Korean J Urol.  2012 Oct;53(10):716-720. 10.4111/kju.2012.53.10.716.

Abnormal Dimercaptosuccinic Acid Scan May Be Related to Persistence of Vesicoureteral Reflux in Children with Febrile Urinary Tract Infection

Affiliations
  • 1Department of Urology, Chonnam National University Medical School, Gwangju, Korea. seinsena@hanmail.net

Abstract

PURPOSE
This study assessed whether 99mtechnetium dimercaptosuccinic acid (DMSA) scintigraphy used for the assessment of renal sequelae after febrile urinary tract infection (UTI) has any prognostic value for outcome measurement of vesicoureteral reflux (VUR) by retrospectively evaluating the correlation between abnormal DMSA scintigraphy results and persistence of VUR in children with febrile UTI.
MATERIALS AND METHODS
The medical records of 142 children (57 boys, 85 girls) admitted with febrile UTI from January 2004 to December 2006 and who were followed up for more than 1 year were retrospectively reviewed. At the initial and follow-up visits, renal ultrasound and DMSA scans were performed within 7 days from the diagnosis and voiding cystourethrography (VCUG) was performed within 1 month in all case and follow-up evaluations.
RESULTS
The children's mean age was 4.8+/-3.6 years (range, 0.3 to 14 years). The mean follow-up was 28.2+/-4.8 months. At the initial examination, VUR was more often associated with an abnormal DMSA scan result (83.3%) than with a normal DMSA scan result (16.7%, p=0.02). The frequency of VUR with an abnormal DMSA scan during acute UTI was significantly higher than the frequency of VUR with a normal DMSA scan (38.8% vs, 25.8%, respectively, p=0.004). Also, high-grade VUR was associated with an abnormal DMSA scan result (32.5%) more often than with a normal DMSA scan result (0%, p=0.01). Children with an abnormal DMSA scan had a lower resolution rate of VUR (17.5%) than did children with a normal DMSA scan (75.0%) at the follow-up VCUG (p=0.02).
CONCLUSIONS
An abnormal result on a DMSA scan during febrile UTI is associated with high-grade and persistent VUR. DMSA scans performed during febrile UTI are useful in reflux resolution in childhood.

Keyword

Technetium Tc 99m dimercaptosuccinic acid; Urinary tract infections; Vesico-ureteral reflux

MeSH Terms

Child
Follow-Up Studies
Humans
Medical Records
Retrospective Studies
Succimer
Technetium Tc 99m Dimercaptosuccinic Acid
Urinary Tract
Urinary Tract Infections
Vesico-Ureteral Reflux
Succimer
Technetium Tc 99m Dimercaptosuccinic Acid

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