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Journal of the Korean Society of Pediatric Nephrology 1998;2(2): 145-151.
급성신우신염과 방광요관역류 환아에서 DMSA신주사의 추적관찰
오창희, 최원규, 김지홍, 이재승, 김병길
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 소아과학교실
3연세대학교 의과대학 소아과학교실
4연세대학교 의과대학 소아과학교실
5연세대학교 의과대학 소아과학교실
A Follow-up Study of DMSA Renal Scan in Children with . Acute Pyelonephritis and Vesicoureteral Reflux
Chang-Hee Oh, Won-Kyoo Choi, Ji-Hong Kim, Jae-Seung Lee, Pyung-Kil Kim
1Department of Pediatrics, Yonsei University, College of Medicine
2Department of Pediatrics, Yonsei University, College of Medicine
3Department of Pediatrics, Yonsei University, College of Medicine
4Department of Pediatrics, Yonsei University, College of Medicine
5Department of Pediatrics, Yonsei University, College of Medicine
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Purpose : DMSA renal scan is known as a valuable method for evaluating acute pyelonephritis and renal scar in patients with febrile urinary tract infection or vesicoureteral reflux. We made this study, to determine the most effective use of DMSA renal scan.
Methods : 155 children were admitted to the Pediatric Department of Yonsei University, Severance hospital with the symptom of urinary tract infection from January, 1992 to June, 1995. DMSA scan, renal ultrasound and VCUG were performed. One consisted of 29 patients with the diagnosis of acute pyelonephritis without vesicoureteral reflux and the otherconsistedofllpatientswithvesicoureteralreflux.
Results : The follow-up DMSA scans at mean $0.99{pm}0.46$ months after the initial DMSA scans were performed in the 29 children with acute pyetonephritis. 21($72.4%$) of 29 children showed normal DMSA scans. 8 children with abnormal DMSA scans had follow-up DMSA scans at 2.5 months after the initial scans and 6 of 8 children showed normal DMSA scans. Only 12($41.4%$) of 29 children showed abnormal renal ultrasound. The data about DMSA scans in 32 children with vesicoureteral reflux showed that there were abnormal DMSA scans in Grade $I;25.0%$, Grade $II;44.5%$, Grade $III;64.3%$, Grade $IV;92.9%$ and Grade $V;100.0%$. There was a significant difference in that 36 renal unit ($68.0%$) on DMSA renal scan and 26 renal units ($49.1%$) on renal ultrasound showed abnormal finding(P<0.05).
Conclusion : DMSA renal scan is more useful than renal ultrasound for the diagnosis of acute pyelonephritis. It is considered that if the initial DMSA scan is abnormal, a follow-up DMSA scan must be performed after 10weeks (8-12weeks) and the change in DMSA scan evaluated.
Key words: Acute pyelonephritis | Vesicoureteral reflux
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