Renal scintigraphy in children with vesicoureteral reflux

Indian J Pediatr. 2009 Oct;76(10):1023-6. doi: 10.1007/s12098-009-0217-8. Epub 2009 Nov 12.

Abstract

Objective: To determine the incidence and pattern of abnormal scintigraphy findings in children with UTI and VUR.

Methods: Data of 118 children who underwent micturating cystourethrography (MCU) and late Tc-99m dimercaptosuccinic acid (DMSA) scan were evaluated. Findings were categorized under the image appearance and relative kidney uptake (RKU) and related to the grade of VUR, sex and child's age.

Results: MCU revealed VUR (78 unilateral and 40 bilateral) of grades I, II, III, IV and V in 2, 47, 35, 19 and 15 patients respectively. There were 52 children with normal and 66 with abnormal DMSA finding. Scarring rate was significantly associated with high grade VUR (p=0.0023) and male gender ( p=0.0412). Bilateral scarring was seen exclusively in children with bilateral VUR. No significant difference was found between renal scarring and child's age in the same gender group. Poor kidney function was shown in 5 patients.

Conclusion: Renal scarring highly correlated with grade of VUR. A strategy to perform MCU only on patients with abnormal DMSA finding is proposed.

Publication types

  • Comparative Study

MeSH terms

  • Age Distribution
  • Child
  • Child, Preschool
  • Cohort Studies
  • Comorbidity
  • Confidence Intervals
  • Cystoscopy
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • India / epidemiology
  • Infant
  • Male
  • Probability
  • Radionuclide Imaging
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Technetium Tc 99m Dimercaptosuccinic Acid*
  • Urinalysis
  • Urinary Tract Infections / diagnostic imaging*
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / physiopathology
  • Urodynamics
  • Vesico-Ureteral Reflux / diagnostic imaging*
  • Vesico-Ureteral Reflux / epidemiology*
  • Vesico-Ureteral Reflux / physiopathology

Substances

  • Technetium Tc 99m Dimercaptosuccinic Acid