Sonography with sonicated albumin in the detection of vesicoureteral reflux

A. Atala, J. H. Wible, J. C. Share, M. C. Carr, A. B. Retik, J. Mandell

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

The primary radiological procedures for diagnosing vesicoureteral reflux are fluoroscopic and radionuclide cystography. Ultrasonography, with no ionizing radiation, would be useful as a screening tool for the diagnosis of reflux due to its absence of radiation exposure. We evaluated the usefulness of ultrasonography with sonicated albumin in the diagnosis of vesicoureteral reflux. Sonicated albumin contains approximately 3 to 5 x 108 microspheres per ml., which are echogenic. Sonicated albumin was tested in vitro, alone, and in human and porcine urine to assess microsphere stability. Urine dilutions, specific gravity, temperature and pH were used as variables. The mode of delivery was also tested in vitro and in vivo. These studies showed that sonicated albumin microspheres were stable over a wide range of chemical variables and urine composition. Sonicated albumin produced an image of uniform echogenicity when it was pre-loaded into a Foley catheter and followed by saline infusion in vitro. Fluoroscopic cystograms, using standard radiopaque contrast media, in 5 Hanford mini-swine in which unilateral reflux had been created previously confirmed the presence of reflux unilaterally. Sonographic cystograms with various dilutions of sonicated albumin in 0.9% sodium chloride (1:100, 1:250, 1:500, 1:750 and 1:1,000) were performed. At a dilution of 1:100 sonicated albumin produced dramatic echogenicity in the bladder and refluxing ureters during sonographic imaging. The microspheres appeared to be stable for prolonged periods (more than 40 minutes), thus allowing for a careful sonographic assessment of the entire genitourinary tract. Sonicated albumin may be valuable for the sonographic detection of vesicoureteral reflux.

Original languageEnglish
Pages (from-to)756-758
Number of pages3
JournalJournal of Urology
Volume150
Issue number2 SUPPL.
StatePublished - Jan 1 1993
Externally publishedYes

Fingerprint

Vesico-Ureteral Reflux
Albumins
Ultrasonography
Microspheres
Urine
Contrast Media
Swine
Specific Gravity
Ureter
Ionizing Radiation
Sodium Chloride
Radioisotopes
Urinary Bladder
Catheters
Temperature

Keywords

  • albumins
  • sonication
  • ultrasonography
  • vesico-ureteral reflux

ASJC Scopus subject areas

  • Urology

Cite this

Atala, A., Wible, J. H., Share, J. C., Carr, M. C., Retik, A. B., & Mandell, J. (1993). Sonography with sonicated albumin in the detection of vesicoureteral reflux. Journal of Urology, 150(2 SUPPL.), 756-758.

Sonography with sonicated albumin in the detection of vesicoureteral reflux. / Atala, A.; Wible, J. H.; Share, J. C.; Carr, M. C.; Retik, A. B.; Mandell, J.

In: Journal of Urology, Vol. 150, No. 2 SUPPL., 01.01.1993, p. 756-758.

Research output: Contribution to journalArticle

Atala, A, Wible, JH, Share, JC, Carr, MC, Retik, AB & Mandell, J 1993, 'Sonography with sonicated albumin in the detection of vesicoureteral reflux', Journal of Urology, vol. 150, no. 2 SUPPL., pp. 756-758.
Atala A, Wible JH, Share JC, Carr MC, Retik AB, Mandell J. Sonography with sonicated albumin in the detection of vesicoureteral reflux. Journal of Urology. 1993 Jan 1;150(2 SUPPL.):756-758.
Atala, A. ; Wible, J. H. ; Share, J. C. ; Carr, M. C. ; Retik, A. B. ; Mandell, J. / Sonography with sonicated albumin in the detection of vesicoureteral reflux. In: Journal of Urology. 1993 ; Vol. 150, No. 2 SUPPL. pp. 756-758.
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