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• W2034397978 abstract "No AccessJournal of UrologyPEDIATRIC UROLOGY1 Sep 2002Reliability of Contrast Enhanced Sonography with Harmonic Imaging for Detecting Early Renal Scarring in Experimental Pyelonephritis in a Porcine Model: Preliminary Results Walid Farhat, Jeffrey Traubici, Christopher Sherman, Tara Williams, Paul Babyn, and Gordon Mclorie Walid FarhatWalid Farhat More articles by this author , Jeffrey TraubiciJeffrey Traubici More articles by this author , Christopher ShermanChristopher Sherman More articles by this author , Tara WilliamsTara Williams More articles by this author , Paul BabynPaul Babyn More articles by this author , and Gordon MclorieGordon Mclorie More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64603-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Contrast medium enhanced harmonic ultrasound is a recently developed ultrasound technique that improves the assessment of renal parenchymal vascularity. We performed a preliminary study to define the ability of contrast enhanced ultrasound with harmonic imaging to detect and localize renal scars in a porcine model of experimentally induced pyelonephritis. Materials and Methods: Vesicoureteral reflux was surgically induced in 10 pigs weighing 10 kg. with the contralateral kidney serving as a control. Approximately 4 weeks after the creation of vesicoureteral reflux cystography confirmed reflux. Infection was induced by placing a suspension of paraffin broth impregnated with Escherichia coli in the bladder of each pig. At 4 to 8 weeks (mean 6.5) after the induction of infection a radiologist blinded to the side of the previous procedure performed conventional gray scale ultrasound, color Doppler ultrasound and contrast enhanced ultrasound with harmonic power imaging. The animals were sacrificed; the kidneys were inspected and tissues from the upper, mid and lower poles were sent for culture and histological examination. Histology results were compared with the findings of the 3 ultrasound modalities. Results: All 10 pigs survived the surgical procedures with no complications. Post-contrast harmonic ultrasound images were available in 9 pigs (18 renal units). Harmonic ultrasound revealed decreased blood flow in 11 renal units, including the upper pole in 7, lower pole in 3, and upper and lower poles in 2. Renal tissue cultures were positive in 11 renal units (6 refluxing units). Histological findings revealed fibrosis in 10 renal units (8 refluxing units). Harmonic ultrasound findings in these 10 renal units showed 9 with changes consistent with inflammation or scars. Using histological results as the gold standard for renal injury harmonic ultrasound was more sensitive than gray scale ultrasound for detecting renal injury with 90% sensitivity, 75% specificity, 81% positive predictive value and 85% negative predictive value. Conclusions: Preliminary results indicate that contrast enhanced ultrasound with harmonic imaging is a sensitive method for determining renal scarring without the need for radiation exposure. It may be prove to be a useful adjunct for evaluating children who present with urinary tract infection. References 1 : Prevalence of urinary tract infection in febrile infants. J Pediatr1993; 123: 17. Crossref, Medline, Google Scholar 2 : Immunology of pyelonephritis. VIII. E. coli causes granulocytic aggregation renal ischemia. J Urol1986; 136: 1117. Link, Google Scholar 3 : Microvascular changes in the early stage of reflux pyelonephritis. An experimental study in the pig kidney. Eur Urol1987; 13: 219. Crossref, Medline, Google Scholar 4 : [Prognosis in vesicoureteral reflux]. Med Arh2000; 54: 291. Medline, Google Scholar 5 : Reflux nephropathy. J Am Soc Nephrol1998; 9: 2377. 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Crossref, Medline, Google Scholar From the Departments of Urology, Radiology and Pathology, Hospital for Sick Children, Toronto, Ontario, Canada© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Stærk K, Langhorn L and Andersen T (2022) Clean-catching urine from pigs: A method for collecting quality specimens for urinalysis and microbiological culturing in a laboratory environmentLaboratory Animals, 10.1177/00236772221133433, (002367722211334) Barber A, Norton J, Wiles T and Mulvey M (2016) Strengths and Limitations of Model Systems for the Study of Urinary Tract Infections and Related PathologiesMicrobiology and Molecular Biology Reviews, 10.1128/MMBR.00067-15, VOL. 80, NO. 2, (351-367), Online publication date: 1-Jun-2016. Blandino A, Mazziotti S, Minutoli F, Ascenti G and Gaeta M (2014) Acute Renal Infections Radiological Imaging of the Kidney, 10.1007/978-3-642-54047-9_16, (411-436), . Darge K, Papadopoulou F, Ntoulia A, Bulas D, Coley B, Fordham L, Paltiel H, McCarville B, Volberg F, Cosgrove D, Goldberg B, Wilson S and Feinstein S (2013) Safety of contrast-enhanced ultrasound in children for non-cardiac applications: a review by the Society for Pediatric Radiology (SPR) and the International Contrast Ultrasound Society (ICUS)Pediatric Radiology, 10.1007/s00247-013-2746-6, VOL. 43, NO. 9, (1063-1073), Online publication date: 1-Sep-2013. De Palma D and Manzoni G (2013) Different imaging strategies in febrile urinary tract infection in childhood. What, when, why?Pediatric Radiology, 10.1007/s00247-012-2469-0, VOL. 43, NO. 4, (436-443), Online publication date: 1-Apr-2013. Berdichevski E, Mattos S, Bezerra S, Vilas E and Baldisserotto M (2013) Prevalência de pielonefrite aguda e incidência de cicatriz renal em crianças menores de dois anos de idade com infecção do trato urinário avaliadas por cintilografia renal com 99mTc-DMSA: a experiência de um hospital universitárioRadiologia Brasileira, 10.1590/S0100-39842013000100010, VOL. 46, NO. 1, (30-34), Online publication date: 1-Feb-2013. Khoury A and Bägli D (2012) Vesicoureteral Reflux Campbell-Walsh Urology, 10.1016/B978-1-4160-6911-9.00122-5, (3267-3309.e8), . Blandino A, Mazziotti S, Minutoli F, Ascenti G and Gaeta M (2010) Acute Renal Infections Radiological Imaging of the Kidney, 10.1007/978-3-540-87597-0_16, (417-444), . Sanna-Cherchi S, Ravani P, Corbani V, Parodi S, Haupt R, Piaggio G, Innocenti M, Somenzi D, Trivelli A, Caridi G, Izzi C, Scolari F, Mattioli G, Allegri L and Ghiggeri G (2009) Renal outcome in patients with congenital anomalies of the kidney and urinary tractKidney International, 10.1038/ki.2009.220, VOL. 76, NO. 5, (528-533), Online publication date: 1-Sep-2009. Avni F, Hall M, Cassart M and Massez A (2008) Urinary Tract Infection Pediatric Uroradiology, 10.1007/978-3-540-33005-9_15, (295-313), . Stogianni A, Nikolopoulos P, Oikonomou I, Gatzola M, Balaris V, Farmakiotis D and Dimitriadis A (2007) Childhood acute pyelonephritis: comparison of power Doppler sonography and Tc-DMSA scintigraphyPediatric Radiology, 10.1007/s00247-007-0510-5, VOL. 37, NO. 7, (685-690), Online publication date: 11-Jun-2007. Eiss D, Correas J, Ghouadni M and Hélénon O (2004) Imagerie des pyélonéphrites aiguësFeuillets de Radiologie, 10.1016/S0181-9801(04)94721-5, VOL. 44, NO. 1, (14-20), Online publication date: 1-Feb-2004. Robbin M, Lockhart M and Barr R (2003) Renal imaging with ultrasound contrastRadiologic Clinics of North America, 10.1016/S0033-8389(03)00070-8, VOL. 41, NO. 5, (963-978), Online publication date: 1-Sep-2003. Volume 168Issue 3September 2002Page: 1114-1117 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordspyelonephritisswineurinary tract infectionskidneyultrasonographyMetricsAuthor Information Walid Farhat More articles by this author Jeffrey Traubici More articles by this author Christopher Sherman More articles by this author Tara Williams More articles by this author Paul Babyn More articles by this author Gordon Mclorie More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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