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Diagnostic and Prognostic Value of DMSA Scintigraphy in the Acute Stage of Pyelonephritis


Authors: K. Bláhová;  J. Janda;  H. Křížová 1
Authors‘ workplace: I. dětská klinika 2. LF UK a Fakultní nemocnice v Motole, Praha, přednosta doc. MUDr. J. Janda, CSc. Klinika nukleární medicíny a endokrinologie 2. LF UK a Fakultní nemocnice v Motole, Praha, 1 přednosta doc. MUDr. P. Vlček, CSc.
Published in: Čes-slov Pediat 2002; (10): 547-549.
Category:

Overview

Renal cortical scintigraphy (dimercaptosuccinic acid - DMSA) has been reported to be useful in children forconfirmation of the diagnosis of acute pyelonephritis. Subsequent experimental studies demonstrated thatDMSA,when compared directly with the histopathology, is highly reliable for the detection and localization of parenchymalinflammatory changes associated with acute pyelonephritis. DMSA is also the isotope agent of choice for thedetection of renal scarring. Clinical studies report a higher sensitivity ofDMSA renal scintigraphy for the detectionof renal scarring when compared with the excretory urogram, particularly in infants and young children. Renalscarring only occurs in sites corresponding exactly to previous areas of acute pyelonephritis damage demonstratedby DMSA scintigraphy at the time of infection. Whether or not the DMSA scan can replace or only supplementother routine investigations in the acute phase of children with urinary tract infection is still a matter of debate.

Key words:
acute pyelonephritis, dimercaptosuccinic acid scintigraphy, vesicoureteral reflux, renal scarring,children

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Labels
Neonatology Paediatrics General practitioner for children and adolescents
Topics Journals
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