VALUE OF DMSA RENAL SCINTIGRAPHY IN ACUTE PYELONEPHRITIS IN PEDIATRIC-PATIENTS

Quantitative renal DMSA scintigraphy was performed after a documented episode of acute pyelonephritis in 150 patients aged 1 month to 15 yea rs. In 75 % of cases there were-abnormal findings including polar defe cts, heterogeneous uptake, or a diffuse decrease in uptake. DMSA scann ing showed significantly greater sensitivity for detecting parenchymat ous disease (0.76) than intravenous urography (0.53) or ultrasonograph y (0.22). No correlations were found between DMSA scan anomalies and a ge, sex, or severity of clinical or laboratory abnormalities. Patients with urological anomalies (mainly vesicoureteral reflux) were more li kely to have abnormal DMSA scans, although 89 kidneys with normal urin ary tracts and normal intravenous urograms exhibited DMSA scan anomali es. Repeat DMSA scans performed in 53 patients showed improvement or r esolution of anomalies in 67 % of cases and persistence in 33 %. DMSA scanning is useful to differentiate true pyelonephritis from acute pye litis in children with febrile urinary tract infections.