title: Uncomplicated duplex kidney and DMSA scintigraphy in children with urinary tract infection.
abstract: BACKGROUND
  Renal duplication is the most common malformation of the urinary tract and is frequently seen among children with urinary tract infection (UTI).
  
  
  OBJECTIVE
  To evaluate problems in the interpretation of dimercaptosuccinic acid (DMSA) scintigraphy and to establish the range of relative function in uncomplicated unilateral duplication.
  
  
  METHODS
  Retrospective analysis of 303 children less than 2 years of age with first time non-obstructive urinary tract infection investigated by both urography and DMSA scintigraphy. At DMSA scintigraphy, renal lesions and/or relative function below 45% was considered abnormal. Urography was used as reference for the diagnosis of duplication.
  
  
  RESULTS
  Duplex kidneys were found in 22 of 303 patients (7%). Of the 16 children with unilateral duplication, 10 had bilaterally undamaged kidneys with a range of relative function varying between 51% and 57% in the duplex kidney. In two of the children with unilateral duplication the imaging results were discordant.
  
  
  CONCLUSIONS
  There was risk of underdiagnosis as well as overdiagnosis of renal damage at scintigraphy. Although it is important to be aware of this risk, the rate of misinterpretation was low. A range of 51% to 57% can be used as the limit for normality of the relative function of a unilateral duplex kidney.
authors.affiliation: Department of Paediatric Radiology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. eira.stokland@vgregion.se
authors.forename: Eira
authors.initials: E
authors.lastname: Stokland
authors.forename: Ulf
authors.initials: U
authors.lastname: Jodal
authors.forename: Rune
authors.initials: R
authors.lastname: Sixt
authors.forename: Svante
authors.initials: S
authors.lastname: Swerkersson
authors.forename: Sverker
authors.initials: S
authors.lastname: Hansson
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging*; D014567:Urography
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid