Can MRI replace DMSA in the detection of renal parenchymal defects in children with urinary tract infections?
BACKGROUND
Renal parenchymal defects may be a consequence of urinary tract infections (UTI) in childhood. MRI is a non-radiation imaging modality compared with DMSA scanning.


OBJECTIVE
To compare DMSA with MRI for the detection of renal parenchymal defects in children presenting for radiological investigation after a first UTI.


METHODS
Both DMSA and MRI were performed at the same appointment in 37 children (aged 4 months-13 years; mean 4.5 years) with a history of UTI. Both planar and SPECT DMSA were performed. MRI of the kidneys employed axial and coronal T1-, T2- and fat-saturated T1-weighted (T1-W) sequences. Some children had imaging after IV contrast medium.


RESULTS
The coronal fat-saturated T1-W sequence was the best sequence and it detected all the findings on MRI. MRI had a sensitivity of 77% and a specificity of 87% for the detection of a scarred kidney using DMSA as the gold standard. MRI diagnosed pyelonephritis in two children that had been interpreted as scarring on DMSA.


CONCLUSIONS
Renal MRI using a single, coronal, fat-saturated T1-W sequence is a rapid, accurate and minimally invasive technique for the detection of renal scarring that does not employ ionizing radiation.
Kavanagh
Eoin C
EC
Department of Radiology, Children's University Hospital, Temple Street, Dublin, Ireland.
Ryan
Stephanie
S
Awan
Atif
A
McCourbrey
Siobhan
S
O'Connor
Rachel
R
Donoghue
Veronica
V
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011704:Pyelonephritis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D015899:Tomography, Emission-Computed, Single-Photon; D014552:Urinary Tract Infections / Q000150:complications*
D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid