RENAL CORTICAL SCINTIGRAPHY IN THE ASSESSMENT OF ACUTE PYELONEPHRITIS IN CHILDREN

Authors

  • Ashoke Kumar Paul Senior Medical Officer Centre for Nuclear Medicine and Ultrasound, Khulna Bangladesh ? Choudhury Habibur Rasul Associate Professor Department of Paediatrics Khulna Medical College Hospital Bangladesh
  • Choudhury Habibur Rasul Department of Paediatrics Khulna Medical College Hospital Bangladesh

Abstract

Acute pyelonephritis is a major cause of morbidity in children with urinary tract infection and can result in irreversible renal scarring leading to hypertension and end-staged renal disease. Tc-99m-dimercaptosuccinic acid (DMSA) scintigraphy is the imaging modality of choice for the detection of acute pyelonephritis and renal scarring. Forty-nine children (ages ranging from 9 months to 11 years) with urinary tract infection, having positive urine culture, were studied. A DMSA scan was performed within 72 hours of receiving antibiotic during acute infection. Follow-up scintigraphy was done at 6 months of initial scan in children with acute pyelonephritis documented by DMSA scan. Scintigraphy showed changes consistent with acute pyelonephritis in 27 (55.10%) children and the abnormalities were bilateral in 17 (63%) cases and unilateral in 10(37%) cases. Among these 44 abnormal kidneys, scintigraphy demonstrated solitary defect in 29 kidneys, multiple defects in 6 kidneys and diffused decreased uptake in 9 kidneys. Twenty children (34 kidneys) were available for follow-up evaluation and scintigraphy showed complete recovery in 21 of 34 (62%) kidneys and renal scarring in 13 of 34 (38%) kidneys. Renal scarring was found in 5 of 7 kidneys (71%) with diffuse decreased uptake, 2 of 5 kidneys (40%) with multiple cortical defect and 6 of 22 (27%) with single focal defect. From the study, it is observed that the scintigraphic pattern of acute pyelonephritis might be helpful to JAN. - APR. 2006 Volume XII Number| assess the risk of renal damage due to scarring following acute pyelonephritis.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Jakobsson B, Nolstedt L, Svensson L, et al. Technitum-99m-dimercatosuccinic acid scan in the diagnosis of acute pyelonephritis in chil dren: relation to clinical and radiological findings. Pediatr Nephrol 1992; 6: 328-334

Kass EJ, Fink-Bennett D, Cacciarelli AA, et al. The sensitivity of renal scintigraphy and sonography in detecting nonobstructive acute pyelonephritis. J Urol 1992; 148: 606-608

June CH, Browning MD, Smith LP, et al. Ultrasonography and computed tomography in severe urinary tract infection. Arch Intern Med 1985; 145: 841-845

Montgomery P, Kuhn JP, Afshani E. CT evaluation of severe renal inflammatory disease in children. Pediatr Radiol 1987; 17: 216-222

Majid M, Rushton HG. Renal cortical scintigraphy in the diagnosis of acute pyelonephritis. Semin Nucl Med 1992; 22: 98-111

Handmaker H. Nuclear renal imaging in acute pyelonephritis. Semin Nucl Med 1982; 12: 245-253

Bjorgvinsson E, Majid M, Eggli KD. Diagnosis of acute pyelonephritis in children: Comparison of sonography and 99m Te-DMSA scintigraphy. AJR 1991; 157: 539-543

Rosenberg AR, Rossleigh MA, Brydon MP, etal. Evaluation of acute urinary tract infection in children by dimercaptosuccinic acid scintigraphy: A prospective study. J Urol 1992; 148; 1746-1749.

Eggli DF, Tulchinsky M. Scintigraphic evaluation of pediatric urinary tract infection. Semin Nucl Med 1993; 23: 199-218.

Rushton HG, Majid M, Jantausch B, etal. Renal scarring following reflux and nonreflux pyelonephritis in children: Evaluation with 99mTechnetium-dimercaptosuccinic acid scintigraphy. J Urol 1992; 147: 1327-1332.

Orellana P, Baquedano P, Cavagnaro F,et al. Can acute renal scintigraphy abnormalities predict the evolution of renal damage in children with pyelonephritis? WJNM 2002; 1: 145.

Downloads

Published

2023-04-22

How to Cite

1.
Kumar Paul A, Habibur Rasul C. RENAL CORTICAL SCINTIGRAPHY IN THE ASSESSMENT OF ACUTE PYELONEPHRITIS IN CHILDREN. ASEAN J Radiol [Internet]. 2023 Apr. 22 [cited 2024 Oct. 5];12(1):13-6. Available from: https://asean-journal-radiology.org/index.php/ajr/article/view/753

Issue

Section

Original Article