Tc-99m DMSA Renal Scan in First-Time Versus Recurrent Urinary Tract Infection-Yield and Patterns of Abnormalities

摘要

PurposeTo determine the yield and patterns of abnormalities noted by Tc-99m DMSA renal imaging in cases of first-time versus recurrent urinary tract infections (UTIs) in children.Materials and MethodsWe reviewed 101 Tc-99m DMSA studies performed for 52 first-time and 49 recurrent UTIs in 99 children during a period of 1 year. The average age of the patients was 4.4 years, and the femalecolon;male ratio was 7colon;1. Static images of the kidneys were acquired 2 hours after injection of Tc-99m DMSA in anterior, posterior, and right and left posterior oblique views. SPECT was performed in 9percnt; of the cases. The studies were scored as normal or abnormal.ResultsThe yield of abnormal scans in first-time UTIs was 22 (42percnt;) and in recurrent UTI 27 (55percnt;). Three categories of abnormalities were notedcolon; 1) renal cortical defects (55percnt; of the abnormal scans in first-time UTIs and 59percnt; of the abnormal scans in recurrent UTIs;Pequals; 0.40); 2) dilated pelvicalyceal system (27percnt; of the abnormal studies in first-time UTIs and 63percnt; of the abnormal studies in recurrent UTIs;P 0.01); and 3) renal swelling showing disproportionate function with size (41percnt; of the abnormal scans in first-time UTIs and 22percnt; of the abnormal scans in recurrent UTIs;Pequals; 0.21).ConclusionsThe high yield of renal abnormalities by Tc-99m DMSA scanning emphasizes the importance of testing all cases of UTI, including patients with a first-time infection. Documentation of the pattern of abnormalities may help in planning for subsequent management of UTIs in these patients.