Document Detail

Renal infection and vesico-ureteric reflux.
MedLine Citation:
PMID:  17544626     Owner:  NLM     Status:  MEDLINE    
Urinary tract infection (UTI) is a common disease of childhood. The investigation of UTI in children has been the subject of debate and controversy for many years. Most workers agree that the first imaging modality to be used should be an ultrasound examination to exclude obstruction, structural abnormalities, and renal calculi. The role of (99m)Tc dimercaptosuccinic acid scintigraphy (DMSA) in the diagnosis of acute pyelonephritis is becoming increasingly important. Many argue that if the DMSA study is normal at the time of acute UTI, no further investigation is required because the kidneys have not been involved and thus there will be no late sequelae. Others use the acute DMSA study to determine the intensity of antibiotic therapy. The importance of the role of vesico-ureteric reflux (VUR) is being debated. Some workers will only proceed to cystography to detect VUR if the DMSA study is abnormal, whereas others advocate a more aggressive approach. VUR can be identified by a variety of radiological and scintigraphic techniques. Although the radiological cystogram is the gold standard and is essential in the first UTI in a male patient, to exclude the presence of posterior urethral valves, radionuclide cystograms are advantageous in other situations. Suprapubic cystography techniques have been described to overcome the trauma of urethral catheterization but have not been widely accepted.
Monica A Rossleigh
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in nuclear medicine     Volume:  37     ISSN:  0001-2998     ISO Abbreviation:  Semin Nucl Med     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-04     Completed Date:  2007-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1264464     Medline TA:  Semin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  261-8     Citation Subset:  IM    
Department of Nuclear Medicine, Prince of Wales Hospital and Sydney Children's Hospital and University of New South Wales, Sydney, Australia.
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MeSH Terms
Kidney / radionuclide imaging
Pyelonephritis / complications,  radionuclide imaging*
Technetium Tc 99m Dimercaptosuccinic Acid / diagnostic use
Vesico-Ureteral Reflux / etiology,  radionuclide imaging*
Reg. No./Substance:
0/Radiopharmaceuticals; 65438-08-6/Technetium Tc 99m Dimercaptosuccinic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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