title: Comparison of renal ultrasonography and dimercaptosuccinic acid renal scintigraphy in febrile urinary tract infection.
abstract: Accurate and early diagnosis and appropriate treatment of patient with urinary tract infection (UTI) are essential for the prevention or restriction of permanent damage to the kidneys in children. The aim of this study was to compare renal ultrasonography (US) and dimercaptosuccinic acid (DMSA) renal scan in the diagnosis of patients with febrile urinary tract infection. This study involved the medical records of children with febrile urinary tract infection who were admitted to the children's hospital in Qazvin, Iran. Pyelonephritis was diagnosed on the basis of clinical symptoms, laboratory tests and abnormal DMSA renal scans. The criteria for abnormality of renal US were an increase or a decrease in diffuse or focal parenchymal echogenicity, loss of corticomedullary differentiation, kidney position irregularities, parenchymal reduction and increased kidney size. Of the 100 study patients, 23% had an abnormal US and 46% had an abnormal DMSA renal scan. Of the latter patients, 15 had concurrent abnormal US (P value ≤ 0.03, concordance rate: 18%). Renal US had a sensitivity of 32%, specificity of 85%, positive predictive value of 65% and negative predictive value of 60%. Of the 77 patients with normal US, 31 (40.2%) had an abnormal DMSA renal scan. Despite the benefits and accessibility of renal US, its value in the diagnosis of pyelonephritis is limited.
authors.affiliation: Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Parviz
authors.initials: P
authors.lastname: Ayazi
authors.affiliation: Department of Pediatrics, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Mahyar
authors.affiliation: Department of Pediatrics, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Noroozian
authors.affiliation: Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Neda
authors.initials: N
authors.lastname: Esmailzadehha
authors.affiliation: Children Growth Research Center, Qazvin university of Medical Sciences, Qazvin, Iran.
authors.forename: Ameneh
authors.initials: A
authors.lastname: Barikani
mesh_terms: D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000382:microbiology; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007492:Iran; D008297:Male; D011237:Predictive Value of Tests; D011704:Pyelonephritis / Q000175:diagnosis; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D012042:Registries; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014463:Ultrasonography / Q000379:methods; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid