Follow-up of acute pyelonephritis in children by Tc-99m DMSA scintigraphy - Quantitative and qualitative assessment

Lena Wallin, Ingemar Helin, Marika Bajc

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The author's goal was to create a system to identify children at risk for development of progressive renal damage, Methods: Thirty-four children were examined with Tc-99m DMSA scintigraphy in the acute stage of an initial episode of pyelonephritis, after 6 months, and again after 1 year, The scintigraphic findings were correlated with clinical and laboratory data, Results: All children had parenchymal defects in the acute stage: 93% of the kidneys and 85% bilaterally, After 6 months, the defects had diminished or disappeared in 66% of the kidneys, New defects appeared in 22%, At 1 year, no further improvement was seen in the kidneys, with an improved or unchanged pattern at 6 months, New defects appeared in 34%, Mean kidney activity uptake expressed as the percentage of administered dose (KU/AD), was low in the acute stage, increased at 6 months, with no further significant increase at 1 year, Eighty-three percent of children with urine cultures growing greater than or equal to 10(4) bacteria/ml at follow-up had decreased KU/AD values, whereas all children with urine cultures growing < 10(4) bacteria/ml had increased KU/AD values. Conclusions: Quantitative assessment increases the sensitivity of Tc-99m DMSA scintigraphy. Follow-up with this method makes it possible to identify the children with decreasing renal tubular function who may be at risk for progressive renal damage, Moderate bacteria of 104 bacteria/ml urine is associated with deterioration of renal tubular function.
Original languageEnglish
Pages (from-to)423-432
JournalClinical Nuclear Medicine
Volume26
Issue number5
Publication statusPublished - 2001

Subject classification (UKÄ)

  • Respiratory Medicine and Allergy
  • Cardiac and Cardiovascular Systems

Free keywords

  • Acute Pyelonephritis
  • Bacteruria
  • Tc-99m DMSA Scintigraphy

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