Renal scintigraphy in children with urinary tract infections

Background/Aim. To determine the incidence of abnormal Technetium Tc 99m Dimercaptosuccinic Acid (Tc99m DMSA) renal scintigraphy findings in the children with urinary tract infection (UTI), and to evaluate the difference between the children with UTI and vesico-ureteral reflux (VUR), and the childre...

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Main Authors: Ajdinović Boris, Krstić Zoran, Dopuđa Marija, Jauković Ljiljana
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2005-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2005/0042-84500510745A.pdf
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author Ajdinović Boris
Krstić Zoran
Dopuđa Marija
Jauković Ljiljana
author_facet Ajdinović Boris
Krstić Zoran
Dopuđa Marija
Jauković Ljiljana
author_sort Ajdinović Boris
collection DOAJ
description Background/Aim. To determine the incidence of abnormal Technetium Tc 99m Dimercaptosuccinic Acid (Tc99m DMSA) renal scintigraphy findings in the children with urinary tract infection (UTI), and to evaluate the difference between the children with UTI and vesico-ureteral reflux (VUR), and the children with UTI without VUR. Methods. Tc99m DMSA renal scintigraphy was performed in 170 children with UTI, mean age 7.07 years (1 month to 14 years, 137 were girls and 33 were boys). In 88 of the children, VUR was proved by micturating cystouretherography (MCU), while in 82 VUR could not be detected by MCU. VUR was graded in accordance with MCU recommended by the international study of VUR. In 13 of the children the grade of VUR was grade I, in 30 was grade II, in 23 grade III, in 17 grade IV, while the grade V was in 5 of the children. Findings of Tc99m DMSA renal scintigraphy were classified as: 1 - normal, 2 - probably normal, 3 - equivocal, 4 - probably abnormal, and 5 - abnormal. The degree of the significance of the difference of the findings was estimated using χ2, taking p < 0.01 as the limit of statistical significance. Results. Of the total number of 170 studied children, the abnormal findings were detected in 30% (51/170), normal findings in 62% (106/170), and equivocal in 8% (13/170). In the children with UTI and VUR, the incidence of abnormal findings was 49% (43/88), of normal 43% (38/88), and of equivocal findings 8% (7/88). All the children with VUR grade V had the abnormal findings (the incidence of the abnormal findings was 100%). In the children with VUR grade IV, the abnormal findings were 71%. In the children with VUR grade I, 77% of the findings were normal, in the children with VUR grade II, 53% of the findings were normal and in the children with VUR grade III, 30% of the findings of renal scintigraphy were normal. In the children with UTI without VUR, the incidence of abnormal findings was 10% (8/82), of normal findings 83% (68/82), and of equivocal findings 7% (6/82). The incidence of abnormal findings was significantly higher in the children with UTI and VUR than in those with UTI without VUR (p < 0.01). Also, the incidence of the abnormal findings was higher in the children with VUR grades IV and V than in the children with VUR grade I (p < 0.01). Conclusion. DMSA renal scintigraphy in the children with ITU revealed the abnormal findings in 30% of the cases. The incidence of the abnormal findings was significantly higher when VUR was present, as well as if the grade of VUR was higher. Our results confirmed that Tc99m DMSA renal scintigraphy was a very important technique in the evaluation of the children with ITU.
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spelling doaj-art-bfde07d7e62e45d3875993396224f6b12025-08-20T03:05:17ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502005-01-01621074574910.2298/VSP0510745ARenal scintigraphy in children with urinary tract infectionsAjdinović BorisKrstić ZoranDopuđa MarijaJauković LjiljanaBackground/Aim. To determine the incidence of abnormal Technetium Tc 99m Dimercaptosuccinic Acid (Tc99m DMSA) renal scintigraphy findings in the children with urinary tract infection (UTI), and to evaluate the difference between the children with UTI and vesico-ureteral reflux (VUR), and the children with UTI without VUR. Methods. Tc99m DMSA renal scintigraphy was performed in 170 children with UTI, mean age 7.07 years (1 month to 14 years, 137 were girls and 33 were boys). In 88 of the children, VUR was proved by micturating cystouretherography (MCU), while in 82 VUR could not be detected by MCU. VUR was graded in accordance with MCU recommended by the international study of VUR. In 13 of the children the grade of VUR was grade I, in 30 was grade II, in 23 grade III, in 17 grade IV, while the grade V was in 5 of the children. Findings of Tc99m DMSA renal scintigraphy were classified as: 1 - normal, 2 - probably normal, 3 - equivocal, 4 - probably abnormal, and 5 - abnormal. The degree of the significance of the difference of the findings was estimated using χ2, taking p < 0.01 as the limit of statistical significance. Results. Of the total number of 170 studied children, the abnormal findings were detected in 30% (51/170), normal findings in 62% (106/170), and equivocal in 8% (13/170). In the children with UTI and VUR, the incidence of abnormal findings was 49% (43/88), of normal 43% (38/88), and of equivocal findings 8% (7/88). All the children with VUR grade V had the abnormal findings (the incidence of the abnormal findings was 100%). In the children with VUR grade IV, the abnormal findings were 71%. In the children with VUR grade I, 77% of the findings were normal, in the children with VUR grade II, 53% of the findings were normal and in the children with VUR grade III, 30% of the findings of renal scintigraphy were normal. In the children with UTI without VUR, the incidence of abnormal findings was 10% (8/82), of normal findings 83% (68/82), and of equivocal findings 7% (6/82). The incidence of abnormal findings was significantly higher in the children with UTI and VUR than in those with UTI without VUR (p < 0.01). Also, the incidence of the abnormal findings was higher in the children with VUR grades IV and V than in the children with VUR grade I (p < 0.01). Conclusion. DMSA renal scintigraphy in the children with ITU revealed the abnormal findings in 30% of the cases. The incidence of the abnormal findings was significantly higher when VUR was present, as well as if the grade of VUR was higher. Our results confirmed that Tc99m DMSA renal scintigraphy was a very important technique in the evaluation of the children with ITU.http://www.doiserbia.nb.rs/img/doi/0042-8450/2005/0042-84500510745A.pdfurinary tract infectionsvesico-ureteral refluxchildradonuclide imagingtechnetium Tc 99mdimercaptosuccinic acid
spellingShingle Ajdinović Boris
Krstić Zoran
Dopuđa Marija
Jauković Ljiljana
Renal scintigraphy in children with urinary tract infections
Vojnosanitetski Pregled
urinary tract infections
vesico-ureteral reflux
child
radonuclide imaging
technetium Tc 99mdimercaptosuccinic acid
title Renal scintigraphy in children with urinary tract infections
title_full Renal scintigraphy in children with urinary tract infections
title_fullStr Renal scintigraphy in children with urinary tract infections
title_full_unstemmed Renal scintigraphy in children with urinary tract infections
title_short Renal scintigraphy in children with urinary tract infections
title_sort renal scintigraphy in children with urinary tract infections
topic urinary tract infections
vesico-ureteral reflux
child
radonuclide imaging
technetium Tc 99mdimercaptosuccinic acid
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2005/0042-84500510745A.pdf
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AT dopuđamarija renalscintigraphyinchildrenwithurinarytractinfections
AT jaukovicljiljana renalscintigraphyinchildrenwithurinarytractinfections