Diagnostic value of power doppler sonography in acute pyelonephritis in children

Background: Urinary tract infection is common in pediatric age group and can result in serious complications such as chronic renal failure and hypertension if renal parenchyma is involved. Thus, definitive diagnosis of pyelonephritis in equivocal cases is of great importance. Objective: Comparing the diagnostic value of power color Doppler sonography and DMSA scan in acute pyelonephritis in children. Methods: This was a descriptive study carried out on 80 pediatric patients (160 renal units) suspected of having pyelonephritis. Two diagnostic methods (DMSA scan and power color Doppler sonography) were performed for all patients. Assuming DMSA scan as the gold standard method in diagnosis of acute pyelonephritis, the sensitivity, specificity, positive and negative predictive values and also the accuracy of power color Doppler sonography were calculated and analyzed, statistically. Findings: Power color Doppler sonography showed a sensitivity of 66.3%, specificity of 77.5%, positive predictive value of 78.7%, and negative predictive value of 64.7% with an accuracy of 71.3% in diagnosis of acute pyelonephritis in children. The agreement between the two diagnostic tests was shown to be around 43%. Conclusion: Based on our data, the power color Doppler sonography of kidneys has lower sensitivity and specificity compared to those obtained by DMSA scan in diagnosing acute pyelonephritis in children and is not considered as an ideal diagnostic technique for this particular clinical condition.