[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].
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.
Donoso
Gilda
G
Servicio de Medicina Nuclear, Hospital San Juan de Dios, Universidad de Chile, Santiago. gdonosor@yahoo.com
Lobo
Gabriel
G
Arnello
Francisca
F
Arteaga
María Paz
MP
Hevia
Pilar
P
Rosati
Pía
P
Lagos
Elizabeth
E
Wolff
Carlos
C
Pérez
Andrés
A
Jiménez
César
C
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
D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
Cintigrama renal DMSA en niños con primera pielonefritis aguda: correlación con exámenes de laboratorio, ecografía y la presencia de reflujo vésico ureteral.