[Renal scintigraphy using technetium Tc 99m-ethylenedicysteine or SPECT as a method for examining kidneys in children diagnosed with vesicoureteral reflux].
Vesicoureteral reflux (VUR) can lead to parenchymal lesions of the kidneys. Renal scarring is an important cause of chronic renal failure and hypertension in children. Effective prevention necessitates an early diagnosis of urinary tract pathology. The aim of this work was to examine renal morphology and function in VUR using radioisotope techniques and to compare the sensitivity of the planar technique and single photon emission computed tomography (SPECT) for detection of renal scarring. The following examinations were performed in 45 children with VUR: ultrasonography, renoscintigraphy with technetium-99m-etylenedicysteine (EC-Tc-99m) or technetium-99m-dimercaptosuccinic acid (DMSA-Tc-99m) in planar and SPECT modes. The stage of VUR correlated with cortical lesions as reflected by effective renal plasma flow (ERPF), and scarring as shown by static scintigraphy. The use of SPECT increased diagnostic sensitivity in the case of small and isolated scars. Thus, SPECT would be recommended in children at risk of renal scarring. The correlation between ERPF and DMSA scintigraphy findings supports the use of EC-Tc-99m renoscintigraphy to monitor the process of renal scarring.
Cieślak-Puchalska
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Kliniki Chorób Dzieci Katedry Chorób Dzieci Pomorskiej Akademii Medycznej w Szczecinie, ul. Unii Lubelskiej 1, 71-252 Szczecin.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000150:complications / Q000000981:diagnostic imaging; D003545:Cysteine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D015609:Organotechnetium Compounds; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000000981:diagnostic imaging*
D015609:Organotechnetium Compounds; C073806:technetium Tc 99m-ethylenedicysteine; D003545:Cysteine