Abstract
Objectives
To determine use of early Tc-99m dimercaptosuccinic acid scintigraphy in screening for vesicoureteral reflux following first febrile urinary tract infection.
Methods
43 children (1 mo-5 yr) with first febrile urinary tract infection underwent micturating cystourethrography, abdominal sonogram and early dimercaptosuccinic acid scintigraphy.
Results
Early dimercaptosuccinic acid scintigraphy had 72% sensitivity and 76% specificity for vesicoureteral reflux. For dilating vesicoureteral reflux, sensitivity and specificity were 100% and 75%, respectively.
Conclusion
Early dimercaptosuccinic acid scintigraphy has the potential to replace micturating cystourethrography in initial evaluation of febrile urinary tract infection.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Nammalwar BR, Vijayakumar M, Sankar J, Ramnath B, Prahalad N. Evaluation of the use of DMSA in culture positive UTI and culture negative acute pyelonephritis. Indian Pediatr. 2005;42: 691–6.
Sheu JN, Wu KH, Chen SM, Tsai JD, Chao YH, Lue KH. Acute 99mTc-DMSA scan predicts dilating vesicoureteral reflux in young children with a first febrile urinary tract infection: A population based cohort study. Clin Nucl Med. 2013;38:163–8.
Herz D, Merguerian P, McQuiston L, Danielson C, Gheen M, Brenfleck L. 5-year prospective results of dimercapto-succinic acid imaging in children with febrile urinary tract infection: Proof that the top-down approach works. J Urol. 2010;184:1703–9.
Zhang X, Xu H, Zhou L, Cao Q, Shen Q, Sun L, et al. Accuracy of early DMSA scan for VUR in young children with febrile UTI. Pediatrics. 2014; 133:e30–8.
Printza N, Farmaki E, Piretzi K, Arsos G, Kollinos K, Papachristou F. Acute phase 99mTc-DMSA in infants with first episode of febrile urinary tract infection. World J Pediatr. 2012;8: 52–6.
Vijayakumar M, Kanitkar M, Nammalwar BR, Bagga A, Indian Society of Paediatric Nephrology. Revised statement on management of urinary tract infection, Indian Paediatr. 2011;48:709–17.
Massanyi EZ, Preece J, Gupta A, Lin SM, Wang MH. Utility of screening ultrasound after first febrile UTI among patients with clinically significant vesicoureteral reflux. Urology. 2013;82:905–9.
Sorkhi H, Nooreddini HG, Amiri M, Osia S, Farhadi-Niakee S. Prediction of vesicoureteral reflux in children with first urinary tract infection by dimercaptosuccinic acid and ultrasonography. Iran J Pediatr. 2012;22:57–62.
Tseng MH, Lin WJ, Lo WT, Wang SR, Chu ML, Wang CC. Does a normal DMSA obviate the performance of voiding cystourethrography in evaluation of young children after their first urinary tract infection?. J Pediatr. 2007;150:96–9.
Mohkam M, Maham S, Khatami A, Naghi I, Otukesh B, Shamshiri AR, et al. Kidney ultrasonography and dimercaptosuccinic acid scans for revealing vesicoureteral reflux in children with pyelonephritis: A 7-Year prospective cohort study of 1500 pyelonephritic patients and 2986 renal units. Nephrourol Mon. 2012;4:350–5.
Fouzas S, Krikelli E, Vassilakos P, Gkentzi D, Papanastasiou DA, Salakos C. DMSA scan for revealing vesicoureteral reflux in young children with urinary tract infection. Pediatrics. 2010;126:e513–9.
Camacho V, Estorch M, Fraga G, Mena E, Fuertes J, Hernandez MA, et al. DMSA study performed during febrile urinary tract infection: A predictor of patient outcome? Eur J Med Mol Imaging. 2004;31:862–6.
Ki HC, Kim SO, Yoo DH, Hwang IS, Hwang EC, Oh KJ, et al. Abnormal dimercaptosuccinic acid scan may be related to persistence of vesicoureteral reflux in children with febrile urinary tract infection. Korean J Urol. 2012;53:716–20.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Umamageswari, K., Terance, B.A. & Anirudhan, N. Early dimercaptosuccinic acid renal scan in children with first febrile urinary tract infection. Indian Pediatr 52, 315–317 (2015). https://doi.org/10.1007/s13312-015-0631-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13312-015-0631-0