title: Renal power Doppler ultrasonographic evaluation of children with acute pyelonephritis.
abstract: Urinary tract infections are common in children. The available gold standard method for diagnosis, Tc-99m dimercaptosuccinic acid scan is expensive and exposes patients to considerable amount of radiation. This study was performed to compare and assess the efficacy of Power Doppler Ultrasound versus Tc-99m DMSA scan for diagnosis of acute pyelonephritis. A quasi experimental study was conducted on 34 children with mean age of 2.8 ± 2.7 years who were hospitalized with their first episode of febrile urinary tract infection. All children were evaluated in the first 3 days of admission by Doppler Ultrasound and Tc-99m DMSA scan. Patients with congenital structural anomalies were excluded. Each kidney was divided into three zones. The comparison between efficacy of Doppler Ultrasound and DMSA scan was carried out based on number of patients and on classified renal units. Based on the number of patients enrolled; the sensitivity, specificity, positive and negative predictive values and accuracy of Doppler Ultrasound were 89%, 53%, 70%, 80% and 74%, respectively but based on the renal units, it was 66%, 81%, 46%, 91% and 79% , respectively. Although Doppler Ultrasound has the potential for identifying acute pyelonephritis in children, but it is still soon to replace DMSA scan.
authors.affiliation: Department of Pediatric Nephrology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Shajari
authors.forename: Reza
authors.initials: R
authors.lastname: Nafisi-Moghadam
authors.forename: Mahrooz
authors.initials: M
authors.lastname: Malek
authors.forename: Agha
authors.initials: A
authors.lastname: Smaili
authors.forename: Mahmud
authors.initials: M
authors.lastname: Fallah
authors.forename: Ali
authors.initials: A
authors.lastname: Pahlusi
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007492:Iran; D007668:Kidney / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011704:Pyelonephritis / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D018608:Ultrasonography, Doppler
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid