The RIVUR Voiding Cystourethrogram Pilot Study: Experience with Radiologic Reading Concordance

摘要: Purpose Two reference radiologists independently review voiding cystourethrograms for the National Institutes of Health sponsored RIVUR (Randomized Intervention Children with Vesicoureteral Reflux) trial children vesicoureteral reflux. A pilot study was required from all clinical centers before enrolling patients. Materials and Methods Digital images were reviewed. Responses compared discrepancies adjudicated by teleconference to a final assessment. Results total 75 studies 19 sites Discrepancies in reflux grade level noted on left right side 11 (15%, kappa 0.85) 12 (16%, 0.83) ureters, respectively. Other areas disagreement presence paraureteral diverticulum (left 11%, 0.31; 9%, 0.34), urethral anatomy 0.33), whether child voided (8%, 0.21), ureteral duplication 7%, 0.64; 3%, 0.78) bladder trabeculation (5%, 0.32). Of 83 ureters which seen there about 23 (28%). 61 initially assessed as II or III both readers, 9 (15%). these 7 (78%) higher (grade III). Conclusions assessment intermediate noteworthy. Recommendations patients advanced rely single reading, categorize only significant, may not be valid.