Using technetium-99M dimercaptosuccinic acid renal cortex scintigraphy to differentiate acute pyelonephritis from other causes of fever in patients with spinal cord injury.
OBJECTIVE
To differentiate acute pyelonephritis (APN) from fever due to other sources in patients with spinal cord injury by using technetium-99m dimercaptosuccinic acid (DMSA) renal cortex scintigraphy (DMSA scan).


METHODS
A total of 24 patients with spinal cord injury were admitted with fever. DMSA scans were performed on all patients. The final determination of the cause of the fever was based on the medical history, physical examination, laboratory evaluation, and imaging studies.


RESULTS
DMSA scan accurately diagnosed APN in 12 patients with inflammation on the DMSA scan. In 5 patients with scarred lesions on the DMSA scans and in 7 patients with negative DMSA scan, the fever was attributed to other causes. The sensitivity and specificity of the DMSA scan for detecting APN were both 100%.


CONCLUSIONS
The DMSA scan is a valuable adjunct in the evaluation of fever in patients with SCI.
Kao
C
C
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Hsieh
J
J
Tsai
S
S
Ho
Y
Y
Changlai
S
S
Sun
S
S
Lee
J
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D007672:Kidney Cortex / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013119:Spinal Cord Injuries / Q000150:complications*; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid