Age-related Radiological Imaging in Children with Acute Pyelonephritis.
- Author:
Chang Hee HAN
1
;
Su Yeon CHO
;
Sung Hak KANG
Author Information
1. Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea. urodr@cmc.cuk.ac.kr
- Publication Type:Original Article
- Keywords:
Age groups;
Pyelonephritis;
Technetium Tc 99m dimercaptosuccinic acid;
Vesico-ureteral reflux;
Ultrasonography
- MeSH:
Child*;
Diagnosis;
Humans;
Pyelonephritis*;
Retrospective Studies;
Succimer;
Technetium Tc 99m Dimercaptosuccinic Acid;
Ultrasonography;
Urinary Tract;
Vesico-Ureteral Reflux
- From:Korean Journal of Urology
2003;44(8):780-784
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The accurate diagnosis of acute pyelonephritis(APN) using clinical and laboratory parameters is often difficult in children. The 99mTc-dimercaptosuccinic acid (DMSA) renal scan is utilized as a gold standard for renal involvement, and renal ultrasonography(RUS) and voiding cystourethrography(VCUG) are utilized to evaluate underlying urinary tract anomalies. In this study the radiological imaging in children of different age groups, with clinical APN, were retrospectively compared. MATERIALS AND METHODS: Between May 1994 and April 2002, 375 children presented with a febrile urinary tract infection(UTI), and had a DMSA renal scan. Of the patients, 270 had RUS and 220 had contrast VCUG. The sensitivity of these tests in febrile UTI in three age groups was determined: group I less than 2 years; group II 2-5 years; group III older than 5 years. RESULTS: The clinical and laboratory manifestations of APN correlated better with a positive DMSA renal scan in the older children than in the younger children; 76.1% of the DMSA renal scans were positive in group III; 68.3% in group II; 50.8% in group I(p<0.05). RUS had no correlation with a positive DMSA renal scan in any of the age groups. Vesicoureteral reflux was more prevalent in the older age groups. High grades of reflux(grade IV-V) correlated better with positive DMSA renal scans(p<0.05). CONCLUSIONS: This study demonstrates that the clinical and laboratory manifestations of APN do not correlate with the findings of DMSA renal scans in young children. Therefore, a young child with a clinical suspicion of APN should be evaluated by a DMSA renal scan to confirm renal parenchymal involvement.
