Research Article
The Efficacy of Tc-99m DMSA Scintigraphy in Children with Vesicoureteral Reflux Accompanying Frequent Urinary Tract Infection
Abstract
Objective:
Urinary tract infection is one of the most common diseases in childhood.
Experimental studies have shown that renal damage due to urinary tract
infection can be prevented by early diagnosis and treatment. The aim of this
study was to evaluate the correlation between vesicoureteral reflux grade and
Technetium-99m- dimercaptosuccinic acid scintigraphy in patients with frequent
urinary tract infection
Methods
Between January and October 2017, 34 cases were
diagnosed as vescoureteral reflux with voiding cystoureterography were
retrospectively evaluated with Technetium-99m- dimercaptosuccinic acid
scintigraphy in terms of renal scar and function. Scars and function ratios
were evaluated in Technetium-99m- dimercaptosuccinic acid scintigraphy
according to voiding cystourethrography grades and correlation between the vesicoureteral
reflux grade and Technetium-99m- dimercaptosuccinic acid scintigraphy findings
were investigated.
Results:
Of 34 patients, 26 (76.5%) were female and 8 (23.5%) were
male. The mean age of the patients was 6.08 ± 4.03 (min: 1 month, max: 17 years).
Twenty-one patients had unilateral vesicoureteral reflux and 13 patients had
bilateral vesicoureteral reflux. Vesicoureteral reflux were detected in 47 of
the total 68 kidneys.
Conclusion:
In children with vesicoureteral reflux, Technetium-99m-
dimercaptosuccinic acid scintigraphy provides useful information to show the
kidney damage and as the vesicoureteral reflux grade increases, the rate of
kidney damage increases. Even in the case of grade 1 and grade 2 vesicoureteral
reflux, which are not expected to cause renal parenchymal damage.
Technetium-99m- dimercaptosuccinic acid scintigraphy is the most successful
imaging method for detecting parenchymal injury.
References
- Agras K, Ortapamuk H, Naldoken S, Tuncel A, Atan A. Resolution of cortical lesions on serial renal scans in children with acute pyelonephritis. Pediatr Radiol. 2007 Feb;37(2):153-8.
- Awais M, Rehman A, Zaman MU, Nadeem N. Recurrent urinary tract infections in young children: role of DMSA scintigraphy in detecting vesicoureteric reflux. Pediatr Radiol. 2015 Jan;45(1):62-8.
- Bhatnagar V, Mitra D, Agarwala S, Kumar R, Patel C, Malhotra A, et al. The role of DMSA scans in evaluation of the correlation between urinary tract infection, vesicoureteric reflux, and renal scarring. Pediatric surgery international. 2002;18(2-3):128-34.
- Biggi A, Dardanelli L, Cussino P, Pomero G, Noello C, Sernia O, et al. Prognostic value of the acute DMSA scan in children with first urinary tract infection. Pediatric Nephrology. 2001;16(10):800-4.
- Camacho V, Estorch M, Fraga G, Mena E, Fuertes J, Hernandez M, et al. DMSA study performed during febrile urinary tract infection: a predictor of patient outcome? European journal of nuclear medicine and molecular imaging. 2004;31(6):862-6.
- Dogan CS, Koyun NS, Aksoy GK, Cekic B, Savas M, Comak E. Delayed diagnosis of primary vesicoureteral reflux in children with recurrent urinary tract infections: Diagnostic approach and renal outcomes. Turk J Urol. 2018 Nov;44(6):498-502.
- Hoberman A, Charron M, Hickey RW, Baskin M, Kearney DH, Wald ER. Imaging studies after a first febrile urinary tract infection in young children. New England Journal of Medicine. 2003;348(3):195-202.
- Hodson C, Maling T, McManamon PJ, Lewis M. The pathogenesis of reflux nephropathy (chronic atrophic pyelonephritis). The British journal of radiology. 1975:1-26.
- Peters CA, Skoog SJ, Arant BS, Copp HL, Elder JS, Hudson RG, et al., Snodgrass, W. T. Summary of the AUA guideline on management of primary vesicoureteral reflux in children. The Journal of urology. 2010; 184(3), 1134-1144.
- Piepsz A, Blaufox M, Gordon I, Granerus G, Majd M, O'reilly P, et al., editors. Consensus on renal cortical scintigraphy in children with urinary tract infection. Seminars in nuclear medicine; 1999: Elsevier.
- Piepsz A, Colarinha P, Gordon I, Hahn K , Olivier P , Roca I , et al. European Association of Nuclear Medicine. Guidelines on 99mTc-DMSA scintigraphy in children 2009 ;39: 156-73
- Roebuck D, Howard R, Metreweli C. How sensitive is ultrasound in the detection of renal scars? The British journal of radiology. 1999;72(856):345-8.
- Rushton HG. Urinary tract infections in children: epidemiology, evaluation, and management. Pediatric Clinics of North America. 1997;44(5):1133-69.
- Tekgul S, Riedmiller H, Hoebeke P, Kocvara R, Nijman RJ, Radmayr C., et al., EAU guidelines on vesicoureteral reflux in children. European urology, 2012; 62(3), 534-542.
- Stokland E, Hellstrom M, Jacobsson B, Sixt R. Imaging of renal scarring. Acta Paediatrica. 1999;88:13-21. Stokland E, Hellstrom M, Jacobsson B, Jodal U, Lundgren P, Sixt R. Early 99mTc dimercaptosuccinic acid (DMSA) scintigraphy in symptomatic first‐time urinary tract infection. Acta Paediatrica. 1996;85(4):430-6.
- Swerkersson S, Jodal U, Sixt R, Stokland E, Hansson S. Urinary tract infection in small children: the evolution of renal damage over time. Pediatr Nephrol. 2017 Oct;32(10):1907-1913.
- Simsek F, Ilker Y, Akdas A, Türkeri L. Teflon injection in the treatment of vesicoureteral reflux: a promising alternative for surgery. International urology and nephrology. 1991;23(1):27-30.
- Temiz Y, Tarcan T, Onol F, Alpay H, Şimşek F. The efficacy of Tc99m dimercaptosuccinic acid (Tc-DMSA) scintigraphy and ultrasonography in detecting renal scars in children with primary vesicoureteral reflux (VUR). International Urology and Nephrology. 2006;38(1):149-52.
- Wani KA, Ashraf M, Bhat JA, Parry NA, Shaheen L, Bhat SA. Paediatric Urinary Tract Infection: A Hospital Based Experience. J Clin Diagn Res. 2016 Oct;10(10):SC04-SC07.
- Wongbencharat K, Tongpenyai Y, Na-Rungsri K. Renal ultrasound and DMSA screening for high-grade vesicoureteral reflux. Pediatr Int. 2016 Mar;58(3):214-8.
- Yılmaz I, Peru H, Yılmaz FH, Sekmenli T, Ciftci İ, Kara F. Association of vesicoureteral reflux and renal scarring in urinary tract infections. Arch Argent Pediatr. 2018 Aug 1;116(4):e542-e547
Year 2019,
Volume: 5 Issue: 3, 252 - 257, 31.12.2019
Abstract
References
- Agras K, Ortapamuk H, Naldoken S, Tuncel A, Atan A. Resolution of cortical lesions on serial renal scans in children with acute pyelonephritis. Pediatr Radiol. 2007 Feb;37(2):153-8.
- Awais M, Rehman A, Zaman MU, Nadeem N. Recurrent urinary tract infections in young children: role of DMSA scintigraphy in detecting vesicoureteric reflux. Pediatr Radiol. 2015 Jan;45(1):62-8.
- Bhatnagar V, Mitra D, Agarwala S, Kumar R, Patel C, Malhotra A, et al. The role of DMSA scans in evaluation of the correlation between urinary tract infection, vesicoureteric reflux, and renal scarring. Pediatric surgery international. 2002;18(2-3):128-34.
- Biggi A, Dardanelli L, Cussino P, Pomero G, Noello C, Sernia O, et al. Prognostic value of the acute DMSA scan in children with first urinary tract infection. Pediatric Nephrology. 2001;16(10):800-4.
- Camacho V, Estorch M, Fraga G, Mena E, Fuertes J, Hernandez M, et al. DMSA study performed during febrile urinary tract infection: a predictor of patient outcome? European journal of nuclear medicine and molecular imaging. 2004;31(6):862-6.
- Dogan CS, Koyun NS, Aksoy GK, Cekic B, Savas M, Comak E. Delayed diagnosis of primary vesicoureteral reflux in children with recurrent urinary tract infections: Diagnostic approach and renal outcomes. Turk J Urol. 2018 Nov;44(6):498-502.
- Hoberman A, Charron M, Hickey RW, Baskin M, Kearney DH, Wald ER. Imaging studies after a first febrile urinary tract infection in young children. New England Journal of Medicine. 2003;348(3):195-202.
- Hodson C, Maling T, McManamon PJ, Lewis M. The pathogenesis of reflux nephropathy (chronic atrophic pyelonephritis). The British journal of radiology. 1975:1-26.
- Peters CA, Skoog SJ, Arant BS, Copp HL, Elder JS, Hudson RG, et al., Snodgrass, W. T. Summary of the AUA guideline on management of primary vesicoureteral reflux in children. The Journal of urology. 2010; 184(3), 1134-1144.
- Piepsz A, Blaufox M, Gordon I, Granerus G, Majd M, O'reilly P, et al., editors. Consensus on renal cortical scintigraphy in children with urinary tract infection. Seminars in nuclear medicine; 1999: Elsevier.
- Piepsz A, Colarinha P, Gordon I, Hahn K , Olivier P , Roca I , et al. European Association of Nuclear Medicine. Guidelines on 99mTc-DMSA scintigraphy in children 2009 ;39: 156-73
- Roebuck D, Howard R, Metreweli C. How sensitive is ultrasound in the detection of renal scars? The British journal of radiology. 1999;72(856):345-8.
- Rushton HG. Urinary tract infections in children: epidemiology, evaluation, and management. Pediatric Clinics of North America. 1997;44(5):1133-69.
- Tekgul S, Riedmiller H, Hoebeke P, Kocvara R, Nijman RJ, Radmayr C., et al., EAU guidelines on vesicoureteral reflux in children. European urology, 2012; 62(3), 534-542.
- Stokland E, Hellstrom M, Jacobsson B, Sixt R. Imaging of renal scarring. Acta Paediatrica. 1999;88:13-21. Stokland E, Hellstrom M, Jacobsson B, Jodal U, Lundgren P, Sixt R. Early 99mTc dimercaptosuccinic acid (DMSA) scintigraphy in symptomatic first‐time urinary tract infection. Acta Paediatrica. 1996;85(4):430-6.
- Swerkersson S, Jodal U, Sixt R, Stokland E, Hansson S. Urinary tract infection in small children: the evolution of renal damage over time. Pediatr Nephrol. 2017 Oct;32(10):1907-1913.
- Simsek F, Ilker Y, Akdas A, Türkeri L. Teflon injection in the treatment of vesicoureteral reflux: a promising alternative for surgery. International urology and nephrology. 1991;23(1):27-30.
- Temiz Y, Tarcan T, Onol F, Alpay H, Şimşek F. The efficacy of Tc99m dimercaptosuccinic acid (Tc-DMSA) scintigraphy and ultrasonography in detecting renal scars in children with primary vesicoureteral reflux (VUR). International Urology and Nephrology. 2006;38(1):149-52.
- Wani KA, Ashraf M, Bhat JA, Parry NA, Shaheen L, Bhat SA. Paediatric Urinary Tract Infection: A Hospital Based Experience. J Clin Diagn Res. 2016 Oct;10(10):SC04-SC07.
- Wongbencharat K, Tongpenyai Y, Na-Rungsri K. Renal ultrasound and DMSA screening for high-grade vesicoureteral reflux. Pediatr Int. 2016 Mar;58(3):214-8.
- Yılmaz I, Peru H, Yılmaz FH, Sekmenli T, Ciftci İ, Kara F. Association of vesicoureteral reflux and renal scarring in urinary tract infections. Arch Argent Pediatr. 2018 Aug 1;116(4):e542-e547
There are 21 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research articles |
| Authors | |
| Publication Date | December 31, 2019 |
| Published in Issue | Year 2019 Volume: 5 Issue: 3 |
e-ISSN 2149-7796