Evaluation of renal scars by technetium-labeled dimercaptosuccinic acid scan, intravenous urography, and ultrasonography: a comparative study.
The objective of our prospective study was to compare the sensitivity and specificity of ultrasonography, intravenous pyelography, and dimercaptosuccinic acid scan in detecting scarred kidneys. Twenty-seven consecutive subjects with recurrent urinary tract infections, vesicoureteral reflux, scarred kidneys, or a combination of these problems had all three imaging procedures performed. With the total number of scars serving as the gold standard, the sensitivity (94%) and specificity (100%) in identifying renal scars in children were highest for the DMSA scan. Intraobserver (95%) and interobserver (90%) reliability were also high for the DMSA scan. However, the clinical interpretation of the increased sensitivity of the DMSA scan is unknown. Changes on the scan not identified by intravenous urography may not represent true scars. Research into the long-term significance of these scars is indicated.
Shanon
A
A
Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Feldman
W
W
McDonald
P
P
Martin
D J
DJ
Matzinger
M A
MA
Shillinger
J F
JF
McLaine
P N
PN
Wolfish
N
N
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D015588:Observer Variation; D015609:Organotechnetium Compounds; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014463:Ultrasonography; D014567:Urography
D015609:Organotechnetium Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004113:Succimer