Effectiveness of ultrasonography in children after urinary tract infection

ABSTRACT

To determine the effectiveness of ultrasonography in identification of reflux nephropathy in children after urinary tract infection. A prospective study carried out at pediatric and radiology department at Prince Au Ben Al-Hussein Hospital. Rena] ultrasonography was performed in 135 children, by an experienced radiologist after first attack of urinary tract infection, Age between 2 to 10 years, 70 males and 65 females. The overall size of each kidney was estimated and length was measured in all patients. Voiding cystourethrography and scintigraphy [DMSA scan] were done in all patients. Scinligraphy [dimercaptosuccinic acid labelled with technetium-99rn] was used as a method of reference. From 270 kidney examined, 31 were scarred and 239 were normal according to scintigraphy. When we used DMSA scan as the method of reference with scarring as diagnostic criterion, only 9 of 31 were correctly classified as abnormal at ultrasonography, [sensitivity 29% and specificity 78%]. When scarring or reduced renal size or both were used as diagnostic criterion, 14 were correctly classified as abnormal at US, [sensitivity 68% and specificity 45%]. Ultrasonography is not a reliable tool for diagnosing reflux nephropathy and should not be used as the only imaging study in children with urinary tract infection