title: The value of direct radionuclide cystography in the detection of vesicoureteral reflux in children with normal voiding cystourethrography.
abstract: BACKGROUND
  Vesicoureteral reflux (VUR) is one of the most important risk factors for urinary tract infection (UTI). Diagnosis and treatment of VUR is important to prevent irreversible complications, such as renal scarring and chronic renal failure. This study was conducted to assess the value of direct radionuclide cystography (DRNC) in the detection of VUR in children with UTI and a normal voiding cystourethrography (VCUG).
  
  
  METHODS
  DRNC was performed in 35 children with a normal VCUG after an episode of febrile UTI who had hydronephrosis or hydroureter, abnormal acute dimercaptosuccinic acid (DMSA) scan results and/or febrile UTI recurrence. This study was conducted in the nephrology department of Mofid Children's Hospital, Tehran (Iran).
  
  
  RESULTS
  The results were statistically analyzed. Among the 70 ureters studied, 33 (49.1 %) were observed to have VUR. Of these, 17 (51.5 %) had mild, 14 (42.4 %) moderate, and 2 (6.1 %) severe reflux. A significant relationship was observed between DRNC results and DMSA renal scan findings (P < 0.05).
  
  
  CONCLUSIONS
  Based on our results, we suggest that DRNC may reveal VUR despite a normal VCUG in children with hydronephrosis, abnormal acute DMSA, and/or recurrent febrile UTI.
authors.affiliation: Shahid Beheshti University of Medical Sciences, Tehran, Iran, rdalirani@yahoo.com.
authors.forename: Reza
authors.initials: R
authors.lastname: Dalirani
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Mahyar
authors.forename: Mostafa
authors.initials: M
authors.lastname: Sharifian
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Mohkam
authors.forename: Nasrin
authors.initials: N
authors.lastname: Esfandiar
authors.forename: Azam
authors.initials: A
authors.lastname: Ghehsareh Ardestani
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid