All issues > Volume 45(1); 2002

Original Article

J Korean Pediatr Soc. 2002;45(1):72-78. Published online January 15, 2002.

Diagnostic Value of 99mTc-DMSA Pinhole Imaging in Childhood Urinary Tract Infection with Renal Cortical Defect

Tae Won TW Lee¹, Seung Jun SJ Seong¹, Byung Moon BM Ahn¹, Ie Ryung IR Yoo², Il Soo IS Kim¹, Eun Ryoung ER Kim¹, Sung Hoon SH Kim², Yong-Whee YW Bahk³

¹Departments of Pediatric, Sung-Ae General Hospital, Seoul, Korea
¹Departments of Pediatric, Sung-Ae General Hospital, Seoul, Korea
²Department of Nuclear Medicine, Kangnam St. Mary`s Hospital, Catholic University M edical School, Seoul, Korea
³Departments of Nuclear Medicine, Sung-Ae General Hospital, Seoul, Korea

Correspondence Eun Ryoung ER Kim ,Email: NICU@chollian.net

Abstract

Purpose
: The aim of this study was to assess the diagnostic value of the 99mTc-DMSA pinhole imaging by comparing the detection rate of cortical defects identified from planar and pinhole imaging.
Methods
: 99mTc-DMSA planar and pinhole imaging, voiding cystoureth-rogram(VCUG), renal ultrasonography were performed in 67 patients diagnosed with urinary tract infection at the Department of Pediatrics, Sung-Ae General Hospital, from September, 1999 to Feburary, 2001. The follow-up of 99mTc-DMSA pinhole imaging was performed on 25 patients.
Results
: Overall detection rate of 99mTc-DMSA planar imaging was 41.8%(28 patients/67 patients), but 99mTc-DMSA pinhole imaging showed cortical defects in 62.7%(42 patients/67 patients) and the patients with renal cortical defects in planar imaging showed all definite or more additional cortical defects in pinhole imaging. The detection rate of cortical defect by 99mTc- DMSA pinhole imaging in patients with vesicoureteral reflux(VUR) was 80%(24 kidneys/30 kidneys). Those without VUR, however, also presented high detection rate as 25.9%(27 kidneys/ 104 kidneys). Out of 25 patients, improvement of cortical defect was presented in 19, no change in 4, and aggravation in 2 from the follow-up studies by 99mTc-DMSA pinhole imaging.
Conclusion
: This study indicates that 99mTc-DMSA pinhole imaging is superior to planar imaging and, hence, that pinhole imaging is a useful initial diagnostic tool for children suspected of urinary tract infection, irrespective of VUR, and to identify patients who need more extensive radiological studies and early treatment.

Keywords :99mTc-DMSA, Pinhole, Planar, Urinary tract infection