Using technetium-99m dimercaptosuccinic acid renal cortex scintigraphy to differentiate acute pyelonephritis from other causes of fever in patients with spinal cord injury
Ch. Kao et al., Using technetium-99m dimercaptosuccinic acid renal cortex scintigraphy to differentiate acute pyelonephritis from other causes of fever in patients with spinal cord injury, UROLOGY, 55(5), 2000, pp. 658-662
Objectives. To differentiate acute pyelonephritis (APN) from fever due to o
ther sources in patients with spinal cord injury by using technetium-99m di
mercaptosuccinic acid (DMSA) renal cortex scintigraphy (DMSA scan).
Methods. A total of 24 patients with spinal cord injury were admitted with
fever. DMSA scans were performed on all patients. The final determination o
f the cause of the fever was based on the medical history, physical examina
tion, laboratory evaluation, and imaging studies.
Results. DMSA scan accurately diagnosed APN in 12 patients with inflammatio
n on the DMSA scan. In 5 patients with scarred lesions on the DMSA scans an
d in 7 patients with negative DMSA scan, the fever was attributed to other
causes. The sensitivity and specificity of the DMSA scan for detecting APN
were both 100%.
Conclusions. The DMSA scan is a valuable adjunct in the evaluation of fever
in patients with SCI. UROLOGY 55: 658-662, 2000. (C) 2000, Elsevier Scienc
e Inc.