Childhood acute pyelonephritis: comparison of power Doppler sonography and Tc-DMSA scintigraphy.

Abstract

BACKGROUND:

Tc 99m DMSA scintigraphy is regarded as the gold standard for the detection and localization of acute pyelonephritis (APN) in children. Power Doppler sonography (PD US) is a radiation-free and cost-effective technique that could be useful in the diagnosis of APN in children.

OBJECTIVE:

To compare the predictive value of PD US with DMSA scintigraphy in the diagnosis of APN in children.

MATERIALS AND METHODS:

A total of 74 neonates and children with clinical findings consistent with possible upper urinary tract infection were evaluated with PD US and DMSA scintigraphy. Children with anatomic (grey-scale) abnormalities were excluded. A total of 147 kidneys were examined within the first 48 h after the onset of symptoms. Each kidney was divided into three zones (upper, middle, and lower third).

RESULTS:

APN was diagnosed by PD US in 46 kidneys. Sensitivity and specificity for detecting APN using DMSA scintigraphy as the reference standard were 73.8% and 85.7%, respectively. There was good agreement between PD US and DMSA scintigraphy in the localization of lesions.

CONCLUSION:

In clinically suspected APN, PD US has acceptable specificity and sensitivity, if performed within the first 48 h and could be helpful in neonates and children under 3 months of age in whom the use of scintigraphy is generally discouraged.

• Authors: Aggeliki Stogianni, Panagiotis Nikolopoulos, Ippoliti Oikonomou, Magdalini Gatzola, Vassilios Balaris, Dimitrios Farmakiotis, Athanasios Dimitriadis
• Journal: Pediatric radiology (Pediatr Radiol) Vol. 37 Issue 7 Pg. 685-90 (Jul 2007) ISSN: 0301-0449 [Print] Germany
• PMID: 17520245 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Radiopharmaceuticals
• Technetium Tc 99m Dimercaptosuccinic Acid

Topics

• Acute Disease
• Adolescent
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Infant, Newborn
• Male
• Predictive Value of Tests
• Pyelonephritis (diagnostic imaging)
• Radionuclide Imaging
• Radiopharmaceuticals
• Sensitivity and Specificity
• Technetium Tc 99m Dimercaptosuccinic Acid
• Ultrasonography, Doppler