title: [Radiologic and gammagraphic findings in a case of pyonephrosis. Anatomopathologic correlation].
abstract: OBJECTIVE
  To describe a case of pyonephrosis in a child with special reference to the importance of scintigraphy in its evaluation.
  
  
  METHODS
  We studied the correlation of the findings of conventional radiology (abdominal x-ray), ultrasound, abdominal CT, scintigraphy and anatomopathology (left kidney) in a 5-year-old boy with a history of renal lithiasis that was seen at our pediatric emergency services. The patient's clinical course and the scinscan findings using two tracers (Tc-99m DMSA, Ga-67 citrate) showed a severely compromised left renal function. The foregoing finding and the risk of major life-threatening complications prompted surgical treatment. Pathological analysis showed pyonephrosis of left kidney.
  
  
  RESULTS
  X-ray, ultrasound and abdominal CT showed left renal lithiasis, an enlarged left kidney, poor cortico-medullary differentiation and parenchymal destructuring with areas suggestive of cortical abscesses. A Ga-67 citrate scintiscan showed a notable intensity that completely affected the left renal parenchyma with no other changes. On the other hand, Tc-99m DMSA showed no uptake in the left kidney and normal uptake in the right kidney. A left nephrectomy was performed. Histological analysis demonstrated pyonephrosis of left kidney.
  
  
  CONCLUSIONS
  Tc-99m DMSA and Ga-67 citrate scintigraphy and the patient's poor clinical course showed the extent and severity of the underlying condition that was underestimated by the other imaging techniques.
authors.affiliation: Unidad de Medicina Nuclear Instituto Galego de Medicina Técnica (MEDTEC) Hospital Meixoeiro s.n. 36200 Vigo, Pontevedra España. joutomuro@hotmail.com
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Outomuro Perez
authors.forename: Ana María
authors.initials: AM
authors.lastname: Lopez Lopez
authors.forename: Ramón
authors.initials: R
authors.lastname: Guitian Iglesias
authors.forename: Alfonso
authors.initials: A
authors.lastname: Bao Corral
authors.forename: Juan
authors.initials: J
authors.lastname: Mata Varela
authors.forename: Eduardo
authors.initials: E
authors.lastname: Vazquez Martule
mesh_terms: D002675:Child, Preschool; D006801:Humans; D008297:Male; D011704:Pyelonephritis / Q000000981:diagnostic imaging* / Q000473:pathology; D011859:Radiography; D011877:Radionuclide Imaging