Comparison of 99m Tc-DMSA Renal SPECT and Ultrasonography for Diagnosis of Acute Pyelonephritis in Children

比較鎝-99m-DMSA腎臟單光子電腦斷層所描與超音波對兒童急性腎盂腎炎的診斷

吳宜臻(Yi-Chen Wu) ； 吳佩珊(Pei-Shen Wu) ； 邱南津(Nan-Tsing Chiu) ； 李碧芳(Bi-Fang Lee) ； 姚維仁(Wei-Jen Yao) ； 邱元佑(Yuan-Yow Chiou)

《核子醫學雜誌》 16卷3期 (2003/09) Pp. 111-116

https://doi.org/10.6332/ANMS.1603.001

摘要

Introduction: It is often difficult, especially in children, to accurately diagnose acute pyelonephritis(APN)through clinical and laboratory testing. The main goal of this retrospective study was to compare the values of renal ultrasonography(US)and technetium-99m dimercaptosuccinic acid((superscript 99m)Tc-DMSA)single photon emission computed tomography(SPECT)in detecting APN in children. Methods: We studied 37 children(26 boys,11 girls;agerange,2 weeks to 9 years;mean,11 months)with culture-documented febrile urinary tract infection. They were referred consecutively to our department for (superscript 99m)Tc-DMSA renal SPECT. The scintigraphic and sonographic results were recorded to evaluate the values of US and(superscript 99m)Tc-DMSA renal SPECT. The Wilcoxon signed ranks test was performed to analyze the difference in detection rates of the two imaging modalities. Results:(superscript 99m)Tc-DMSA scans showed changes consistent with APN in 51%(19/37)of the patients. US showed changes consistent with APN in 32%(12/37)of the whole group and in only 47%(9/19)of the patients with scintigraphically documented APN. There is a significant difference(P＜0.05)between the detection rates of these two imaging modalities. Dilatation of the collecting system was noted in 16 patients(43%)byUS. Conclusions:(superscript 99m)Tc-DMSA renal SPECT is a more sensitive method than US in detecting APN. However, US is useful in depicting anatomical abnormalities that maybe associated with UTI.

關鍵字

急性腎盂腎炎 ； 鎝-99m-DMSA腎臟SPECT ； 超音波

並列摘要

Introduction: It is often difficult, especially in children, to accurately diagnose acute pyelonephritis(APN)through clinical and laboratory testing. The main goal of this retrospective study was to compare the values of renal ultrasonography(US)and technetium-99m dimercaptosuccinic acid((superscript 99m)Tc-DMSA)single photon emission computed tomography(SPECT)in detecting APN in children. Methods: We studied 37 children(26 boys,11 girls;agerange,2 weeks to 9 years;mean,11 months)with culture-documented febrile urinary tract infection. They were referred consecutively to our department for (superscript 99m)Tc-DMSA renal SPECT. The scintigraphic and sonographic results were recorded to evaluate the values of US and(superscript 99m)Tc-DMSA renal SPECT. The Wilcoxon signed ranks test was performed to analyze the difference in detection rates of the two imaging modalities. Results:(superscript 99m)Tc-DMSA scans showed changes consistent with APN in 51%(19/37)of the patients. US showed changes consistent with APN in 32%(12/37)of the whole group and in only 47%(9/19)of the patients with scintigraphically documented APN. There is a significant difference(P＜0.05)between the detection rates of these two imaging modalities. Dilatation of the collecting system was noted in 16 patients(43%)byUS. Conclusions:(superscript 99m)Tc-DMSA renal SPECT is a more sensitive method than US in detecting APN. However, US is useful in depicting anatomical abnormalities that maybe associated with UTI.

並列關鍵字

acute pyelonephritis ； 99m Tc-DMSA renal SPECT ； ultrasonography