TECHNETIUM-99M-DIMERCAPTOSUCCINIC ACID RENAL SCINTIGRAPHY IN CHILDRENOVER 5 YEARS

We retrospectively evaluated the frequency of renal scintigraphic abno rmalities in children over 5 years admitted with a first symptomatic u rinary tract infection (UTI). Among 261 children investigated, we foun d only 23 over 5 years having had technetium-99m-dimercaptosuccinic ac id scintigraphy during the acute phase of a first UTI. Obvious scintig raphic abnormalities were detected in 14 children (15 kidneys): 12 kid neys showed focal cortical defects and 3 were small and deformed. Ultr asound was normal in 7 of the 15 kidneys with abnormal scintigraphy an d in all the kidneys with normal scintigraphy. Among the 12 kidneys wi th focal cortical lesions, 8 kidneys returned to normal or improved co nsiderably 2-12 months after initial work-up. In conclusion, in childr en over 5 years admitted with a first symptomatic UTI, the frequency o f scintigraphic abnormalities is high and a strategy based only on ult rasound data would miss about 50% of the abnormal kidneys.