Abstract
Purpose: Routine radiological evaluation in children with urinary tract infections includes ultrasound. Additional dimercapto-succinic acid scintigraphy in this setting is a common but not routine practice to determine whether there is parenchymal injury. Because dimercapto-succinic acid scintigraphy involves further time, expense and radiation, we determined whether ultrasound findings could substitute for dimercapto-succinic acid scintigraphy. Therefore, in children with urinary tract infections we researched the incidence of discordant findings between dimercapto-succinic acid scintigraphy and normal ultrasound. Materials and Methods: A retrospective review of children with a history of urinary tract infections who had normal ultrasound and dimercapto-succinic acid scintigraphy within 6 weeks of each other was performed through a chart review. Children with pyelonephritis within 4 months of the radiological tests were excluded. Dimercapto-succinic acid scintigraphy was considered abnormal if there was less than 40% differential function, global atrophy or focal defects. Results: From January 2005 to December 2006, 100 children met inclusion criteria. Median patient age was 4.5 years (range 4 months to 19 years) and 84% were female. Of the 100 children 74 (74%) demonstrated vesicoureteral reflux and 18 (18%) showed abnormal dimercapto-succinic acid scintigraphy despite normal ultrasound. Children with vesicoureteral reflux showed an increased incidence of abnormal dimercapto-succinic acid scintigraphy compared to those without vesicoureteral reflux (20.3% vs 11.5%), although this did not attain statistical significance (p = 0.04). Conclusions: Although dimercapto-succinic acid scintigraphy is not part of routine practice in all children with urinary tract infections and/or vesicoureteral reflux, it is frequently abnormal despite normal ultrasound. Therefore, dimercapto-succinic acid scintigraphy should be considered in these patients to evaluate cortical defects and possibly guide further management.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1639-1642 |
| Number of pages | 4 |
| Journal | Journal of Urology |
| Volume | 180 |
| Issue number | 4 SUPPL. |
| DOIs | |
| State | Published - Oct 1 2008 |
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Keywords
- kidney
- radionuclide imaging
- ultrasonography
- ureter
- vesico-ureteral reflux
ASJC Scopus subject areas
- Urology
Cite this
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Ultrasound Fails to Delineate Significant Renal Pathology in Children With Urinary Tract Infections : A Case for Dimercapto-Succinic Acid Scintigraphy. / Hamoui, Nabeel; Hagerty, Jennifer A.; Maizels, Max; Yerkes, Elizabeth B; Chaviano, Antonio; Shore, Richard; Kaplan, William E; Cheng, Earl Y.
In: Journal of Urology, Vol. 180, No. 4 SUPPL., 01.10.2008, p. 1639-1642.Research output: Contribution to journal › Article
TY - JOUR
T1 - Ultrasound Fails to Delineate Significant Renal Pathology in Children With Urinary Tract Infections
T2 - A Case for Dimercapto-Succinic Acid Scintigraphy
AU - Hamoui, Nabeel
AU - Hagerty, Jennifer A.
AU - Maizels, Max
AU - Yerkes, Elizabeth B
AU - Chaviano, Antonio
AU - Shore, Richard
AU - Kaplan, William E
AU - Cheng, Earl Y
PY - 2008/10/1
Y1 - 2008/10/1
N2 - Purpose: Routine radiological evaluation in children with urinary tract infections includes ultrasound. Additional dimercapto-succinic acid scintigraphy in this setting is a common but not routine practice to determine whether there is parenchymal injury. Because dimercapto-succinic acid scintigraphy involves further time, expense and radiation, we determined whether ultrasound findings could substitute for dimercapto-succinic acid scintigraphy. Therefore, in children with urinary tract infections we researched the incidence of discordant findings between dimercapto-succinic acid scintigraphy and normal ultrasound. Materials and Methods: A retrospective review of children with a history of urinary tract infections who had normal ultrasound and dimercapto-succinic acid scintigraphy within 6 weeks of each other was performed through a chart review. Children with pyelonephritis within 4 months of the radiological tests were excluded. Dimercapto-succinic acid scintigraphy was considered abnormal if there was less than 40% differential function, global atrophy or focal defects. Results: From January 2005 to December 2006, 100 children met inclusion criteria. Median patient age was 4.5 years (range 4 months to 19 years) and 84% were female. Of the 100 children 74 (74%) demonstrated vesicoureteral reflux and 18 (18%) showed abnormal dimercapto-succinic acid scintigraphy despite normal ultrasound. Children with vesicoureteral reflux showed an increased incidence of abnormal dimercapto-succinic acid scintigraphy compared to those without vesicoureteral reflux (20.3% vs 11.5%), although this did not attain statistical significance (p = 0.04). Conclusions: Although dimercapto-succinic acid scintigraphy is not part of routine practice in all children with urinary tract infections and/or vesicoureteral reflux, it is frequently abnormal despite normal ultrasound. Therefore, dimercapto-succinic acid scintigraphy should be considered in these patients to evaluate cortical defects and possibly guide further management.
AB - Purpose: Routine radiological evaluation in children with urinary tract infections includes ultrasound. Additional dimercapto-succinic acid scintigraphy in this setting is a common but not routine practice to determine whether there is parenchymal injury. Because dimercapto-succinic acid scintigraphy involves further time, expense and radiation, we determined whether ultrasound findings could substitute for dimercapto-succinic acid scintigraphy. Therefore, in children with urinary tract infections we researched the incidence of discordant findings between dimercapto-succinic acid scintigraphy and normal ultrasound. Materials and Methods: A retrospective review of children with a history of urinary tract infections who had normal ultrasound and dimercapto-succinic acid scintigraphy within 6 weeks of each other was performed through a chart review. Children with pyelonephritis within 4 months of the radiological tests were excluded. Dimercapto-succinic acid scintigraphy was considered abnormal if there was less than 40% differential function, global atrophy or focal defects. Results: From January 2005 to December 2006, 100 children met inclusion criteria. Median patient age was 4.5 years (range 4 months to 19 years) and 84% were female. Of the 100 children 74 (74%) demonstrated vesicoureteral reflux and 18 (18%) showed abnormal dimercapto-succinic acid scintigraphy despite normal ultrasound. Children with vesicoureteral reflux showed an increased incidence of abnormal dimercapto-succinic acid scintigraphy compared to those without vesicoureteral reflux (20.3% vs 11.5%), although this did not attain statistical significance (p = 0.04). Conclusions: Although dimercapto-succinic acid scintigraphy is not part of routine practice in all children with urinary tract infections and/or vesicoureteral reflux, it is frequently abnormal despite normal ultrasound. Therefore, dimercapto-succinic acid scintigraphy should be considered in these patients to evaluate cortical defects and possibly guide further management.
KW - kidney
KW - radionuclide imaging
KW - ultrasonography
KW - ureter
KW - vesico-ureteral reflux
UR - http://www.scopus.com/inward/record.url?scp=51049087932&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=51049087932&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2008.03.119
DO - 10.1016/j.juro.2008.03.119
M3 - Article
VL - 180
SP - 1639
EP - 1642
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 4 SUPPL.
ER -