The efficacy of Tc99m dimercaptosuccinic acid (Tc-DMSA) scintigraphy and ultrasonography in detecting renal scars in children with primary vesicoureteral reflux (VUR)

International Urology and Nephrology
Y TemizF Simşek

Abstract

Pyelonephritis-induced renal scarring in children is a major predisposing factor for proteinuria, hypertension, and ultimate renal failure. The aim of this study was to investigate and compare the efficacy of Tc99m dimercaptosuccinic acid (Tc-DMSA) renal scintigraphy and renal ultrasonography (USG) in detecting renal scars in children with primary vesicoureteral reflux (VUR). Tc-DMSA scan and USG studies were done in 62 children who were admitted to our clinic between 1997 and 2003 because of documented urinary tract infection (UTI) and diagnosed with primary VUR. Renal scarring detection rates of Tc-DMSA scan and USG were compared according to reflux grades. In the whole group, renal scars were detected by Tc-DMSA scan and USG in 55% and 38% of refluxing units, respectively. Detection rates of Tc-DMSA and USG according to reflux grades were as follows: 47% and 29 % in low-grade VUR (grades 1 and 2), 46 % and 25% in mid-grade VUR (grade 3), 76% and 65% in high-grade VUR (grades 4 and 5), respectively. USG was found to be an inappropriate study in the detection of renal parenchymal scars, irrespective of the reflux grade. In this study, Tc-DMSA scan detected scars in 35% of kidneys reported to be normal on USG.

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Citations

Nov 21, 2007·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Maheen AhmedTej K Mattoo
Aug 9, 2008·International Urology and Nephrology·Harun PeruEnver Hasanoglu
Oct 7, 2008·International Urology and Nephrology·Aggeliki KotoulaGeorge Vaos
Feb 19, 2013·Seminars in Nuclear Medicine·Amer ShammasMartin Charron
Aug 22, 2008·The Journal of Urology·Kenneth G NeppleChristopher S Cooper
May 1, 2010·Journal of Magnetic Resonance Imaging : JMRI·Bingyin WangLinda M Dairiki Shortliffe
Jan 13, 2012·Journal of Pediatric Urology·Christopher S CooperPatrick D Brophy
Jul 6, 2016·The Cochrane Database of Systematic Reviews·Nader ShaikhStephanie W Hum
Mar 31, 2012·Acta Paediatrica·Katarzyna Taranta-JanuszMałgorzata Sutuła
Jun 15, 2007·Current Opinion in Urology
Nov 10, 2007·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·C Ochoa SangradorUNKNOWN Grupo Investigador del Proyecto

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