title: Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis.
abstract: The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) (99m)Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden.
authors.affiliation: Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 9, A-8036, Graz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Brader
authors.forename: Michael
authors.initials: M
authors.lastname: Riccabona
authors.forename: Thomas
authors.initials: T
authors.lastname: Schwarz
authors.forename: Ursula
authors.initials: U
authors.lastname: Seebacher
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Ring
mesh_terms: D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009393:Nephritis / Q000150:complications* / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods; D011866:Radioisotope Renography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014552:Urinary Tract Infections / Q000150:complications* / Q000175:diagnosis*
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid