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DOI:10.2214/AJR.08.2187
AJR 2009; 192:1197-1208
© American Roentgen Ray Society


Review

Vesicoureteral Reflux and Urinary Tract Infection: Evolving Practices and Current Controversies in Pediatric Imaging

Ruth Lim1

1 Division of Pediatric Radiology and Division of Nuclear Medicine Molecular Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 34 Fruit St., ELL 237, Boston, MA 02114.

OBJECTIVE. Pediatric patients with urinary tract infection (UTI) undergo imaging tests to detect vesicoureteral reflux (VUR) in the belief that VUR correlates to risk of renal scarring. This article describes recent evolution and controversies in the management of UTI and VUR.

CONCLUSION. Multitechnique imaging of UTI and VUR is complex and controversial. Evolution in practice patterns is motivated by the desire to rationally minimize unnecessary interventions and radiation exposure. Ongoing evidence-based research is needed to further improve practice guidelines.

Keywords: pediatric imaging • radionuclide cystography • renal cortical scintigraphy • ultrasound • urinary tract infection • vesicoureteral reflux • voiding cystourethrography


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