ABSTRACT
The lower urinary tract is evaluated with either a fluoroscopic voiding cystourethrogram (VCUG) or a radionuclide cystogram (RNC). VCUG gives more anatomic detail and can document associated anomalies such as ureterocelas and paraureteric divoticula. It also allows for a more precise estimate of grading. Figure 27.1 shows a VCUG with bilaternal duplication anomalies with a partial triplication on the right. An RNC may have less radiation exposure and is helpful for following patients being managed non-operatively. VUR is graded on a scale of one to five based on the International Reflux Study group guidelines. Figure 27.2 describes the currently accepted grading system.10
