The risk of developing a urinary tract infection (UTI) during childhood is approximately 8% for girls and 2% for boys. Many of these children afflicted by recurrent UTIs have VUR. Children with VUR are at risk of renal scarring. This scarring can cause serious sequelae as these children grow into adulthood, including renal hypertension, proteinuria, and end-stage renal disease. The negative health impacts of VUR can be successfully ameliorated by prompt diagnosis, allowing for early  management with antibiotic prophylaxis to prevent UTIs and surgical interventions in more severe cases.

Currently, it is recommended that children with recurrent UTIs undergo diagnostic imaging to detect and/or confirm VUR. Three imaging modalities are currently available and include VCUG, DRNC, and ceVUS. Many children, once diagnosed with VUR, may require serial imaging to guide treatment; therefore, the safety and cost of the imaging modality are important. While ceVUS is perhaps the least utilized of the three above-mentioned modalities in the United States, it has a distinct advantage compared to both VCUG and DRNC because it does not expose children to ionizing radiation.

After completing this activity, participants should be better able to:

• Review the epidemiology and potential consequences of VUR in pediatric patients
• Summarize indications, practice guidelines, and recommendations demonstrating the diagnostic utility and safety of ceVUS for the diagnosis of VUR
• Describe the diagnostic efficacy of ceVUS compared with voiding cystourethrography (VCUG) and direct radionuclide cystography (DRNC)
  agents (UCAs)

This activity is designed for pediatric radiologists, pediatric urologists, sonographers, and other healthcare professionals to help them better understand the indications, applications, potential benefits, and technical considerations in performing contrast-enhanced voiding urosonography (ceVUS) for the evaluation of vesicoureteral reflux (VUR) in pediatric patients.

This SDMS CME activity has been planned and submitted for approval of 1.00 hour of SDMS CME Credit Category AB by the Society of Diagnostic Medical Sonographers (SDMS).

Release Date: 7/14/25 | Expires 7/14/2026

Faculty and Planner Disclosures:
As an accredited provider of continuing medical education, it is the policy of Northwest Imaging Forums, Inc. (NWIF) to ensure balance, independence, objectivity, and scientific rigor in all of its webinar activities. In accordance with this policy, faculty and planners must disclose any financial relationships with ineligible companies. Additionally, in the event a relevant financial relationship does exist, it is the policy of NWIF to ensure that the relevant financial relationship is mitigated in order to ensure the integrity of the SDMS CME activity. The planner has nothing to disclose.

Dana A. Weiss, MD

Assistant Professor of Urology in Surgery Attending Pediatric Urologist, Division of Urology Children’s Hospital of Philadelphia
Perelman School of Medicine, University of Pennsylvania Philadelphia, Pennsylvania

Susan J. Back, MD, FAAP

Assistant Professor of Radiology
Director, Section of Genitourinary Imaging Director, Center for Pediatric Contrast Ultrasound,
Division of Body Imaging Children’s Hospital of Philadelphia
Perelman School of Medicine, University of Pennsylvania Philadelphia, Pennsylvania