Update on dimercaptosuccinic acid renal scanning in children with urinary tract infection

@article{Goldraich2004UpdateOD,
  title={Update on dimercaptosuccinic acid renal scanning in children with urinary tract infection},
  author={Noemia P. Goldraich and Isidoro Henrique Goldraich},
  journal={Pediatric Nephrology},
  year={2004},
  volume={9},
  pages={221-226}
}
The dimercaptosuccinic acid (DMSA) renal scan is a method for assessing kidney function. Indications for DMSA scanning in children with urinary tract infection (UTI), as well as timing, have changed. Pitfalls in interpreting DMSA scans include: (1) acute pyelonephritis (APN), (2) tubular dysfunction, (3) hypertension, (4) use of captopril in patients with renovascular hypertension and (5) duplex kidneys. Interpretation of DMSA scans in children with UTI vary according to timing and clinical… 
Renal infection and vesico-ureteric reflux.
TLDR
The role of (99m)Tc dimercaptosuccinic acid scintigraphy (DMSA) in the diagnosis of acute pyelonephritis is becoming increasingly important and the importance of vesico-ureteric reflux (VUR) is being debated.
Tc-99 m DMSA Scintigraphy in Recurrent Urinary Tract Infection in Children
TLDR
DMSA scanning is the most valid modality in the evaluation of kidneys at risk for scarring in children, and is defined in the pediatric nephrology field and enhanced the clinicians' interest in the renal cortical scintigra­ phy.
SCINTIGRAPHIC SCREENING IN THE DETECTION OF RENAL SCARRING IN SIBLINGS OF CHILDREN WITH PRIMARY REFLUX
TLDR
The incidence of renal parenchymal damage and outcome in the siblings of children with primary VUR is determined and vesicoureteral reflux, urinary tract infection and renal scarring are determined.
Urinary tract infection in small children: the evolution of renal damage over time
TLDR
Most small children with febrile UTI do not develop renal damage and if they do the majority remain unchanged or regress over time, however, up to one-fifth of children with renal damage diagnosed after UTI are at risk of renal deterioration.
Necessity of 99mTc-dimercaptosuccinic acid scan in infants with low grade vesicoureteral feflux
TLDR
The aim of this study was to reevaluate the necessity of DMSA scans as a screening test in infants without reflux or with low grade reflux, and the incidence of renal defects was significantly correlated with VUR grade.
Procalcitonin as a predictor of renal scarring in infants and young children
TLDR
It is suggested that serum PCT concentration at admission is a useful predictive tool of renal scarring in infants and young children with acute pyelonephritis.
PEDIATRIC NUCLEAR MEDICINE Variability in the Interpretation of Dimercaptosuccinic Acid Scintigraphy After Urinary Tract Infection in Children
TLDR
Two experienced nuclear medicine physicians showed good agreement in the interpretation of DMSA scintigraphy in children after urinary tract infection and using the modified 4-level grading system for DMSA abnormality of Goldraich.
Abnormal dimercapto-succinic acid scans predict an increased risk of breakthrough infection in children with vesicoureteral reflux.
TLDR
It is concluded that children with grade 3 to 5 vesicoureteral reflux and an abnormal DMSA scan are at increased risk for breakthrough urinary tract infection.
ULTRASOUND EVALUATION OF RENAL SCARRING IN CHILDREN WITH VESICOURETRAL REFLUX
TLDR
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.
ACE gene polymorphism and renal scar in children with acute pyelonephritis
TLDR
ACE gene deletion polymorphism did not affect the development of renal scar as an independent variable in children with APN, and ACE genotype frequency after stratification by risk factors was evaluated.
...
...

References

SHOWING 1-10 OF 39 REFERENCES
Involvement of the renal parenchyma in acute urinary tract infection: The contribution of99mTc dimercaptosuccinic acid scan
TLDR
99mTc DMSA scan is a sensitive method for the detection of parenchymal involvement during acute UTI and the exact nature of these lesions and their relation with scars need, however, to be defined.
Urography versus DMSA scan in children with vesicoureteric reflux
TLDR
It is concluded that abnormalities detected by the DMSA scan may precede the radiological findings, especially in young children, and even severe RN can be established in kidneys that appear normal on the IVU.
99mTc dimercaptosuccinic acid (DMSA) scan in patients with established radiological renal scarring.
TLDR
The intravenous urogram and the DMSA scan showed good correlation but should be regarded as complementary investigations in these patients, giving morphological and functional information, respectively.
99mTc dimercaptosuccinic acid (DMSA) scan as first investigation of urinary tract infection.
TLDR
DMSA scans are more useful than other upper renal tract imaging techniques in detecting renal defects and should be given to their use as a first investigation in place of routine intravenous urograms.
99mTechnetium-dimercaptosuccinic acid scan in the diagnosis of acute pyelonephritis in children: relation to clinical and radiological findings
TLDR
It is suggested that persistent renal damage after APN in children without VUR may be more common than previously assumed and a weak but significant correlation with routine clinical and radiological parameters is shown.
99mTc-DMSA scintigraphy in acute urinary tract infection in children
TLDR
It is suggested that the DMSA scan has to be considered at present as the most sensitive imaging technique for the detection of acute pyelonephritis.
Diagnostic significance of 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy in urinary tract infection.
TLDR
It is suggested that a normal DMSA scan during or approximately two months after urinary tract infection in children indicates a low risk of finding significant pathology of the urinary tract.
Typical technetium dimercaptosuccinic acid distribution patterns in acute pyelonephritis
TLDR
Technetium dimercaptosuccinic acid renal scintiscans in 37 children with clinical diagnosis of acute pyelonephritis were reviewed and typical pathological uptake patterns were identified.
...
...