Correlation of ultrasonographical findings of hydronephrosis/atrophy with 99m technetium-dimercaptosuccinic acid in childhood: A single-center experience from Turkey

Abstract

Introduction:To assess the association of frequently detected abnormalities (hydronephrosis and/or atrophy) on renal ultrasound with dimercaptosuccinic acid (DMSA) scan and the impact of vesicoureteral reflux (VUR) on these abnormalities to find new perspectives in pediatric age group.Materials and Methods:We retrospectively reviewed the DMSA, ultrasonography (US), micturating cystourethrography (MCUG) findings, and medical records of pediatric patients with hydronephrosis and/or atrophy who were at follow-up between January 2013 and December 2016 in our center which is located in the southeast region of Turkey.Results:Among 148 pediatric patients (male/female = 60/88), 66 had hydronephrosis, 72 had atrophy, and 10 patients had both. MCUG study detected VUR in 66 patients. Patients with atrophy were significantly older than patients with hydronephrosis (77.8 ± 58.6 vs. 39.3 ± 38.9 months, P = 0.002). Only 19.4% of our patients with atrophy had VUR. The rate of VUR was higher in the high-grade group than the mild-to-moderate-grade group although the difference was not statistically significant (80% vs. 61%, P = 0.199). Patients with high-grade hydronephrosis had more severe DMSA findings (73% vs. 39%). On the other side, 79% of the patients with high-grade VUR had severe DMSA findings. A total of 10 patients had both atrophy and hydronephrosis all affecting the left side. Six of them had VUR. Severe DMSA findings were more likely in toddlers (age 24–72 months) (48%). This finding was abruptly lowered after 72 months of age.Conclusions:The presence of atrophy and cases of left-sided hydronephrosis should be closely monitored, and DMSA may not be necessary in cases with high-grade hydronephrosis before MCUG.

Static Renal Scintigraphy in Diagnosis of Pediatric Renal Pyelonephritis

“…In the present study, according to ultrasound and/or MRU findings, 14 out of 50 (28%) patients had atrophic changes, 18 out of 50 (36%) patients had mild to moderate hydronephrosis, 13 out of 50 (26%) patients had marked hydronephrosis and 5 out of 50 (10%) patients had both atrophic changes and hydronephrosis. This disagreed with Kandur, et al [10] who reported that 72 out of 148 (48.6%) patients had atrophic changes, 36 out of 148 (24.3%) patients had mild to moderate hydronephrosis, 30 out of 148 (20.3%) patients had marked hydronephrosis and 10 out of 148 (6.8%) patients had both atrophic changes and hydronephrosis. This disagreement may be attributed to difference in number of patients included in the studies.…”