Radiologic evaluation of urinary tract infection.

This prospective study was designed to investigate the most relevant radiological approach for the evaluation of urinary tract infections (UTI) in childhood. In the first 48 hours following the diagnosis of UTI, all patients underwent 99mTc dimercaptosuccinic acid (DMSA) scanning, ultrasonography (US) and intravenous urography (IVU). For the imaging of renal parenchymal infection the sensitivity of IVU and US as compared to DMSA scanning were found to be 9.09% and 25%, respectively. It was concluded that 99mTc DMSA, where available, should be the first step for the accurate diagnosis and follow-up of patients with UTI.

The importance of 99mTc DMSA scanning in the localization of childhood urinary tract infections.

The use of 99mTechnetium dimercaptosuccinic acid (99mTc DMSA) scanning for the early diagnosis of upper urinary tract infections has been preferred for a few years. In this research we investigated the use of 99mTc DMSA scanning in the localization of renal parenchymal involvement in urinary tract infection. Twenty-four children presenting with first acute urinary tract infection were studied. Investigations included physical examination, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), antibody-coated bacteria (ACB) and early 99mTc DMSA scanning. 99mTc DMSA scanning was taken as the gold standard method in determining renal parenchymal inflammation. According to the 99mTc DMSA scanning the sensitivity of clinical findings was 57.14%, WBC 23.80%, ESR 33.33%, CRP 14.28% and ACB 71.42% in the localization of urinary tract infection. We propose early 99mTc DMSA scanning performed around the time of infection as a good technique for localization of the level of infection in the urinary tract.