MP17-18 SUPERB MICROVASCULAR IMAGING FOR THE EVALUATION OF PARENCHYMAL PERFUSION IN THE UNDESCENDED TESTES IN YOUNG CHILDREN

THE JOURNAL OF UROLOGYâ

Vol. 193, No. 4S, Supplement, Saturday, May 16, 2015

e183

MP17-18 SUPERB MICROVASCULAR IMAGING FOR THE EVALUATION OF PARENCHYMAL PERFUSION IN THE UNDESCENDED TESTES IN YOUNG CHILDREN Yong Seung Lee*, Sang Won Han, Myung-Joon Kim, Young Jae Im, Mi-Jung Lee, Seoul, Korea, Republic of INTRODUCTION AND OBJECTIVES: Superb microvascular imaging (SMI) is a new Doppler technique which can detect the subtle low-flow components. The purpose of this study was to evaluate perfusion difference in the undescended testes compared with normal testes in young children using this technique. METHODS: We retrospectively reviewed testicular ultrasonographic images including power Doppler imaging (PDI) and SMI in young children. The diagnosis of cryptorchidism or normal testis was determined according to the physical examination by an experienced pediatric urologist. Testicular size, volume, and flow on both PDI and SMI for each testis were evaluated. The flow was categorized as four grades; grade 0 as no detectable flow, grade 1 as one or two spots of flow, grade 2 as one linear or more than two spots of flow, and grade 3 as more than one linear flow. Statistical analysis was performed to compare the undescended and normal testes using Mann-Whitney U test and Pearson¡s chi-squared test. RESULTS: Forty testes from twenty boys (age; 2e29 months) were included. Eleven boys had normal testes, seven had unilateral cryptorchidism, and two had bilateral cryptorchidism. The mean age was younger in boys with cryptorchidism (7.8 vs. 15.9 months, p < 0.001). In comparing 29 normal and 11 undescended testes, testicular size and volume were not different. However, the flow grades were different on SMI (p < 0.001). In univariate analysis, age (odds ratio [OR], 0.829; p ¼ 0.012) and low grades flow on SMI (OR of grade 1, 14.296; p ¼ 0.017 and OR of grade 0, 51.886; p < 0.001) were associated with cryptorchidism. These parameters were also significant in multivariate analysis with the area under the curve of 0.892. CONCLUSIONS: This study demonstrated decreased perfusion in the undescended testes in young children using SMI which may attribute to illuminate the pathophysiology of cryptorchidism. Table 1 Comparison between the normal group and cryptorchidism group Normal group

Cryptorchidism group

Number of patients, n *

18

9

Number of testes, n

29

11

**pvalue

Age, months

15.97.9

7.84.9

<.001

Size, mm

13.12.1

12.92.3

0.833

Volume, cc

0.50.2

0.40.1

0.199

Grade 0

9 (31%)

7 (64%)

Grade 1

10 (35%)

4 (36%)

Grade 2

8 (28%)

0 (0%)

Grade 3

2 (7%)

0 (0%)

Grade 0

1 (4%)

5 (46%)

Grade 1

5 (17%)

4 (36%)

Grade 2

6 (21%)

2 (18%)

Grade 3

17 (59%)

0 (0%)

Flow grades on PDI

0.130

<.001

Flow grades on SMI

PDI power Doppler imaging, SMI Superb microvascular imaging, *Total 20 patients were enrolled with seven unilateral and two bilateral undescended testes. The patients with unilateral undescended testes were included in both groups. **from independent t-test except flow grades using Fisher’s exact test

Source of Funding: none

MP17-19 QUANTITY ASSESSMENT OF VESICOURETERAL REFLUX BY DIRECT RADIONUCLIDE CYSTOGRAPHY Zukhra Sabirzyanova*, Andrey Pavlov, Dmitry Fomin, Gevorg Simonyan, Moscow, Russian Federation INTRODUCTION AND OBJECTIVES: Usually a grade of vesicoureteral reflux can be define by roentgen micturition cistography, at the same time the radionuclide methods may help only in its quality diagnostic, answering the question about its presenting, but not about it’s grade. The advantages of radionuclide method are minimal radiation dose and possibility attentively track whole process of filling and empting a bladder. We evaluate the diagnostic value of direct radionuclide cystography in comparing with “gold standard” - micturition cystourethrography (MCUG) in the detecting of the grade of vesicoureteral reflux (VUR) METHODS: 150 children in the age of from 3 month to 14 years with VUR were detected by both methods - direct radionuclide cystography and MCUG. Imaging parameters, which were described by direct radionuclide cystography, includes volume of bladder when VUR occurs, duration of VUR and its activity. Activity of VUR was measured as a relevance quantity of nuclear tracer in ureter comparing to its activity in bladder RESULTS: VUR grade 4 was found in 22 children. On direct radionuclide cystography, it was characterized by active VUR, when the activity in ureter was more than 15% comparing the activity in bladder. In 10 cases, it occurs on the small bladder volume less than 50% of effective volume, in others the bladder volume was 50e70%. There were prolonged VUR more than 120sec.in all cases. VUR grade 3 was detected in 40 children by MCUG. On radionuclide method, it was completely confirm in all patients. Its activity in 15 of them was 2,5%-5% with bladder volume less 50% from effective, in 10 5e7,5% on bladder volume above 50% from effective volume, in 15 there was 8e10% activity on bladder volume 60e80% from effective one. Duration of VUR was very different, from 10sec. until 110sec. Among 98 children where the radionuclide cystography found VUR activity less than 3,5% on the bladder volume near effective (80e100%) with it different duration MUCG confirm VUR grade 2 in 40 and VUR grade 1 in 45, in others 13 cases VUR was not confirm by roentgen cystography