Limitations of 99mTc-DMSA scan in diagnosing acute pyelonephritis in children / 소아과
Korean Journal of Pediatrics
; : 408-413, 2010.
Article
em Ko
| WPRIM
| ID: wpr-155214
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE: We aimed to prove the relative limitation of 99mTc-DMSA scintigraphy (DMSA) compared to computed tomography (CT) in diagnosing acute pyelonephritis (APN) in children. METHODS: Since September 2006, after a 64-channel CT was imported, 10 DMSA false-negative patients have been identified: these patients underwent a CT scan for acute abdomen or acute febrile symptoms and were diagnosed as having APN; however, their DMSA scans were clear. We focused on these 10 DMSA false-negative patients and analyzed their clinical findings and CT results. We used Philips Brilliance Power 64-channel CT scanner for the CT scan and Siemens Orbitor Nuclear Camera 60 Hz for the DMSA scan. RESULTS: The 10 DMSA false-negative patients were mostly males (80%) and infants (80%). They had fever for a mean of 1.1-day duration before admission and showed increase in acute reactants: leukocyte, erythrocyte sedimentation rate, and C-reactive protein. The CT findings of renal lesions were focal in 6 (60%) cases and diffuse in 4 (40%) cases, and most of the lesions were unilateral in 80% of patients. CT proved that 22 renal lesions were neglected by DMSA. Differential renal function test by DMSA was also of no use in the evaluation of renal lesions. CONCLUSION: In this study, DMSA scan showed limitation in finding renal cortical lesions of CT-proven APN patients. DMSA false-negative results seem to occur at early-phase disease of infantile age, but more prospective studies are needed to determine the reasons and their prevalence.
Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Pielonefrite
/
Sedimentação Sanguínea
/
Proteína C-Reativa
/
Câmaras gama
/
Prevalência
/
Succímero
/
Ácido Dimercaptossuccínico Tecnécio Tc 99m
/
Febre
/
Abdome Agudo
/
Leucócitos
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
Limite:
Child
/
Humans
/
Infant
/
Male
Idioma:
Ko
Revista:
Korean Journal of Pediatrics
Ano de publicação:
2010
Tipo de documento:
Article