sciences"],"original-title":[],"link":[{"URL":"https:\/\/oamjms.eu\/index.php\/mjms\/article\/download\/oamjms.2017.055\/1343","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/oamjms.eu\/index.php\/mjms\/article\/download\/oamjms.2017.055\/1366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T07:05:40Z","timestamp":1744700740000},"score":1,"resource":{"primary":{"URL":"https:\/\/oamjms.eu\/index.php\/mjms\/article\/view\/oamjms.2017.055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,11]]},"references-count":37,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,4,13]]}},"URL":"https:\/\/doi.org\/10.3889\/oamjms.2017.055","relation":{},"ISSN":["1857-9655"],"issn-type":[{"value":"1857-9655","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,11]]}}}