Comparison between scintigraphy, B-mode and power Doppler sonography in acute pyelonephritis of childhood

Purpose: Comparing Power Doppler imaging versus technetium-dimercapto-succi nic-acid (Tc-DMSA) scintigraphy in acute pyelonephritis of childhood. Patients and Methods. inclusion criteria: First episode of urinary tract in fection, clinical and biological findings suggesting an upper lesion, absen ce of urological malformation or obstruction, absence of reflux (or vesico- ureteral reflux interior to grade 3). Number of patients: 49, length of the study: 26 months (from November 95 to January 98). Methods: Tc99m-DMSA scintigraphy tatter five days), B mode and Power Dopple r imaging ton the day of admission or the following day). Systematic cystog raphy (day 5 to day 30). Results: In terms of positive diagnosis, scintigraphy was superior to Power Doppler, and the latter was superior to B mode ultrasonography. Sensitivit y (scintigraphy being the gold standard) was equal for both B mode and Powe r DopplerUS imaging, but combined Power Doppler and B mode US provided impr oved results. Conclusion: Currently, the results with Power Doppler imaging are insuffici ent to replace DMSA scintigraphy. However, Power Doppler is a good compleme nt to B mode US.