Imaging of renal scarring.
Children with urinary tract infection should be investigated and followed up, as those with pyelonephritis may develop renal scarring. In this review, after discussing the advantages and disadvantages of various imaging modalities for diagnosis of renal scarring, it is concluded that DMSA scintigraphy and urography can both be used to detect significant renal scarring. With DMSA scintigraphy, small renal lesions (functional uptake defects) not seen at urography will also be detected. The long-term clinical significance of these lesions is, as yet, unknown. A normal DMSA scintigraphy after infection indicates low risk for clinically significant damage. In order to allow acute, reversible lesions to first disappear, a follow-up DMSA examination should not be performed until at least 6 mo after the acute infection. Ultrasonography in isolation cannot be recommended for the diagnosis of renal scarring.
Stokland
E
E
Department of Paediatric Radiology, The Queen Silvia Children's Hospital, Göteborg University, Sweden.
Hellström
M
M
Jakobsson
B
B
Sixt
R
R
D002614:Chelating Agents; D002648:Child; D002921:Cicatrix / Q000000981:diagnostic imaging*; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011866:Radioisotope Renography; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; D016284:Technetium Tc 99m Pentetate; D014463:Ultrasonography; D014567:Urography
D002614:Chelating Agents; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; D016284:Technetium Tc 99m Pentetate