engleski

DMSA scintigraphy after the first urinary tract infection in children without vesicoureteral reflux.

Introduction: Urinary tract infection (UTI) is the most common infection in children and the 99mTc DMSA scintigraphy is the golden standard for detection of parenchymal damage. The aim of this study is to determine the necessity and value of the DMSA scintigraphy after the first UTI in kidneys without vesicoureteral reflux (VUR).Material and methods: In 52 patients (104 renal units) after first UTI and without reflux on VCUG DMSA scans were performed 2 months or more after the first UTI. The scans were graded as normal, pathological with cortical defects and equivocal. Ultrasound (US) was also performed in all patients and parenchyma thickness was assessed as normal or diminished, and findings were compared with DMSA scanResults: DMSA scans showed pathological findings in 33 out of 104 (32 %) kidneys. Cortical defects were found in 10 (10 %) kidneys and suspected damage in 23 (22 %) kidneys. US detected diminished parenchymal thickness in 11 out of 104 (10, 5 %) kidneys . In 7 out of 11 kidneys DMSA scans had pathological findings too. On DMSA scans cortical defects were found in 1 and suspected damage in 6 out of 11 kidneys.Conclusions: Our study confirms DMSA scintigraphy as a valuable method in detection of renal damage and identifies the children for more careful medical attention. In contrary US cannot be used as a single study for evaluation of parenchymal damage after the first UTI. We suggest DMSA scinitigraphy in all children after the first UTI because of over 30 % of pathological findings after the first UTI even in those without VUR.

DMSA scintigraphy; urinary tract infection

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