Tc-99m dimercaptosuccinic acid(DMSA) renal scintigraphy in patients with acute pyelonephritis.
OBJECTIVE
Recently, several authors reported that Tc-99m DMSA renal scan frequently showed cortical defects of the involved kidneys even in the patients with acute pyelonephritis who did not show abnormal findings in the ultrasonography and intravenous pyelography (IVP).


METHODS
In order to evaluate the utilities of Tc-99m DMSA renal scan and the clinical meaning of cortical defects in the Tc-99m DMSA renal scan of the patients with acute pyelonephritis, ninety two patients with acute pyelonephritis, from March 1991 to February 1994 in Chungnam National University Hospital(CNUH), were included in this study. Patients were subdivided as Group A:Patients showing normal Tc-99m DMSA renal scan (n = 42) and Group B:Patients with definite cortical defects on the Tc-99m DMSA renal scan (n = 50). We compared clinical characteristics such as age and sex, recurrency, duration of fever, bacterial culture study, incidence of renal insufficiency and the results of renal ultrasonography and intravenous pyelography between the two groups.


RESULTS
Fifty four percents of 92 patients with acute pyelonephritis showed a significantly longer febrile period after admission, higher positive rates on the urine and blood culture studies and higher incidence of renal insufficiency than those of the Group A patients. Sixty nine percents of Group B patients showed normal results in ultrasonography or IVP study.


CONCLUSIONS
Tc-99m DMSA renal scan was a more sensitive imaging test than ultrasonography in kidneys and IVP to detect pyelonephritis lesions and may be useful to predict the patient group with a severe disease course. These patients may need more careful management and further studies to evaluate the possibility of complications.
Lee
K W
KW
Department of Internal Medicine, College of Medicine, Chungnam National University Hospital, Taejon, Korea.
Bin
K T
KT
Jeong
M S
MS
Shong
M H
MH
Shin
Y T
YT
Ro
H K
HK
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007672:Kidney Cortex / Q000002:abnormalities / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011704:Pyelonephritis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology; D011859:Radiography; D011877:Radionuclide Imaging; D012008:Recurrence; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D016896:Treatment Outcome; D014463:Ultrasonography
D000900:Anti-Bacterial Agents; D015609:Organotechnetium Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004113:Succimer