| Power Doppler sonography versus Tc-99m DMSA scintigraphy for diagnosing acute pyelonephritis in children: are these two methods comparable? | |
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MedLine Citation:
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PMID: 12592126 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE This study assessed the role of renal power Doppler ultrasonography (PDU) to identify acute pyelonephritis (APN) and to determine whether PDU can replace Tc-99m DMSA renal scintigraphy in the diagnosis of APN in children. METHODS A prospective study was conducted in 40 infants and young children (78 kidneys were evaluated) with a mean age of 25.9 months (range, 1 to 68 months) who were hospitalized with a first episode of high fever and bacteruria, possibly APN. All children were examined by PDU and Tc-99m DMSA within the first 3 days after admission. Patients with congenital abnormalities, hydronephrosis, and urinary reflux were excluded. RESULTS Twenty-seven of the 78 kidneys appeared abnormal on Tc-99m DMSA, and 20 of them were abnormal on PDU. Fifty-one of 78 kidneys were normal on Tc-99m DMSA, and 3 of 51 appeared diseased on PDU. The accuracy of PDU was 87%, sensitivity was 74%, and specificity was 94%. The positive predictive and negative predictive values were both 87%. When considering the numbers of lesions in 27 kidneys with positive Tc-99m DMSA studies (38 lesions), PDU did not disclose 16 lesions (false-negative results). Thus, the sensitivity of PDU for diagnosing lesions of APN decreased to 58%. CONCLUSIONS A positive PDU finding should obviate the use of Tc-99m DMSA in patients thought to have possible APN. However, because of a large number of false-negative results (26%) and underestimation of the number of pyelonephritic lesions (low sensitivity of 58%), PDU cannot replace Tc-99m DMSA in the diagnosis of APN in children. |
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Authors:
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Sergey Bykov; Leonid Chervinsky; Vladislav Smolkin; Rafi Halevi; Izak Garty |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article |
Journal Detail:
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Title: Clinical nuclear medicine Volume: 28 ISSN: 0363-9762 ISO Abbreviation: Clin Nucl Med Publication Date: 2003 Mar |
Date Detail:
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Created Date: 2003-02-19 Completed Date: 2003-07-02 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 7611109 Medline TA: Clin Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 198-203 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, Haemek Medical Center, Afula, Israel. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Child Child, Preschool Echocardiography, Doppler / methods False Negative Reactions Female Humans Infant Infant, Newborn Male Pyelonephritis / radionuclide imaging*, ultrasonography* Radionuclide Imaging / methods Radiopharmaceuticals / diagnostic use Reproducibility of Results Sensitivity and Specificity |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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