The role of tissue harmonic imaging ultrasound combined with power Doppler ultrasound in the diagnosis of childhood febrile urinary tract infections.
OBJECTIVE
This study assessed the ability of tissue harmonic imaging ultrasound combined with power Doppler ultrasound in the detection of childhood febrile urinary tract infections in comparison with the gold standard reference method: Tc-99m dimercaptosuccinicacid renal cortical scintigraphy.


METHODS
This prospective study included 60 patients who were hospitalized with a first episode of febrile urinary tract infections. All children were examined with dimercaptosuccinicacid scan and tissue harmonic imaging ultrasound combined with power Doppler ultrasound within the first 3 days of admission.


RESULTS
Signs indicative of acute infection were observed in 29 patients according to the results of tissue harmonic imaging ultrasound combined with power Doppler ultrasound while dimercaptosuccinicacid scan revealed abnormal findings in 33 patients. The sensitivity, specificity, positive predictive value and negative predictive value of tissue harmonic imaging combined with power Doppler ultrasound using dimercaptosuccinicacid scintigraphy as the reference method in patients diagnosed with first episode febrile urinary tract infections were calculated as 57.58% (95% confidence interval: 40.81%-72.76%); 62.96% (95% confidence interval: 44.23%-78.47%); 65.52% (95% confidence interval: 52.04%-77%); 54.84% (95% confidence interval: 41.54%-67.52%); respectively.


CONCLUSIONS
Although current results exhibit inadequate success of power Doppler ultrasound, this practical and radiation-free method may soon be comprise a part of the routine ultrasonographic evaluation of febrile urinary tract infections of childhood if patients are evaluated early and under appropriate sedation.
Department of Pediatrics, General Outpatient Clinic, Ankara University Faculty of Medicine, Ankara, Turkey.
Nisa Eda Çullas
NE
İlarslan
Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey.
Ömer Suat
ÖS
Fitöz
Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey.
Derya Gökmen
DG
Öztuna
Department of Nuclear Medicine, Ankara University Faculty of Medicine, Ankara, Turkey.
Nuriye Özlem
NÖ
Küçük
Department of Pediatrics, Division of Pediatric Nephrology-Rheumatology, Ankara University Faculty of Medicine, Ankara, Turkey.
Fatma Fatoş
FF
Yalçınkaya
Acute pyelonephritis; childhood; power Doppler ultrasound; urinary tract infection