THE DIAGNOSTIC VALUE OF CURRENT PRACTICE OF PEDIATRIC INTRAVENOUS UROGRAPHY IN AFGHANISTAN IN PRESENCE OF ULTRASONOGRAPHY; CROSS-SECTIONAL ANALYTIC STUDY IN A PEDIATRIC TERTIARY CARE HOSPITAL
Abstract
Background: Intravenous urography (IVU), an old imaging method was accepted as the mainstay of urologic imaging and the gold standard for assessing the upper urinary tract anatomy and excretory function for many years; but with advances in the uroradiologic examinations; its usage is now in universal decline in pediatric population. Due to various reasons, IVU is still widely practiced in children in Afghanistan. On the other hand, Ultrasonography (USG) is accepted universally as first-line imaging modality in pediatric uroradiology.
Objectives: To evaluate the diagnostic value of current practice of pediatric IVU in Afghanistan in presence of USG; to evaluate the prediction of renal excretory function by means of USG ultrasonographic features; and to compare the validity of USG, plain radiograph, and their combination with IVU in detection of urolithiasis.
Method: Cross-sectional analytic study at radiology department of French Medical Institute for mothers and Children, on children aged >1 month and < 18 years who were prescribed to undergo IVU examination from 17 June 2016 to 31 August 2016.
USG of urinary tract was performed for each participant followed by IVU. The diagnostic value of IVU considered positive whenever IVU could add additional diagnostic information over USG and negative if it could not. P value of <0.001 was considered as statistically significant.
Results: Total 139 affected kidneys were included. The diagnostic value of IVU was positive in 6.5% and negative in 93.5% of cases.
Conclusion: IVU can be largely replaced by USG in the pediatric population — and by combination of USG and plain radiograph in urolithiasis work up—.
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