Accuracy of Ultrasound in Identifying Renal Scarring as Compared to DMSA Scan

Urology ◽  
2020 ◽  
Vol 138 ◽  
pp. 134-137
Author(s):  
Julia B. Finkelstein ◽  
James T. Rague ◽  
Jeanne Chow ◽  
Alyssia Venna ◽  
Tanya Logvinenko ◽  
...  
Keyword(s):  
2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Sandrine Leroy ◽  
Alain Gervaix

Urinary tract infections (UTIs) are the most common source of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN) and vesicoureteral reflux (VUR) is important because of their association with renal scarring, leading in the cases to long-term complications. However, the gold standard examinations for both are either DMSA scan (for APN and scar) or cystography (for VUR) and present limitations (feasibility, pain, cost, etc.). Procalcitonin, a reliable marker of bacterial infections, was demonstrated to be a good predictor of both renal parenchymal involvement in the acute phase and late renal scars. Furthermore, it was also found to be associated with high-grade VUR and was the key tool of a clinical decision rule to predict high-grade VUR in children with a first UTI. Therefore, procalcitonin may certainly be found playing a role in the complex and still debated picture of which examination should be performed after UTI in children.


Author(s):  
Majid Vafaie ◽  
Javad Zare-noghabi ◽  
Hadiseh Bahri

Background: Acute pyelonephritis and vesicoureteral reflux are one of the main causes of renal scarring in children, which can lead to serious complications such as hypertension and chronic renal failure. The aim of this study was to evaluate the scan disorders in children aged 1-12 years with acute pyelonephritis and its relation with ureteral bladder reflux.Methods: This retrospective cross-sectional descriptive study was conducted on all patients who had been diagnosed with febrile UTI for 4 years (2012-2015) in Ardebil's Children's Hospital. Information about 99mTc-DMSA scan and ultrasonography and cystoyurethrography of patients were extracted from the files and then analyzed by statistical methods inSPSS.19.Results: 148 children (9 boys and 139 girls) with a range of 1 to 12 years old (mean age of 52.34±4.34 months) were included in the study. Of these, 123 patients were subjected to cystoyurethrography after a negative urine culture. A 99mTc-DMSA scan report in the acute phase of the disease was abnormal in 80.4% of the children. VCUG and RNC tests were performed in 123 patients, in 70 (57%) normal cases, and in 53 cases (43%) of urinary reflux. The incidence of reflux with abnormal 99mTc-DMSA scan was 42%. There was no significant correlation between the prevalence of reflux in patients with abnormal 99mTc-DMSA scan in two groups of 1-4 years old and more than 4 years old. No significant difference was found in patients with abnormal scan in responding to treatment and comparing fever after admission in patients with normal 99mTc-DMSA.Conclusions: The results indicate high prevalence of reflux in patients with acute pyelonephritis. Due to the high sensitivity of the scan to detect pyelonephritis and, Pyelonephritis.


Author(s):  
Nisha Jacob Arackal Jacob ◽  
Seshagiri Koripadu ◽  
Harishchandra Venkata Yanamandala

Background: The aim of the study was to determine the risk factors for renal scarring detected by DMSA (dimercaptosuccinic acid) scan in children with culture-proven urinary tract infection (UTI).Methods: A hospital based observational case-control study was conducted from 2018 June to 2020 June in children aged between 1 month to 5 years who underwent a DMSA scan following culture-proven UTI (N=72). Of the children fulfilling the criteria, 43 had renal scarring in the DMSA scan as a case group and the remaining 29 children who had no renal scarring were taken as a control group.Results: Of the total 72 cases with culture-positive UTI, 59% of patients had renal scarring and the rest and 40% were scar negative. There was no significant difference in the renal scarring observed with respect to age in the two groups. There was significant (p<0.05) the association noted between renal scarring and VUR (vesicoureteric reflux). A significant difference was observed in the renal scarring between the two groups regarding the presence of recurrent UTI (p=0.000). Although most cases (97.7%) had a fever in the DMSA positive group, this was not a significant risk factor for scarring (p>0.05). In DMSA positive group, circumcision was not a significant risk factor for scarring.Conclusions: VUR and recurrent UTI were significant risk factors for renal scarring in children with culture-proven UTI as detected by DMSA scan. The other risk factors like age, sex, fever, leucocytosis and circumcision were not found to be significant. 


1988 ◽  
Vol 63 (11) ◽  
pp. 1315-1319 ◽  
Author(s):  
J M Smellie ◽  
P J Shaw ◽  
N P Prescod ◽  
H M Bantock

2004 ◽  
Vol 19 (2) ◽  
pp. 153-156 ◽  
Author(s):  
Ima Moorthy ◽  
Deirdre Wheat ◽  
Isky Gordon

Urology ◽  
2010 ◽  
Vol 76 (1) ◽  
pp. 204-208 ◽  
Author(s):  
Jenny H. Yiee ◽  
Michael DiSandro ◽  
Ming-Hsien Wang ◽  
Adam Hittelman ◽  
Laurence S. Baskin

2008 ◽  
Vol 53 (4) ◽  
pp. 7-10 ◽  
Author(s):  
H Narchi ◽  
R Donovan

Objective Young children may develop renal scarring following a urinary tract infection (UTI) especially after pyelonephritis which is difficult to diagnose. Permanent renal scars are diagnosed by dimercapto-succinic acid (DMSA) scan several months later. To decrease unnecessary exposure to radiation, we investigate the role of renal power Doppler (RPD) in predicting those who may not require a late DMSA scan. Methods Children under four years of age with a first UTI underwent an RPD study soon after diagnosis, and a DMSA scintigraphy six months later. The predictive values of the early RPD to detect DMSA renal scarring were calculated. Results Twenty three children (median age 30 months) were enrolled: 13 had a febrile presentation, two with bacteraemia. Permanent scarring occurred in three children (13%). In the 46 kidney units studied, initial RPD was abnormal in two and late DMSA abnormal in three units. Overall concordance between RPD and DMSA was 93.5%. The sensitivity of RPD for renal scar as per DMSA was 33.3%, specificity 97.7%; positive predictive value 50% and a negative predictive value of 95.4%. Conclusions RPD offered no advantage over ultrasound to predict renal scarring and cannot be recommended to predict renal scarring following UTI.


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