| Diagnostic Value of 99mTc-DMSA SPECT in Children with Urinary Tract Infection |
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Jae Won Choi1, Sung Ho Cha1, Byoung Soo Cho1, Duk Yoon Kim2 |
1Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
2Department of Nuclear Medicine, College of Medicine, Kyung Hee University, Seoul, Korea |
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최재ì›1, 차성호1, 조병수1, ê¹€ë•ìœ¤2 |
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2ê²½í¬ëŒ€í•™êµ ì˜ê³¼ëŒ€í•™ 핵ì˜í•™ê³¼êµì‹¤ |
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| Abstract |
Purpose
: The accurate identification of renal cortical defects in children with urinary
tract infection is essential in reducing subsequent morbidity. Imaging of the kidneys with
99mTc-dimercaptosuccinic acid (DMSA) has been demonstrated as the sensitive method
available for identification of renal cortical defects. Single photon emission computerized
tomography(SPECT) has been suggested as a method by which the accuracy of
identification of renal cortical defects can be improved. The aim of this study was to
assess the diagnostic value of the 99mTc-DMSA SPECT, comparing the detection rate of
cortical defects identified from planar imaging and SPECT data.
Methods
: 99mTc-DMSA SPECT, planar imaging and voiding cystourethrogram(VCUG)
were performed in 76 patients diagnosed urinary tract infection at the department of
pediatrics, Kyung Hee University Hospital, from March, 1994 to Feburary, 1995. Followup
99mTc-DMSA SPECT was done in 7 patients.
Results
:
1) Overall detection rate of 99mTc-DMSA SPECT imaging was 32.9% (25/76), but,
planar imaging showed cortical defects in 21.1%(16/76).
2) The patients with renal cortical defects in planar imaging showed all definite or
more additional cortical defects in 99mTc-DMSA SPECT imaging.
3) Seven patients presented improvement in 4, no change in 2, and aggrevation in 1 on
follow-up studies.
4) Incidence of renal cortical defects was higher in patients with vesicoureteral reflux
(VUR); the detection rate was 83.3%(10/12). But, those of without VUR also presented
high detection rate as 23.4%(19/60).
5) There is no correlation between renal cortical defects and urine culture findings.
Conclusions
: 99mTc-DMSA SPECT imaging is superior to planar imaging, thus
99mTc-DMSA SPECT is a useful initial diagnostic tool in children suggesting urinary
tract infection, irrespective of VUR, to identify patients who need more extensive
radiological studies and early treatment. |
| Key Words:
99mTc-DMSA SPECT, Urinary Tract Infection |
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