Comparison of 99mTc- Ethylene Dicysteine and 99mTc-Dimercaptosuccinic Acid Scintigraphy for the Evaluation of Cortical Scarring and Differential Renal Function in Children with Recurrent Urinary Tract Infection

ABSTRACT Introduction Urinary tract infection (UTI) is the most common and severe bacterial infection in children. Renal scarring and associated deterioration in the differential renal function is a frequent finding. Scarring may occur even in asymptomatic patients without vesicoureteric reflux. Materials and methods Fifty-three children (43 M:10 F, mean age:5.3 years; range 2-10 years) with evidence of recurrent UTI were enrolled in the study. Patients with duplex or crossed fused ectopic kidneys and with acute or chronic renal failure were excluded from the study protocol. Each patient underwent 99mTc-DMSA and 99mTc-EC renal scintigraphy within a period of 2 weeks. Results Analysis of results was performed by comparing the diagnostic accuracy of the summed 99mTc-EC and 99mTc-DMSA images for the detection of renal cortical scars and correlation (linear regression analysis) between the two renal scintigraphic procedures for the estimation of differential renal function. 99mTc-DMSA imaging demonstrated scarring in 41 kidneys whereas 99mTc-EC scintigraphy revealed scarring in 29/41 kidneys only. The percentage function of both kidneys with 99mTc-EC and 99mTc-DMSA showed good correlation. The r2 for left kidney was 0.95 and for right kidney was 0.94. Conclusion 99mTc-EC scintigraphy has low sensitivity (70%) for the detection of cortical scarring as compared to 99mTc-DMSA (100%) renal imaging. On the hand, 99mTc-DMSA static imaging gives good estimate for the DRF and the values are in good agreement with the corresponding values derived from dynamic 99mTc-EC scanning. How to cite this article Raja S, Pareek V, Singh B, Sharma S, Rao KLN, Mittal BR. Comparison of 99mTc-Ethylene Dicysteine and 99mTc-Dimercaptosuccinic Acid Scintigraphy for the Evaluation of Cortical Scarring and Differential Renal Function in Children with Recurrent Urinary Tract Infection. J Postgrad Med Edu Res 2012;46(4):183-186.

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Anderson-Hynes Pyeloplasty in Children: Nonintubated Versus Intubated

Bangladesh Journal of Child Health ◽

10.3329/bjch.v35i2.10378 ◽

2012 ◽

Vol 35 (2) ◽

pp. 59-61

Author(s):

Gazi Zahirul Hasan ◽

AKM Zahid Hossain ◽

Md Ruhul Amin ◽

Shafiqul Hoque ◽

MTH Siddiqui

Keyword(s):

Urinary Tract Infection ◽

Renal Function ◽

Urinary Tract ◽

Tract Infection ◽

Hospital Stay ◽

Paediatric Surgery ◽

Dhaka City ◽

Additional Advantage ◽

Differential Renal Function ◽

Medical University

Objective: To compare between nonintubated versus intubated Anderson-Hynes (AH) pyeloplasty in children.Study Design: Prospective studyStudy place: Department of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and some private clinics of Dhaka city. Study period: March 2001 to December 2008.Subjects: A total of 75 patients were included in this study. They were divided in two groups. Nonintubated Anderson-Hynes pyeloplasty was done in 45 patients and intubated Anderson-Hynes pyeloplasty was done in 30 patients.Results: The anastomotic leakage of urine, urinary tract infection, hospital stay and improvement of differential renal function were assessed post operatively in both nonintubated and intubated groups. This study showed that there was no anastomotic failure and no post operative urinary tract infection in either group. The percentage of improvement of differential renal function is almost same in both the groups. The post operative hospital stay was markedly reduced in nonintubated Anderson-Hynes pyeloplasty. In this study the post operative hospital stay in nonintubated group was average 6 days and it was average 16.5 days in intubated group.Conclusion: From this study it may be concluded that the effects of nonintubated AH pyeloplasty is as good as intubated one but an additional advantage of significantly less post operative hospital stay was observed in nonintubated group.DOI: http://dx.doi.org/10.3329/bjch.v35i2.10378 Bangladesh J Child Health 2011; Vol 35 (2): 59-61

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