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Dimercapto-succinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infection.

Artikel i vetenskaplig tidskrift
Författare Sverker Hansson
Manjit Dhamey
Olof Sigström
Rune Sixt
Eira Stokland
Martin Wennerström
Ulf Jodal
Publicerad i The Journal of urology
Volym 172
Nummer/häfte 3
Sidor 1071-3; discussion 1073-4
ISSN 0022-5347
Publiceringsår 2004
Publicerad vid Institutionen för kvinnors och barns hälsa, Avdelningen för pediatrik
Sidor 1071-3; discussion 1073-4
Språk en
Länkar dx.doi.org/10.1097/01.ju.0000135337...
Ämnesord Female, Humans, Infant, Infant, Newborn, Kidney, radiography, radionuclide imaging, Male, Radiopharmaceuticals, diagnostic use, Technetium Tc 99m Dimercaptosuccinic Acid, diagnostic use, Urinary Tract Infections, complications, radiography, radionuclide imaging, Urography, Vesico-Ureteral Reflux, complications, radiography, radionuclide imaging
Ämneskategorier Dermatologi och venereologi, Barn

Sammanfattning

PURPOSE: We study the ability of dimercapto-succinic acid (DMSA) scintigraphy to predict the presence of dilating vesicoureteral reflux (VUR) in infants with urinary tract infection (UTI) to simplify the evaluation protocol. MATERIALS AND METHODS: A retrospective analysis of the records of 303 children younger than 2 years with initial UTI investigated with DMSA scintigraphy and voiding cystourethrography (VCU) within 3 months after UTI was performed. RESULTS: In 156 of the 303 children (51%) DMSA scintigraphy showed renal lesions. VUR was found in 80 patients (26%) and VUR grade significantly correlated with the presence of renal lesions. A normal DMSA scintigraphy and dilating VUR (grade III) occurred in 7 infants. At followup after 1 to 2 years, 6 of these 7 patients had normal DMSA scans and 1 had a scarred duplex kidney. VUR resolved spontaneously in 5 and improved spontaneously to grade 1 in 2 patients. None of the 7 children had recurrent UTI. CONCLUSIONS: DMSA scintigraphy in infants with UTI may replace VCU as a first line investigation. A strategy to perform VCU in only patients with renal lesions is proposed. In this study 147 of 303 VCUs would have been unnecessary as only 1 child with a damaged kidney was missed.

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