Power Doppler Sonography Versus Tc-99m DMSA Scintigraphy for Diagnosing Acute Pyelonephritis in Children

Bykov, Sergey; Chervinsky, Leonid; Smolkin, Vladislav; Halevi, Rafi; Garty, I.

doi:10.1097/01.rlu.0000053407.04034.b1

Cited by 26 publications

(32 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study had limitations, since uncooperative children were excluded. In our previous report of 40 children, the sensitivity of PDU was 74% and the specificity was 94%, but the main shortcoming of this study was the lack of repeated DMSA scan for accurate definition of APN [28]. A high specificity of PDU (95%) was reported also by El Hajjar et al [29].…”

Section: Discussionmentioning

confidence: 51%

Power Doppler ultrasonography in the diagnosis of acute childhood pyelonephritis

et al. 2004

Self Cite

View full text Add to dashboard Cite

In the absence of specific symptomatology in children, the early diagnosis of acute pyelonephritis (APN) is a challenge, particularly during infancy. In an attempt to differentiate APN from lower urinary tract infection (UTI), we evaluated the ability of power Doppler ultrasonography (PDU) to predict renal parenchymal involvement, as assessed by dimercaptosuccinic acid ((99m )Tc-DMSA) scintigraphy. The study comprised 62 patients, 46 girls and 16 boys, aged 2 weeks to 5 years, admitted to the pediatric department with febrile UTI. All children were examined by PDU and DMSA scintigraphy within the first 3 days of admission. In the group of 31 patients with one or more DMSA scan abnormalities, the PDU showed a matching perfusion defect in 27 (87%). Of 26 children with normal DMSA scintigraphy, the PDU evaluation was also normal in 24. The sensitivity and specificity of PDU for the detection of affected kidneys were 87% and 92.3%, and the positive predictive value and negative predictive value were 93.1% and 85.7%, respectively. These data indicate the PDU has a high sensitivity and specificity for differentiating APN from lower UTI and may be a useful and practical tool for the diagnosis of APN in infants and children.

show abstract

Section: Discussionmentioning

confidence: 51%

Power Doppler ultrasonography in the diagnosis of acute childhood pyelonephritis

et al. 2004

Self Cite

View full text Add to dashboard Cite

show abstract

“…Eggli et al (18) were the first investigators who showed that the sensitivity of USG in detecting inflammation in renal perenchyma increased from 38% to 63% with As a result, they found the sensitivity and specificity values to be 92.1% and 93.8% for DMSA, 86.8% and 87.5% for CT, 89.50% and 87.5% for magnetic resonance imaging (MRI) and 74.3% and 56,7% for PDUS. After this study, more satisfactory results were published both for adult and pediatric patient groups (4,5,7,10). In fact, a marked advancement occured in the USG technology after the first studies which evaluated the success of this method and the sensitivity has been reported to be 74-89% in recent studies (19,20).…”

Section: Discussionmentioning

confidence: 63%

“…Therefore, the diagnosis of acute pyelonephritis (APN) should be made timely, accurate treatment should be administered, risk factors should be determined and the patient should be referred accordingly. However, it is mostly difficult to definetely differentiate APN from lower UTI by clinical findings and acute phase reactants which have low sensitivity and specificity especially in children below the age of 2 years (2,4,6). Currently, Tc-99m dimercaptosuccinicacid (DMSA) is considered the gold standard imaging method in detecting renal parenchymal involvement in patients diagnosed with APN (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

“…In large-scale prospective studies related with this issue and in a meta-analysis, the prevalence of UTI in febrile infants and young children was found to be approximately 7%, though it varied depending on the age, gender, status of circumsicion and ethnic origin (1). Especially upper UTI (acute pyelonephritis) which recurs in the accompaniment of structural urinary system abnormalities may lead to long-term complications including renal scarring and resulting hypertension, renal failure and problems which may arise TURKISH ARCHIVES of PEDIATRICS TÜRK PEDİATRİ ARŞİVİ in pregnancy (2)(3)(4)(5). Therefore, the diagnosis of acute pyelonephritis (APN) should be made timely, accurate treatment should be administered, risk factors should be determined and the patient should be referred accordingly.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The role of tissue harmonic imaging ultrasound combined with power Doppler ultrasound in the diagnosis of childhood febrile urinary tract infections

et al. 2015

View full text Add to dashboard Cite

Aim: This study assessed the ability of tissue harmonic imaging ultrasound combined with power Doppler ultrasound in the detection of childhood febrile urinary tract infections in comparison with the gold standard reference method: Tc-99m dimercaptosuccinicacid renal cortical scintigraphy. Material and Methods:This prospective study included 60 patients who were hospitalized with a first episode of febrile urinary tract infections. All children were examined with dimercaptosuccinicacid scan and tissue harmonic imaging ultrasound combined with power Doppler ultrasound within the first 3 days of admission.Results: Signs indicative of acute infection were observed in 29 patients according to the results of tissue harmonic imaging ultrasound combined with power Doppler ultrasound while dimercaptosuccinicacid scan revealed abnormal findings in 33 patients. The sensitivity, specificity, positive predictive value and negative predictive value of tissue harmonic imaging combined with power Doppler ultrasound using dimercaptosuccinicacid scintigraphy as the reference method in patients diagnosed with first episode febrile urinary tract infections were calculated as 57.58% (95% confidence interval: 40.81%-72.76%); 62.96% (95% confidence interval: 44.23%-78.47%); 65.52% (95% confidence interval: 52.04%-77%); 54.84% (95% confidence interval: 41.54%-67.52%); respectively. Conclusions:Although current results exhibit inadequate success of power Doppler ultrasound, this practical and radiation-free method may soon be comprise a part of the routine ultrasonographic evaluation of febrile urinary tract infections of childhood if patients are evaluated early and under appropriate sedation. (Turk Pediatri Ars 2015; 50: 90-5)

show abstract

“…[16][17] Subsequent renal parenchymal changes occur in 40% of those with VUR and 6% of those without VUR. 18 Surgical management gains priority with regard to degree of parenchymal involvement.…”

Section: Discussionmentioning

confidence: 99%

Dimercaptosuccinic acid scintigraphy vs. ultrasound for renal parenchymal defects in children

Marceau-Grimard

Marion

Côté

et al. 2017

CUAJ

View full text Add to dashboard Cite

Introduction: Dimercaptosuccinic acid (DMSA) scintigraphy is the gold standard in the evaluation of renal parenchymal defects and is widely used in the pediatric population. As more recent ultrasound equipment was purchased at our tertiary pediatric centre, our objective was to evaluate if renal ultrasound (US) results are equivalent or sufficient when compared to DMSA scintigraphy in the assessment of renal anomalies. Methods: The charts of all 463 patients who underwent DMSA scintigraphy between January 2009 and May 2014 at our pediatric tertiary centre were reviewed. The objective was to look for correlation between US and DMSA scan results for renal scars/dysplasia. A hundred and sixty pediatric patients followed with US and DMSA scan for a total of 285 renal units remained for evaluation after exclusions. Timing of the exams, urinary tract infection (UTI), and indication for imaging were reviewed. Results with older (105 patients) and newer (55 patients) US equipment were compared. Results: Among the 285 renal units evaluated, 39 (14%) had renal parenchymal defects shown by US and 87 (31%) by DMSA scintigraphy (sensitivity 36%, specificity 96%). The DMSA scan was normal for eight abnormal kidneys (3%) on US. The results were not statistically significant when compared to exams performed with newer or older US machines. Conclusions: At our institution, US data are not sensitive enough to give reliable information about renal parenchymal defects, even with newer equipment. DMSA scintigraphy still remains mandatory for the evaluation of renal anomalies, but could be optional if the US exam indicates parenchymal defects.

show abstract

Power Doppler Sonography Versus Tc-99m DMSA Scintigraphy for Diagnosing Acute Pyelonephritis in Children

Cited by 26 publications

References 24 publications

Power Doppler ultrasonography in the diagnosis of acute childhood pyelonephritis

Power Doppler ultrasonography in the diagnosis of acute childhood pyelonephritis

The role of tissue harmonic imaging ultrasound combined with power Doppler ultrasound in the diagnosis of childhood febrile urinary tract infections

Dimercaptosuccinic acid scintigraphy vs. ultrasound for renal parenchymal defects in children

Contact Info

Product

Resources

About