title: DMSA renal scans and the top-down approach to urinary tract infection.
abstract: Assessment of first febrile urinary tract infection in young children has usually involved 2 imaging techniques: renal ultrasonogram and voiding cystourethrography. Currently, there is growing interest in using the dimercaptosuccinic acid (DMSA) scan labeled with technetium-99m as an alternative initial study, in the evaluation of UTI. DMSA renal scanning is the most sensitive radiologic study to detect acute pyelonephritis. Early DMSA renal scanning has been called the top-down approach, because the focus is the identification of kidney injury rather than reflux. Positive and negative aspects of DMSA renal scans are discussed by a pediatric urologist.
authors.affiliation: Division of Pediatric Infectious Diseases, U.T. Southwestern Medical Center, Dallas, TX, USA.
authors.forename: R Doug
authors.initials: RD
authors.lastname: Hardy
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Austin
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D011704:Pyelonephritis / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D011859:Radiography; D004113:Succimer; D013667:Technetium; D014055:Tomography, Emission-Computed / Q000379:methods*; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging*
chemical_list: D013667:Technetium; D004113:Succimer