title: [Tc 99M DMSA scintigraphy in children with a first episode of acute pyelonephritis: correlation with laboratory tests, echography and the presence of vesico-ureteral reflux].
abstract: BACKGROUND
  Tc99m DMSA (dimercaptosuccinic acid) scintigraphy has a high sensitivity for the detection of cortical kidney damage.
  
  
  OBJECTIVE
  To evaluate the Tc99m DMSA renal scintigraphy in children with a first episode of acute pyelonephritis and its association with laboratory parameters, kidney ultrasound and vesicoureteral reflux.
  
  
  METHODS
  We studied 143 children (age range 8 days, 12 years, 66% female) hospitalized with the clinical diagnosis of acute pyelonephritis (first episode) with a positive urine culture and a renal scintigraphy performed within seven days of diagnosis. DMSA was considered the gold standard for the detection of cortical lesions. Its results were related to the presence of fever, C-reactive protein (CRP), erythrocyte sedimentation rate (VHS), white blood count (WBC), ultrasound examination and vesicoureteral reflux.
  
  
  RESULTS
  Seventy nine percent of the population had an abnormal DMSA scan. There were no differences between sex, age and laboratory parameters in children with normal or abnormal DMSA scans, except for CRP (p <0.005). Ultrasound was coincident with the scan in 32% of patients. Eighteen percent had vesicoureteral reflux.
  
  
  CONCLUSIONS
  There is a high proportion of abnormal DMSA scans in children with a first episode of acute pyelonephritis.
authors.affiliation: Servicio de Medicina Nuclear, Hospital San Juan de Dios, Universidad de Chile, Santiago. gdonosor@yahoo.com
authors.forename: Gilda
authors.initials: G
authors.lastname: Donoso
authors.forename: Gabriel
authors.initials: G
authors.lastname: Lobo
authors.forename: Francisca
authors.initials: F
authors.lastname: Arnello
authors.forename: María Paz
authors.initials: MP
authors.lastname: Arteaga
authors.forename: Pilar
authors.initials: P
authors.lastname: Hevia
authors.forename: Pía
authors.initials: P
authors.lastname: Rosati
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lagos
authors.forename: Carlos
authors.initials: C
authors.lastname: Wolff
authors.forename: Andrés
authors.initials: A
authors.lastname: Pérez
authors.forename: César
authors.initials: C
authors.lastname: Jiménez
mesh_terms: D000208:Acute Disease; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011704:Pyelonephritis / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D018709:Statistics, Nonparametric; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014463:Ultrasonography; D014718:Vesico-Ureteral Reflux / Q000150:complications
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
vernacular_title: Cintigrama renal DMSA en niños con primera pielonefritis aguda: correlación con exámenes de laboratorio, ecografía y la presencia de reflujo vésico ureteral.