Ecocistografía con contraste: una nueva modalidad de imagen para diagnosticar el reflujo vesicoureteral
Cystosonography with echoenhancer. a new imaging technique for the diagnosis of vesicoureteral reflux
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Gayá Moreno, N. Gómez León, E. Jaureguízar Monereo" "autores" => array:4 [ 0 => array:3 [ "nombre" => "T." "apellidos" => "Berrocal Frutos" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Gayá Moreno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "N." "apellidos" => "Gómez León" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "E." "apellidos" => "Jaureguízar Monereo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Apoyo a la Investigación" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Urología. Hospital Infantil La Paz. Madrid" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleItalic"><span class="elsevierStyleBold">Correspondencia</span></span>: Dra. T. Berrocal Frutos. Servicio de Radiodiagnóstico. Hospital Infantil La Paz. P.° de la Castellana, 261. 28046 Madrid." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cystosonography with echoenhancer. a new imaging technique for the diagnosis of vesicoureteral reflux" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-02-01" "fechaAceptado" => "2000-07-01" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186492" "palabras" => array:4 [ 0 => "<span class="elsevierStyleItalic">Cystosonography</span>" 1 => "<span class="elsevierStyleItalic">Micturating cystourethrography</span>" 2 => "<span class="elsevierStyleItalic">Vesicoureteral reflux</span>" 3 => "<span class="elsevierStyleItalic">Children</span>" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186493" "palabras" => array:4 [ 0 => "<span class="elsevierStyleItalic">Ecocistografía</span>" 1 => "<span class="elsevierStyleItalic">Cistouretrografía miccional</span>" 2 => "<span class="elsevierStyleItalic">Reflujo vesicoureteral</span>" 3 => "<span class="elsevierStyleItalic">Niños</span>" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar la utilidad de la ecografía realzada con un medio de contraste ecopotenciador (ecocistografía) para diagnosticar el reflujo vesicoureteral, comparando los resultados de esta nueva modalidad de imagen con los de la cistouretrografía miccional convencional (CUMS).</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 169 pacientes (293 unidades renales) con edades comprendidas entre 3 días y 18 años y se estudiaron con ultrasonidos para valorar la existencia de reflujo vesicoureteral, después de rellenar la vejiga con suero salino mezclado con una suspensión de galactosa y ácido palmítico (LevografÒ) que actúa como agente ecopotenciador. Se obtuvieron imágenes ecográficas tanto durante el llenado vesical como durante la micción. Esta exploración fue siempre seguida de una CUMS durante la misma sesión diagnóstica.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En 50 unidades renales se detectó reflujo vesicoureteral pasivo tanto en ecocistografía como en la CUMS. En 22 unidades se detectó reflujo pasivo únicamente en la ecocistografía y en tres se detectó reflujo pasivo en la CUMS y la ecocistografía fue negativa. En 56 unidades renales se detectó reflujo activo por ambos procedimientos. En 17 unidades se objetivó reflujo activo en la ecocistografía y la CUMS fue normal y en cinco se observó reflujo activo en la CUMS y la ecocistografía no consiguió demostrarlo. Considerando el reflujo globalmente, de las 293 unidades renales totales, en 204 (69,6%) no se encontró reflujo vesicoureteral por ninguno de los dos procedimientos y en 63 (21,5%) unidades se detectó reflujo en ambos, independientemente de si éste era activo o pasivo. En 19 unidades se observó reflujo vesicoureteral (activo o pasivo) sólo en la ecocistografía y en siete unidades se encontró únicamente en la CUMS. La sensibilidad de la ecocistografía para detectar reflujo frente a la CUMS fue del 90,5% y la especificidad del 91,4%.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La ecocistografía es una modalidad de imagen útil para diagnosticar el reflujo vesicoureteral, suficientemente sensible y específica, y presenta la ventaja sobre la CUMS de que no es necesario utilizar radiaciones ionizantes.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To analyze the utility of contrast-enhanced ultrasonography of the bladder and kidneys (cystosonography) for the diagnosis of vesicoureteral reflux (VUR) by comparing the results of this new imaging modality with those of micturating cystourethrography (MCU).</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A total of 169 patients (293 kidney units) aged between 3 days and 18 years were sonographically evaluated for the presence of VUR after filling the bladder with saline and a galactose and palmitic acid suspension (Levograf) as an echo-enhancing agent. Ultrasonographic images were obtained during bladder filling and micturation. This procedure was always followed by MCU during the same diagnostic session.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In 50 kidney units both cystosonography and MUR detected VUR during bladder filling. In 22 units, only cystosonography detected passive reflux during bladder filling and in 3 only MCU did so. In 56 units, both methods detected active VUR during micturation. In 17 units, only cystosonography detected active reflux during micturation, the results of MCU being normal, and in 5, only MCU detected active reflux. Overall, of the 293 kidney units, VUR was not detected by either of the imaging modalities in 204 (69.6%) and was detected by both methods, irrespective of whether it was active or passive, in 63 (21.5%). In 19 units, VUR (active or passive) was observed only by cystosonography and in 7 only by MCU. When MCU was used as the reference method, cystosonography had a sensitivity of 90.5% and a specificity of 91.4%.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Contrast-enhanced cystosonography is a reliable modality, with sufficient sensitivity and specificity in the diagnosis of VUR and does not expose patients to ionizing radiation.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:54 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Familial vesicoureteral reflux" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Zel" 1 => "A.B. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 15 | 19 | 34 |
| 2024 Octubre | 163 | 101 | 264 |
| 2024 Septiembre | 164 | 66 | 230 |
| 2024 Agosto | 169 | 111 | 280 |
| 2024 Julio | 162 | 105 | 267 |
| 2024 Junio | 169 | 98 | 267 |
| 2024 Mayo | 189 | 82 | 271 |
| 2024 Abril | 143 | 81 | 224 |
| 2024 Marzo | 132 | 75 | 207 |
| 2024 Febrero | 300 | 66 | 366 |
| 2024 Enero | 141 | 86 | 227 |
| 2023 Diciembre | 169 | 86 | 255 |
| 2023 Noviembre | 165 | 113 | 278 |
| 2023 Octubre | 140 | 79 | 219 |
| 2023 Septiembre | 88 | 46 | 134 |
| 2023 Agosto | 103 | 56 | 159 |
| 2023 Julio | 113 | 106 | 219 |
| 2023 Junio | 137 | 87 | 224 |
| 2023 Mayo | 145 | 83 | 228 |
| 2023 Abril | 82 | 59 | 141 |
| 2023 Marzo | 62 | 69 | 131 |
| 2023 Febrero | 126 | 26 | 152 |
| 2023 Enero | 111 | 42 | 153 |
| 2022 Diciembre | 95 | 30 | 125 |
| 2022 Noviembre | 137 | 40 | 177 |
| 2022 Octubre | 143 | 54 | 197 |
| 2022 Septiembre | 125 | 32 | 157 |
| 2022 Agosto | 118 | 68 | 186 |
| 2022 Julio | 132 | 47 | 179 |
| 2022 Junio | 120 | 73 | 193 |
| 2022 Mayo | 145 | 78 | 223 |
| 2022 Abril | 112 | 63 | 175 |
| 2022 Marzo | 152 | 54 | 206 |
| 2022 Febrero | 149 | 44 | 193 |
| 2022 Enero | 210 | 56 | 266 |
| 2021 Diciembre | 156 | 68 | 224 |
| 2021 Noviembre | 146 | 55 | 201 |
| 2021 Octubre | 200 | 78 | 278 |
| 2021 Septiembre | 115 | 63 | 178 |
| 2021 Agosto | 89 | 38 | 127 |
| 2021 Julio | 173 | 53 | 226 |
| 2021 Junio | 141 | 62 | 203 |
| 2021 Mayo | 157 | 43 | 200 |
| 2021 Abril | 256 | 78 | 334 |
| 2021 Marzo | 197 | 68 | 265 |
| 2021 Febrero | 169 | 57 | 226 |
| 2021 Enero | 151 | 43 | 194 |
| 2020 Diciembre | 98 | 26 | 124 |
| 2020 Noviembre | 96 | 24 | 120 |
| 2020 Octubre | 97 | 16 | 113 |
| 2020 Septiembre | 96 | 8 | 104 |
| 2020 Agosto | 90 | 15 | 105 |
| 2020 Julio | 124 | 23 | 147 |
| 2020 Junio | 131 | 19 | 150 |
| 2020 Mayo | 110 | 22 | 132 |
| 2020 Abril | 61 | 30 | 91 |
| 2020 Marzo | 70 | 16 | 86 |
| 2020 Febrero | 77 | 17 | 94 |
| 2020 Enero | 97 | 26 | 123 |
| 2019 Diciembre | 106 | 38 | 144 |
| 2019 Noviembre | 55 | 27 | 82 |
| 2019 Octubre | 58 | 42 | 100 |
| 2019 Septiembre | 75 | 55 | 130 |
| 2019 Agosto | 74 | 32 | 106 |
| 2019 Julio | 72 | 48 | 120 |
| 2019 Junio | 91 | 58 | 149 |
| 2019 Mayo | 223 | 106 | 329 |
| 2019 Abril | 215 | 84 | 299 |
| 2019 Marzo | 135 | 37 | 172 |
| 2019 Febrero | 83 | 20 | 103 |
| 2019 Enero | 92 | 25 | 117 |
| 2018 Diciembre | 67 | 23 | 90 |
| 2018 Noviembre | 113 | 28 | 141 |
| 2018 Octubre | 144 | 15 | 159 |
| 2018 Septiembre | 76 | 14 | 90 |
| 2018 Agosto | 1 | 0 | 1 |
| 2018 Julio | 2 | 0 | 2 |
| 2018 Junio | 1 | 0 | 1 |
| 2018 Mayo | 17 | 0 | 17 |
| 2018 Abril | 51 | 0 | 51 |
| 2018 Marzo | 45 | 0 | 45 |
| 2018 Febrero | 44 | 0 | 44 |
| 2018 Enero | 54 | 0 | 54 |
| 2017 Diciembre | 33 | 0 | 33 |
| 2017 Noviembre | 74 | 0 | 74 |
| 2017 Octubre | 57 | 0 | 57 |
| 2017 Septiembre | 49 | 0 | 49 |
| 2017 Agosto | 39 | 0 | 39 |
| 2017 Julio | 52 | 2 | 54 |
| 2017 Junio | 59 | 37 | 96 |
| 2017 Mayo | 68 | 17 | 85 |
| 2017 Abril | 64 | 16 | 80 |
| 2017 Marzo | 75 | 29 | 104 |
| 2017 Febrero | 120 | 58 | 178 |
| 2017 Enero | 43 | 21 | 64 |
| 2016 Diciembre | 60 | 24 | 84 |
| 2016 Noviembre | 123 | 32 | 155 |
| 2016 Octubre | 79 | 37 | 116 |
| 2016 Septiembre | 85 | 38 | 123 |
| 2016 Agosto | 66 | 33 | 99 |
| 2016 Julio | 46 | 29 | 75 |
| 2016 Mayo | 1 | 0 | 1 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Marzo | 4 | 0 | 4 |
| 2015 Diciembre | 3 | 0 | 3 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 12 | 0 | 12 |
| 2015 Junio | 6 | 8 | 14 |
| 2015 Mayo | 14 | 17 | 31 |
| 2015 Abril | 13 | 0 | 13 |
| 2015 Marzo | 12 | 0 | 12 |
| 2015 Febrero | 8 | 13 | 21 |
| 2015 Enero | 20 | 5 | 25 |
| 2014 Diciembre | 21 | 1 | 22 |
| 2014 Noviembre | 12 | 3 | 15 |
| 2014 Octubre | 14 | 3 | 17 |
| 2014 Septiembre | 11 | 5 | 16 |
| 2014 Agosto | 13 | 4 | 17 |
| 2014 Julio | 17 | 2 | 19 |
| 2014 Junio | 32 | 4 | 36 |
| 2014 Mayo | 28 | 4 | 32 |
| 2014 Abril | 22 | 3 | 25 |
| 2014 Marzo | 27 | 15 | 42 |
| 2014 Febrero | 19 | 12 | 31 |
| 2014 Enero | 22 | 4 | 26 |
| 2013 Diciembre | 21 | 6 | 27 |
| 2013 Noviembre | 30 | 11 | 41 |
| 2013 Octubre | 52 | 15 | 67 |
| 2013 Septiembre | 47 | 11 | 58 |
| 2013 Agosto | 24 | 11 | 35 |
| 2013 Julio | 3 | 3 | 6 |
| 2013 Junio | 3 | 7 | 10 |
| 2013 Mayo | 4 | 3 | 7 |
| 2013 Abril | 3 | 2 | 5 |
| 2013 Marzo | 4 | 3 | 7 |
| 2013 Febrero | 16 | 2 | 18 |
| 2013 Enero | 36 | 0 | 36 |
| 2012 Diciembre | 23 | 3 | 26 |
| 2012 Noviembre | 30 | 1 | 31 |
| 2012 Octubre | 22 | 1 | 23 |
| 2012 Septiembre | 4 | 1 | 5 |
| 2000 Noviembre | 2901 | 0 | 2901 |
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