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- Title
Childhood acute pyelonephritis: comparison of power Doppler sonography and Tc-DMSA scintigraphy.
- Authors
Stogianni, Aggeliki; Nikolopoulos, Panagiotis; Oikonomou, Ippoliti; Gatzola, Magdalini; Balaris, Vassilios; Farmakiotis, Dimitrios; Dimitriadis, Athanasios
- Abstract
<bold>Background: </bold>Tc 99m DMSA scintigraphy is regarded as the gold standard for the detection and localization of acute pyelonephritis (APN) in children. Power Doppler sonography (PD US) is a radiation-free and cost-effective technique that could be useful in the diagnosis of APN in children.<bold>Objective: </bold>To compare the predictive value of PD US with DMSA scintigraphy in the diagnosis of APN in children.<bold>Materials and Methods: </bold>A total of 74 neonates and children with clinical findings consistent with possible upper urinary tract infection were evaluated with PD US and DMSA scintigraphy. Children with anatomic (grey-scale) abnormalities were excluded. A total of 147 kidneys were examined within the first 48 h after the onset of symptoms. Each kidney was divided into three zones (upper, middle, and lower third).<bold>Results: </bold>APN was diagnosed by PD US in 46 kidneys. Sensitivity and specificity for detecting APN using DMSA scintigraphy as the reference standard were 73.8% and 85.7%, respectively. There was good agreement between PD US and DMSA scintigraphy in the localization of lesions.<bold>Conclusion: </bold>In clinically suspected APN, PD US has acceptable specificity and sensitivity, if performed within the first 48 h and could be helpful in neonates and children under 3 months of age in whom the use of scintigraphy is generally discouraged.
- Subjects
PYELONEPHRITIS; ABDOMEN; DOPPLER ultrasonography; POSITRON emission tomography; DIAGNOSIS; CHILDREN; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; RADIONUCLIDE imaging; RADIOPHARMACEUTICALS; RESEARCH; EVALUATION research; PREDICTIVE tests; ACUTE diseases
- Publication
Pediatric Radiology, 2007, Vol 37, Issue 7, p685
- ISSN
0301-0449
- Publication type
journal article
- DOI
10.1007/s00247-007-0510-5