99mTechnetium-dimercapto-succinic acid renal scan in the evaluation of potential long-term renal parenchymal damage associated with extracorporeal shock wave lithotripsy in children.

PURPOSE: Extracorporeal shock wave lithotripsy (ESWL) has been reported as efficient and safe in children. Because of reports of renal parenchymal damage in adults, this study was designed to assess the effects of ESWL in pediatric kidneys evaluated before and after treatment with (99m)technetium dimercapto-succinic acid (DMSA) renal scan. MATERIALS AND METHODS: A total of 15 children, 9 months to 15 years old (mean age 6.5 years), underwent ESWL treatment for urolithiasis. Evaluation imaging included plain abdominal radiography, excretory urogram and/or renal sonography. DMSA renal scan was performed 24 hours before ESWL and at least 6 months after treatment. RESULTS: ESWL was performed in 1 session for 8 patients, 2 sessions for 6 and 3 sessions for 1, delivering a range of 600 to 3,000 shock waves per session. Treatment was successful in achieving stone-free status in 87% of the cases. Long-term followup (1 to 5 years) showed no blood pressure changes. On DMSA renal scan no acquired parenchymal scar was identified at least 6 months after ESWL treatment. CONCLUSIONS: The efficacy of ESWL in treating pediatric urolithiasis is confirmed. Renal parenchymal trauma associated with ESWL does not appear to cause long-term lesions identifiable by DMSA renal scan.

[Echographic study of thoracic lumps in 9 operated cases (author's transl)]. / Etude échographique des masses thoraciques. A propos de 9 cas opérés.

The authors report 9 cases of thoracic lumps investigated by echography in children and adults and operated later. The ulta-sonic study of intra-thoracic lumps is possible thanks to the echographic "windows" which are described; mediastinal and parenchymal lumps can thereby be investigated provided that they have a direct contact point with the chest wall. The echographic examination cannot reveal the histological nature of the lump but it is interesting in that in case of a liquid content it can assert its benignity, all with a technique simple and easy to use especially in children. The reliability of this examination seems good, the echostructure of the lesion being correctly defined in the 9 cases and in the 14 observations in the literature which are summed up.