Objective : This study was undertaken to evaluate associated underlying disease and follow-up changes of multiple cortical defects(MCD) in recurrent acute pyelonephritis(APN) patients with MCD on DMSA scan.
Methods : DMSA scan was performed in 128patients who visited Asan Medical Center with recurrent APN and 80patients showed MCD. Intravenous pyelography(IVP), ultrasound of the kidney(US), voiding cystourethrography(VCUG) were performed to search associated underlying diseases and changes of MCD were studied with follow-up DMSA scan at least 6 months after initial DMSA scan.
Results : 1) Underlying diseases were detected in 34patients, including vesicoureteral reflux in 21, renal stone in 4, renal tuberculosis in 3, ureteral stenosis in 3, renal infarction in 1, megaureter in 1, neurogenic bladder in 1, 2) Follow up DMSA scan revealed no changes in 14patients, improvement in 2.
Conclusion : The patients with multiple defects on DMSa scan have underlying abnormalities in 42%, so they need more radiologic studies such as VCUG, IVP, US. Multiple defects indicate irreversible damage in most patients.
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