Age-related radiological imaging in children with acute pyelonephritis

被引：0
作者：
Ilyas M. [1 ]
Mastin S.T. [2 ]
Richard G.A. [1 ,3 ]
机构：
[1] Department of Pediatrics, College of Medicine, University of Florida, Gainesville
[2] Department of Radiology, College of Medicine, University of Florida, Gainesville
[3] University of Florida, Gainesville, FL 32610-0296
来源：
Pediatric Nephrology | 2002年 / 17卷 / 1期
关键词：
Age; Dimercaptosuccinic acid renal scan; Pyelonephritis; Ultrasonography; Vesicoureteral reflux;
D O I：
10.1007/s004670200005
中图分类号：
学科分类号：
摘要：
Accurate diagnosis of acute pyelonephritis (APN) using clinical and laboratory parameters is often difficult in children. The aims of this retrospective study were twofold. Firstly, to correlate the clinical and laboratory manifestations of APN with the results of the dimercaptosuccinic acid (DMSA) renal scan in different age groups. Secondly, to compare the DMSA renal scan, renal ultrasonography (RUS), and voiding cystourethrography (VCUG) in patients with clinical APN. The DMSA renal scan was utilized as the gold standard for renal involvement. We determined the sensitivity of these tests in febrile urinary tract infections (UTI) in three age groups: group I less than 2 years; group II 2-8 years; group III older than 8 years. During the period January 1992 through December 1998, 222 children presented with a febrile UTI. All patients had a DMSA renal scan, 208 had contrast VCUG, and 163 had RUS. The clinical and laboratory manifestation of pyelonephritis correlated better with a positive DMSA renal scan in the older children than in the younger children; 85% of the DMSA renal scans were positive in group III; 69% in group II; 48% in group I (P<0.001). Vesicoureteral reflux detected by contrast VCUG was more prevalent in the younger age groups. Although high grades of reflux (grade IV-V) correlated better with a positive DMSA renal scan, it did not reach a level of statistical significance (P>0.05). RUS did not correlate with a positive DMSA renal scan in any age group. © IPNA 2002.
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页码：30 / 34
页数：4
相关论文
共 31 条
[1]  
Robert J.A., Etiology and pathophysiology of acute pyelonephritis, Am J Kidney Dis, 17, pp. 1-9, (1991)
[2]  
Hoberman A., UTI in young febrile children, Pediatr Infect Dis J, 16, pp. 11-17, (1997)
[3]  
Jakobsson B., Berg U., Svensson L., Renal scarring after acute pyelonephritis, Arch Dis Child, 70, pp. 111-115, (1994)
[4]  
Majd M., Rushton H.G., Renal cortical scintigraphy in the diagnosis of acute pyelonephritis, Semin Nucl Med, 22, pp. 98-111, (1992)
[5]  
Benador D., Benador N., Are youngest children at higher risk of renal sequelae after pyelonephritis?, Lancet, 349, pp. 17-19, (1997)
[6]  
Stokland E., Hellstrom M., Jacobsson B., Renal damage one year after first urinary tract infection
[7]  
role of DMSA scintigraphy, J Pediatr, 129, pp. 815-820, (1996)
[8]  
Rushton H.G., Majd M., Jantausch B., Wieldermann B.L., Bellman A.B., Renal scarring following reflux and non-reflux pyelonephritis in children: Evaluation with 99m T DMSA scintigraphy, J Urol, 147, pp. 1327-1332, (1992)
[9]  
Jacobson S.H., Eklof L.E., Wikstand I., Winberg J., Long term prognosis of post infectious renal scarring in relation to radiological finding in childhood: 27 Years follow up, Pediatr Nephrol, 6, pp. 19-24, (1992)
[10]  
Wikstad I., Hannerz L., Karlsson A., 99m Technetium dimercaptosuccinic acid scintigraphy in the diagnosis of acute pyelonephritis in rats, Pediatr Nephrol, 4, pp. 331-334, (1990)
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