Document Detail


Radionuclide studies in the evaluation of urinary tract infections.
MedLine Citation:
PMID:  8979546     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate the prevalence of vesicoureteral reflux (VUR) and renal scarring in children presenting with culture proven urinary tract infections (UTI). DESIGN: Descriptive study. SETTING: Tertiary care hospital-based study. SUBJECTS: Thirty-two children with proven UTI were evaluated by means of an abdominal ultrasonogram (USG), Technetium-99m Dimercapto Succinic Acid (DMSA) scan and Direct Radionuclide Cystography (DRCG). A micturating cystourethrogram (MCU) was performed to rule out any structural abnormality and to grade VUR. RESULTS: A total of 64 renal units in 32 children were evaluated. DMSA scan showed scarring in 27 renal units (42.2%) in 16 patients. Bilateral renal scarring was more common in older (> 2 yr) children as compared to younger ones (89% Vs 43%; p < 0.05). USG detected abnormalities in 13 renal units (20.3%) in 7 cases. VUR was detected in 37.5% of children of all age group by DRCG. In contrast, MCU showed evidence of VUR in only 13/20 renal units with a sensitivity of 65% as compared to DRCG and did not pick up any additional VUR that could have been missed on the DRCG. Only 3/9 in < 2 yr, in contrast to 10/11 in > 2 yr were positive for VUR on MCU (p < 0.05). However, MCU detected evidence of cystitis in 3 children and a bladder diverticulum in one patient. CONCLUSION: Wherever available, DMSA scan should be considered as a part of the first line investigations in any patient presenting with UTI. DRCG can also be performed in the same sitting to screen for the presence of reflux particularly for girls.
Authors:
G Jaya; C S Bal; A K Padhy; G P Bandopadhyaya; S K Pattnayak; K E Malathi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian pediatrics     Volume:  33     ISSN:  0019-6061     ISO Abbreviation:  Indian Pediatr     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1997-01-23     Completed Date:  1997-01-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985062R     Medline TA:  Indian Pediatr     Country:  INDIA    
Other Details:
Languages:  eng     Pagination:  635-40     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Safdarjang Hospital, New Delhi.
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Female
Humans
Infant
Male
Organotechnetium Compounds / diagnostic use*
Sensitivity and Specificity
Succimer / diagnostic use*
Technetium Tc 99m Dimercaptosuccinic Acid
Urinary Tract Infections / physiopathology,  radionuclide imaging*
Urodynamics
Vesico-Ureteral Reflux / physiopathology,  radionuclide imaging
Chemical
Reg. No./Substance:
0/Organotechnetium Compounds; 304-55-2/Succimer; 65438-08-6/Technetium Tc 99m Dimercaptosuccinic Acid

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