Imaging of renal scarring

Children with urinary tract infection should be investigated and followed u p, as those with pyelonephritis may develop renal scarring. In this review, after discussing the advantages and disadvantages of various imaging modal ities for diagnosis of renal scarring, it is concluded that DMSA scintigrap hy and urography can both be used to detect significant renal scarring. Wit h DMSA scintigraphy, small renal lesions (functional uptake defects) not se en at urography will also be detected. The long-term clinical significance of these lesions is, as yet, unknown. A normal DMSA scintigraphy after infe ction indicates low risk for clinically significant damage. In order to all ow acute, reversible lesions to first disappear, a follow-up DMSA examinati on should not be performed until at least 6 mo after the acute infection. U ltrasonography in isolation cannot be recommended for the diagnosis of rena l scarring.