| Diagnostic Value of 99mTc-DMSA Renal Scan for Early Diagnosis of Acute Pyelonephritis in Children with Febrile Urinary Tract Infection |
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Soo Ja Hwang1, Eun Ae Park1, Jeong Wan Seo1, Seung Joo Lee1, Sun Whan Lee2 |
1Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea
2Department of Diagnostic Radiology, Ewha Womans University, College of Medicine, Seoul, Korea |
| 발열성 소아 요로 감염에서 급성 신우신염의 조기진단에 대한 99mTc-DMSA 신주사의 진단적 가치 |
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황수자1, 박은애1, 서정완1, 이승주1, 이선화2 |
1이화여자대학교 의과대학 소아과학교실
2이화여자대학교 의과대학 방사선과학교실 |
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| Abstract |
Purpose
: For prevention of renal scar, early diagnosis and treatement of acute pyelonephritis
are important in children with febrile urinary tract infection. But it has been difficult to
differentiate acute pyelonephritis from lower urinary tract infection. We have performed this study
to evaluate the diagnostic value of 99mTc-DMSA renal scan and to clarify the relationship among
acute pyelonephritis, vesico-ureteral reflux and renal scar.
Methods
: We have studied 100 patients with febrile urinary tract infection, from September,
1993 to June, 1995 at the Pediatric department of Ewha Womans University, Mok-dong hospital.
Acute phase reactants, causative organism, renal ultrasound, 99mTc- DMSA renal scan on the acute
stage, voiding cystouretherogram after 1-2 weeks of treatement, and follow-up 99mTc-DMSA renal
scan were evaluated.
Results
: Ther results are as follows;
1) 57 patients (57%) had defect on 99mTc-DMSA renal scan and diagnosed as acute
pyelonephritis.
2) Acute phase reactants, renal ultrasound had low accuracy.
3) VUR was found in 31 (56.1%) of 57 patients with defect which was significantly higher
than the 4 (9.3%) of 43 patients without defect on 99mTc-DMSA renal scan.
4) On the follow up 99mTc-DMSA renal scan, 34.8% of defects recorvered, and 65.2% of
defects developed renal scar.
Conclusion
: 99mTc-DMSA renal scan is a valuable method for early diagnosis of acute
pyelonephritis in children with febrile urinary tract infection. It would contribute to evaluate the
relationship between acute pyelonephritis, vesico-ureteral reflux and renal scar. |
| Key Words:
99mTc-DMSA renal scan, Acute pyelonephritis |
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