KMID : 1130320100530030408
|
|
Korean Journal of Pediatrics 2010 Volume.53 No. 3 p.408 ~ p.413
|
|
Limitations of 99mTc-DMSA scan in diagnosing acute pyelonephritis in children
|
|
Kim Byung-Gee
Pai Ki-Soo Park Jee-Min Kwak Jae-Reyung
|
|
Abstract
|
|
|
Purpose: We aimed to prove the relative limitation of 99mTc-DMSA scintigraphy (DMSA) compared to computed tomography (CT) in diagnosing acute pyelonephritis (APN) in children.
Methods: Since September 2006, after a 64-channel CT was imported, 10 DMSA false-negative patients have been identified: these patients underwent a CT scan for acute abdomen or acute febrile symptoms and were diagnosed as having APN; however, their DMSA scans were clear. We focused on these 10 DMSA false-negative patients and analyzed their clinical findings and CT results. We used Philips Brilliance Power 64-channel CT scanner for the CT scan and Siemens Orbitor Nuclear Camera 60 Hz for the DMSA scan.
Results: The 10 DMSA false-negative patients were mostly males (80%) and infants (80%). They had fever for a mean of 1.1-day duration before admission and showed increase in acute reactants: leukocyte, erythrocyte sedimentation rate, and C-reactive protein. The CT findings of renal lesions were focal in 6 (60%) cases and diffuse in 4 (40%) cases, and most of the lesions were unilateral in 80% of patients. CT proved that 22 renal lesions were neglected by DMSA. Differential renal function test by DMSA was also of no use in the evaluation of renal lesions.
Conclusion: In this study, DMSA scan showed limitation in finding renal cortical lesions of CT-proven APN patients. DMSA false-negative results seem to occur at early-phase disease of infantile age, but more prospective studies are needed to determine the reasons and their prevalence.
|
|
KEYWORD
|
|
Acute pyelonephritis, 64-Channel computed tomography, 99mTc-DMSA scintigraphy, Children, Infancy
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|