Archives of Pediatric Infectious Diseases
Renal scintigraphy with technetium 99m labeled dimercaptosuccinic acid (99mTc-DMSA) is a traditional imaging technique commonly used to detect renal scar in patients with probable vesicoureteral reflux (VUR) and/or urinary tract infection (UTIs). We determined whether normal results of DMSA renal scan obviate the need for voiding cystourethrography (VCUG) in evaluating children with UTIs.
We observed medical records from June 2006 to April 2007 retrospectively of 208 children admitted with community acquired UTIs to Mofid children hospital (Tehran, IR/Iran) a teaching hospital in Tehran in which their age was between 2-120 months. The association between DMSA renal scan results and VCUG findings performed 48 hours and 1 month after the diagnosis was evaluated. To examine the accuracy of abnormal DMSA results in predicting VUR, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and negative and positive likelihood ratio (LRs) were calculated.
VUR was seen in 14.0% of renal units with normal results of DMSA and 17.3% of renal units with abnormal DMSA findings. High grade VUR (grade IIIV) was seen in 18 (7.1%) of the abnormal findings of DMSA group and in (2.8%) 1 of the normal DMSA results group (P = 0.56). In the group with previous UTI (n = 68), the sensitivity and NPV of abnormalities on DMSA renal scan for detecting the presence of VUR (grade IIIV) were 100%, and100%, respectively. In the group without evidence of previous UTI, the sensitivity and NPV of abnormalities on DMSA renal scan for detecting the presence of VUR (grade IIIV) were 93% and 97%, respectively. Totally the sensitivity and NPV of abnormalities on DMSA renal scan to detect the presence of VUR (grade IIIV) were 94% and 97%, respectively.
As a screening test, DMSA renal scan is a high sensitive technique to assess VUR (grade IIIV) in children with UTI.
© 2012, Author(s). This open-access article is available under the Creative Commons Attribution 4.0 (CC BY 4.0) International License (https://creativecommons.org/licenses/by/4.0/), which allows for unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.
Ayazi P, Mahyar A, Shorvarzi M, Esmailzadehha N, Barikani A. Role of Dimercaptosuccinic Acid Renal Scintigraphy in the Diagnosis of Urine Culture Negative Urinary Tract Infection. J Compr Ped. 2017;8(4):e61232. doi: https://doi.org/10.5812/compreped.61232
Farhadi-Niakee S, Osia S, Amiri M, Nooreddini H, Sorkhi H. Prediction of Vesicoureteral Reflux in Children with First Urinary Tract Infection by Dimercaptosuccinic Acid and Ultrasonography. Inn J Pediatr. 2016;22(1):. doi:
Yousefichaijan P, Rezagholizamenjany M, Safi F, Arjmand A, Taherahmadi H, et al. Dimercaptosuccinic Acid Scan as an Alternative Diagnostic Approach in Vesicoureteric Reflux Disease. J Compr Ped. 2018;9(2):e58055. doi: https://doi.org/10.5812/compreped.58055
Kompani F, Barati L, Moghadam Samba M. Association of Electrolyte Changes and Inflammatory Markers with Renal Involvement in Children with Febrile UTI. Nephro-Urol Mon. 2022;14(1):e118086. doi: https://doi.org/10.5812/numonthly.118086
Vazirian S, Nikibakhsh A, Sayyedzadeh S, Jalili M. The Comparison of Indirect Radionuclide Cystography (IRC) and Voiding Cystourethrography (VCUG) in Diagnosing Vesico Urethral Reflux (VUR). J Kermanshah Univ Med Sci. 2005;9(2):e81530. doi:
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