RENAL CORTICAL SCINTIGRAPHY IN THE ASSESSMENT OF ACUTE PYELONEPHRITIS IN CHILDREN
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
Metrics
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
How to Cite
Issue
Section
License
Copyright (c) 2023 The ASEAN Journal of Radiology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Disclosure Forms and Copyright Agreements
All authors listed on the manuscript must complete both the electronic copyright agreement. (in the case of acceptance)