(99M)TECHNETIUM-DIMERCAPTO-SUCCINIC ACID RENAL SCAN IN THE EVALUATIONOF POTENTIAL LONG-TERM RENAL PARENCHYMAL DAMAGE ASSOCIATED WITH EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY IN CHILDREN

Purpose: Extracorporeal shock wave lithotripsy (ESWL dagger) has been reported as efficient and safe in children. Because of reports of rena l parenchymal damage in adults, this study was designed to assess the effects of ESWL in pediatric kidneys evaluated before and after treatm ent with (99m)technetium dimercapto-succinic acid (DMSA) renal scan. M aterials and Methods: A total of 15 children, 9 months to 15 years old (mean age 6.5 years), underwent ESWL treatment for urolithiasis. Eval uation imaging included plain abdominal radiography, excretory urogram and/or renal sonography. DMSA renal scan was performed 24 hours befor e ESWL and at least 6 months after treatment. Results: ESWL was perfor med in 1 session for 8 patients, 2 sessions for 6 and 3 sessions for 1 , delivering a range of 600 to 3,000 shock waves per session. Treatmen t was successful in achieving stone-free status in 87% of the cases. L ong-term followup (1 to 5 years) showed no blood pressure changes. On DMSA renal scan no acquired parenchymal scar was identified at least 6 months after ESWL treatment. Conclusions: The efficacy of ESWL in tre ating pediatric urolithiasis is confirmed. Renal parenchymal trauma as sociated with ESWL does not appear to cause long-term lesions identifi able by DMSA renal scan.