ABSTRACT
The aim of this study was to evaluate the accuracy of Technetium Tc 99m dimercaptosuccinic acid [99mTc-DMSA] renal scintigraphy in the diagnosis of urinary tract infection [UTI] in children with suspected infection but with a negative urine culture. The records of all children with suspected or definite diagnosis of UTI presented during a 2-year period were reviewed in this study. Abnormal findings on renal scintigraphy, voiding cystourethrography [VCUG], and ultrasonography were evaluated and compared between the patients with the definite diagnosis of UTI and those with suspected UTI and negative urine cultures. Of 210 patients, 86 had a definite diagnosis of UTI [group 1] and 124 had suspected UTI without a positive culture [group 2]. Abnormal findings on DMSA scans were seen in 76 patients [88.4%] in group 1 and 84 [67.7%] in group 2. Vesicoureteral reflux was detected by VCUG in 50% and 32.3% of the patients in groups 1 and 2, respectively. In group 2, vesicoureteral reflux was seen in 40.5% of the patients with abnormal DMSA scan. Ultrasonography findings were abnormal in 51.3% and 39.8% of the patients with abnormal DMSA scan findings in groups 1 and 2, respectively. According to our findings, in children with a negative urine culture and abnormal urinalysis, 99mTc-DMSA renal scintigraphy is helpful in diagnosing UTI and vesicoureteral reflux; we recommend VCUG when DMSA scan supports UTI despite a negative urine culture and a normal ultrasongraphy