title: Abnormal dimercaptosuccinic Acid scan may be related to persistence of vesicoureteral reflux in children with febrile urinary tract infection.
abstract: OBJECTIVE
  This study assessed whether (99m)technetium dimercaptosuccinic acid (DMSA) scintigraphy used for the assessment of renal sequelae after febrile urinary tract infection (UTI) has any prognostic value for outcome measurement of vesicoureteral reflux (VUR) by retrospectively evaluating the correlation between abnormal DMSA scintigraphy results and persistence of VUR in children with febrile UTI.
  
  
  METHODS
  The medical records of 142 children (57 boys, 85 girls) admitted with febrile UTI from January 2004 to December 2006 and who were followed up for more than 1 year were retrospectively reviewed. At the initial and follow-up visits, renal ultrasound and DMSA scans were performed within 7 days from the diagnosis and voiding cystourethrography (VCUG) was performed within 1 month in all case and follow-up evaluations.
  
  
  RESULTS
  The children's mean age was 4.8±3.6 years (range, 0.3 to 14 years). The mean follow-up was 28.2±4.8 months. At the initial examination, VUR was more often associated with an abnormal DMSA scan result (83.3%) than with a normal DMSA scan result (16.7%, p=0.02). The frequency of VUR with an abnormal DMSA scan during acute UTI was significantly higher than the frequency of VUR with a normal DMSA scan (38.8% vs, 25.8%, respectively, p=0.004). Also, high-grade VUR was associated with an abnormal DMSA scan result (32.5%) more often than with a normal DMSA scan result (0%, p=0.01). Children with an abnormal DMSA scan had a lower resolution rate of VUR (17.5%) than did children with a normal DMSA scan (75.0%) at the follow-up VCUG (p=0.02).
  
  
  CONCLUSIONS
  An abnormal result on a DMSA scan during febrile UTI is associated with high-grade and persistent VUR. DMSA scans performed during febrile UTI are useful in reflux resolution in childhood.
authors.affiliation: Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Hyun Chong
authors.initials: HC
authors.lastname: Ki
authors.forename: Sun-Ouck
authors.initials: SO
authors.lastname: Kim
authors.forename: Dong Hun
authors.initials: DH
authors.lastname: Yoo
authors.forename: In Sang
authors.initials: IS
authors.lastname: Hwang
authors.forename: Eu Chang
authors.initials: EC
authors.lastname: Hwang
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Oh
authors.forename: Seung Il
authors.initials: SI
authors.lastname: Jung
authors.forename: Taek Won
authors.initials: TW
authors.lastname: Kang
authors.forename: Dongdeuk
authors.initials: D
authors.lastname: Kwon
authors.forename: Kwangsung
authors.initials: K
authors.lastname: Park
authors.forename: Soo Bang
authors.initials: SB
authors.lastname: Ryu
keywords: Technetium Tc 99m dimercaptosuccinic acid; Urinary tract infections; Vesico-ureteral reflux