A review of renal scarring in children

  title={A review of renal scarring in children},
  author={J. R. MacKenzie},
  journal={Nuclear Medicine Communications},
  • J. MacKenzie
  • Published 1 March 1996
  • Medicine
  • Nuclear Medicine Communications
SummaryIt is now widely accepted that children with a proven urinary tract infection should undergo some form of diagnostic imaging to assess the presence of, or the potential to develop, renal scarring. The type of investigation which should be performed is controversial. Some centres still perform intravenous urography, others rely on ultrasound alone, while others believe that a 99Tcm-dimercaptosuccinic acid (99Tcm-DMSA) scan is essential. This review discusses the advantages and… 

Imaging of renal scarring

It is concluded that DMSA scintigraphy and urography can both be used to detect significant renal scarring.


High-resolution ultrasound performed by experienced ultrasound technicians is suggested to accurately detect diffuse renal scarring when focal scarring was present, and the correlation was poor.

The growing role of ultrasonography in evaluating children after urinary tract infection

The purpose of this review is to advocate the use of ultrasonography (US) techniques in the work-up of children after a urinary tract infection (UTI). Currently, two major approaches are recognized.

Risk assessment of renal cortical scarring with urinary tract infection by clinical features and ultrasonography

The risk of missing renal cortical scarring which would be detected on a technetium-99m dimercaptosuccinic acid (DMSA) gold standard if ultrasound alone were used was determined, factoring for clinical features, UTI recurrence, and age group (infants, preschool, or school age).

Evaluation of acute pyelonephritis with DMSA scans in children presenting after the age of 5 years

The data did not confirm the conventional opinion that the risk of renal scarring after pyelonephritis is low in children over the age of 5 years, and suggest that renal scintigraphy may be a more appropriate method of investigation than VCUG for evaluation of the children over 5  years with acute pyel onephritis.

How sensitive is ultrasound in the detection of renal scars?

The English language medical literature was reviewed to determine the strength of the published evidence for the assertion that dimercaptosuccinic acid scintigraphy (DMSA) is superior to ultrasound

Sensitivity of ultrasonography in detecting renal parenchymal defects in children

It is shown that, compared with DMSA, US is sensitive enough to detect clinically significant RPD in children and the substitution of DMSA with US would be beneficial, as this would eliminate radiation exposure, reduce costs, and increase availability.

Accuracy of ultrasonic detection of renal scarring in different centres using DMSA as the gold standard.

  • M. SinhaP. GibsonT. KaneM. Lewis
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2007
It is concluded that if the detection of renal scars is a prime reason for imaging in children with UTIs, ultrasonography alone is inappropriate at any age and DMSA ought to be the primary investigation.

Technetium‐99m‐dimercaptosuccinic acid studies and urinary tract infection in childhood

DMSA imaging within 5–10 d of the onset of infection will demonstrate parenchymal involvement and indicate those patients needing intensive treatment, follow-up and further investigation and by the classification of abnormal DMSA images and their relation to divided function.