Clinical implications of DMSA Scan in Childhood Acute Pyelonephritis.
10.3339/jkspn.2017.21.2.107
- Author:
Sun Mi HUH
1
;
Bo Kyoung PARK
;
Hyun Mi KANG
;
Jung Woo RHIM
;
Jin Soon SUH
;
Kyung Yil LEE
Author Information
1. Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. leekyungyil@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Acute pyelonephritis;
Urinary tract infection;
Technetium 99m-dimercaptosuccinic acid;
Vesicoureteral reflux;
Child
- MeSH:
C-Reactive Protein;
Child;
Early Diagnosis;
Fever;
Humans;
Infant;
Inflammation;
Pyelonephritis*;
Succimer*;
Urinary Tract Infections;
Vesico-Ureteral Reflux
- From:Childhood Kidney Diseases
2017;21(2):107-113
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to evaluate the relationships between 99mTecnicium-dimercaptosuccinic acid (DMSA) scan findings and clinical parameters including age and fever duration. METHODS: The positive rates for abnormal DMSA scans were analyzed according to the age of patients, fever duration prior to admission, and total fever duration. DMSA scan findings were divided into 3 categories: single defect, multifocal defects, and discrepant defects. We evaluated the detection rates of vesicoureteral reflux according to DMSA scan lesions. RESULTS: Among a total 320 cases, 141 (44.1%) had abnormal DMSA scans. The infant group (0-1 year of age) had a shorter total fever duration, and a lower C-reactive protein (CRP) value and DMSA positive rate (39.8% vs. 60.6%, P=0.002) compared to children group (2-15 years of age). Patients with abnormal scans had a longer total fever duration and higher CRP compared to those with normal scans. The positivity rate of abnormal scans did not differ between the patients with a short fever duration prior to admission of ≤2 days and those with longer fever duration of ≥3 days. However, patients with longer total fever duration had a higher rate of abnormal DMSA scans (P=0.02). Among cases with a single defect, multifocal defects, and discrepant defects, vesicoureteral reflux was observed in 22.4%, 60% and 70.6% of cases, respectively (P=0.004). CONCLUSION: Although DMSA scan has limitations in early diagnosis, DMSA scan findings may aid in the prediction of the severity of systemic inflammation and detection of vesicoureteral reflux.
