The role of renal contour change in the diagnosis of cortical scarring after urinary tract infection

Gysella Muniz; Martin Charron; Ruth Lim; Amer Shammas; Hui Liu; Nader Shaikh

The role of renal contour change in the diagnosis of cortical scarring after urinary tract infection

Am J Nucl Med Mol Imaging. 2022 Feb 15;12(1):41-43. eCollection 2022.

Authors

Gysella Muniz¹, Martin Charron², Ruth Lim³, Amer Shammas⁴, Hui Liu¹, Nader Shaikh¹

Affiliations

¹ University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Division of General Academic Pediatrics Pittsburgh, PA 15224, USA.
² Department of Diagnostic Imaging, Division of Nuclear Medicine, Virginia Commonwealth University Richmond, VA 23219, USA.
³ Department of Radiology, Massachusetts General Hospital, Harvard Medical School Boston, MA 02114, USA.
⁴ University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children Toronto, ON M5G 1X8, Canada.

PMID: 35295886
PMCID: PMC8918400

Abstract

Urinary tract infections in children can lead to permanent renal scarring in approximately 15% of cases. Technetium-99m (^99mTc)-dimercaptosuccinic acid (DMSA) scintigraphy is the gold standard for identifying renal scarring. Using data and scans from children enrolled at our center in a 2-year prospective clinical trial (RIVUR study), we included children with radiologically confirmed pyelonephritis who exhibited renal scarring on their 1 and/or 2-year follow-up scans and asked 3 blinded pediatric nuclear medicine physicians to reexamine the renal contours in these scans. Five girls met all eligibility criteria (each had two late ^99mTc-DMSA scans 1 and 2 years after index UTI). Of the 20 kidneys imaged, 10 exhibited renal scarring and of these, 7 exhibited renal contour abnormalities. These findings suggest that the presence of abnormalities of the renal contour is not necessary for diagnosis of renal scarring.

Keywords: Renal scarring; imaging; infectious disease; nuclear medicine; scintigraphy.