Value of 99Tc m-DMSA renal SPECT/CT imaging in the diagnosis of upper urinary tract infection in adults / 中华核医学与分子影像杂志

ABSTRACT

Objective:To explore the diagnostic value of 99Tc m-dimercaptosuccinic acid (DMSA) renal SPECT/CT imaging in adult upper urinary tract infection. Methods:From September 2017 to December 2019, 99Tc m-DMSA renal SPECT/CT imaging and clinical data of 109 patients (14 males, 95 females; age 23-85(60.0±14.1) years) suspected of upper urinary tract infection from Beijing Hospital were retrospectively analyzed. Final clinical diagnosis was regarded as the diagnostic standard. The diagnostic efficacy of 99Tc m-DMSA renal SPECT/CT imaging was analyzed and compared with that of 99Tc m-DMSA renal SPECT imaging. The imaging features of SPECT/CT imaging in upper urinary tract infection were analyzed. The differences between the diagnostic methods were analyzed by using χ2 test or Fisher′s exact test. Results:Of 109 patients, 91 were diagnosed as upper urinary tract infection by 99Tc m-DMSA renal SPECT/CT imaging, with the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 100%(86/86), 78.26%(18/23), 94.51%(86/91), 18/18 and 95.41%(104/109), respectively. With the application of low-dose CT, the diagnostic specificity of SPECT/CT was significantly higher than that of SPECT (52.17% (12/23); P=0.014), and the causes of upper urinary tract infection were found in 5.81% (5/86) of patients with the help of CT. There were 10 (29.41%, 10/34) patients with chronic pyelonephritis had typical signs of renal scar on SPECT/CT imaging. Excluding the patients with typical renal scar, 11.54% (6/52) and 37.50% (9/24) of patients with acute and chronic pyelonephritis had decrease or defect focus≤2 ( χ2=6.987, P=0.008). Conclusions:99Tc m-DMSA renal SPECT/CT has good clinical value in the diagnosis of adult upper urinary tract infection. Compared with 99Tc m-DMSA renal SPECT, 99Tc m-DMSA renal SPECT/CT can effectively improve the diagnostic specificity and explore the causes of upper urinary tract infection such as urinary tract obstruction and stones.