title: [Technetium-99m-dimercaptosuccinic acid (DMSA) scintigraphy in the first febrile urinary tract infection in children].
abstract: OBJECTIVE
  The objective of this study was to evaluate the findings of 99mTc-DMSA renal scintigraphy in children with their first acute febrile urinary tract infection in relation with several clinical-biological parameters and other imaging studies and a long-term follow up.
  
  
  METHODS
  103 children between 1 month and 10 years old with their first acute febrile urinary tract infection were studied by means of clinical and laboratory assessment, renal ultrasonography and 99mTc DMSA renal scintigraphy in the acute illness period. Patients were divided into two groups, those under 2 years old (n = 63) and those over 2 years old (n = 40).
  
  
  RESULTS
  Cortical scintigraphy showed renal changes in 56 patients (54,5%). Children over 2 years of age had a higher incidence of renal lesions than younger children (39,7% vs. 77,5%). Ultrasonography measuring renal volume showed a simple concordance with scintigraphy in 64% of the patients. Reflux was demonstrated in 23 patients (22,3%) without differences between patients with normal or abnormal cortical scintigraphy. After having studied the factors that were associated independently to the pathological results in the scintigraphy through a logistical multivariant regression, it was observed that the child's age, the elevation of the PCR and the alterations of the renal volume were significant according to statistics and also associated to a larger amount of pathological DMSA scintigraphy.
  
  
  CONCLUSIONS
  DMSA scintigraphy associated with other diagnostic methods can improve the sensitivity and specificity to establish renal damage stage. During the follow-up the acute lesions disappeared or improved in all cases and the chronic lesions have not been modificated.
authors.affiliation: Servicio de Pediatría, Hospital General Universitario de Alicante.
authors.forename: M J
authors.initials: MJ
authors.lastname: Martín Aguado
authors.forename: A
authors.initials: A
authors.lastname: Canals Baeza
authors.forename: J
authors.initials: J
authors.lastname: Vioque López
authors.forename: J L
authors.initials: JL
authors.lastname: Tarazona
authors.forename: J
authors.initials: J
authors.lastname: Flores Serrano
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid