�ESKÁ UROLOGIE / CZECH UROLOGY � 1 / 2018

33 Ces Urol 2018; 22(1): 32�39 ORIGINÁLNÍ PRÁCE reterální reflux 4.-5. stupn� byl prokázán u 22 d�tí (21,8 %) - 5 dívek (23 %), 17 chlapc� (77 %). Pr�m�rný v�k provedení MCUG u této skupiny pacient� byl 3,95 m�síce, medián t�i m�síce (1�22). Mo�ovod ?3 mm byl zachycen u 12 d�tí (55 %), pánvi�ka ?5mm u 21 d�tí (95 %). P�i statistickém posouzení nebyla zji�t�na statisticky významná souvislost mezi sledovanými ultrazvukovými parametry a pr�kazem vezikoureterálního refluxu 4.-5. stupn�. Ve druhém souboru byla mik�ní cystoure- trografie uskute�n�na u 84 d�tí. Vezikoureterální reflux 4.-5. stupn� byl zji�t�n u 24 d�tí (28,6 %) - 11 dívek (46 %), 13 chlapc� (54 %). Pr�m�rný v�k provedení MCUG prokazující vysokostup�ový VUR byl 6,55 m�síc�, medián 4,5 m�síc� (1�17). Mo�o- vod ?3 mm byl zachycen u 9 d�tí (41 %), pánvi�ka ?5 mm u 19 d�tí (86 %). P�i statistickém hodno- cení byla prokázána významná souvislost mezi p�í�ným pr�m�rem pánvi�ky <8 mm a pr�kazem vezikoureterálního refluxu 4.-5. stupn� (p=0,037) a mezi tlou��kou parenchymu <8 mm a pr�kazem vezikoureterálního refluxu 4.-5. stupn� (p=0,019). Záv�r: U pacient� ve v�ku 0-2 roky se screenin- govým ultrazvukovým pr�kazem dilatace horních mo�ových cest neumo�ní ultrazvukové hodnocení �í�e pánvi�ky, mo�ovodu nebo síly parenchymu pre- dikci vysokostup�ového vezikoureterálního refluxu. U pacient� ve v�ku 0-2 roky, kte�í prod�lali akutní pyelonefritidu, sv�d�í pro p�ítomnost vezikourete- rálního refluxu 4.-5. stupn� p�í�ný pr�m�r pánvi�ky do 8mm a/nebo redukce parenchymu pod 8mm. KLÍ�OVÁ SLOVA D�ti, mik�ní cystouretrografie, ultrazvuk, vezikou- reterální reflux. SUMMARY �makal O, �arapatka J, Vrána J, Flögelová H, Kle�tincová T. The value of ultrasound evaluation in predicting high-grade vesicoureteral reflux in children under two years of age The main aspect of the paper: A prospective study evaluated the benefit of ultrasound evalua- tion in predicting grade IV�V vesicoureteral reflux in children aged 0�2 years investigated for asymp- tomatic upper urinary tract dilation detected on ultrasound screening or after having had acute pyelonephritis. Aim: To assess the value of ultrasound evalua- tion in predicting grade IV�V vesicoureteral reflux in children aged 0�2 years investigated for postnatal detection of upper urinary tract dilation or after having had acute pyelonephritis. Method: In a prospective study, the measured ultrasound parameters of the upper urinary tract (anteroposterior renal pelvis diameter, parenchymal thickness, and ureteral width) were compared with the results of voiding cystourethrography in two cohorts of patients aged 0-2 years. Patient cohort 1 was investigated for postnatal detection of upper urinary tract dilation, while patient cohort 2 in- cluded those who had had acute pyelonephritis. Fisher�s test at the 5% significance level, chi- square test, and logistic regression test were used for statistical analysis. Results: Voiding cystourethrography was performed in 101 children in patient cohort 1. Grade IV�V vesicoureteral reflux was shown in 22 children (21.8%) � 5 girls (23%) and 17 boys (77%). The mean age at which a VCUG was performed in this patient cohort was 3.95 months, with a median of 3 months (1�22). A ureter ?3 mm was found in 12 children (55%) and a renal pelvis ?5 mm in 21 children (95%). The statistical analysis failed to find a statistically significant association between the observed ultrasound parameters and evidence of grade IV�V vesicoureteral reflux. In patient cohort 2, voiding cystourethrography was carried out in 84 children. Grade IV�V vesi- coureteral reflux was found in 24 children (28.6%) � 11 girls (46%), 13 boys (54%). The mean age at which a VCUG demonstrating high-grade vesicoureteral reflux was performed was 6.55 months, with a me- dian of 4.5 months (1�17). A ureter ?3 mm was detected in 9 children (41%) and a renal pelvis ?5 mm in 19 children (86%). The statistical analysis demonstrated a significant association between a transverse diameter of the renal pelvis <8 mm and evidence of grade IV�V vesicoureteral reflux (p = 0.037) as well as between a parenchymal thickness <8 mm and evidence of grade IV�V vesi- coureteral reflux (p = 0.019).