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Journal of the Korean Society of Pediatric Nephrology 2003;7(1): 38-43.
급성 신우신염 환아들의 나이에 따른 Dimercaptosuccinic Acid Renal Scan 민감도
장경아, 양정아, 하태선, 박혜원, 이준호
1포천중문의과대학 소아과학교실
2포천중문의과대학 소아과학교실
3충북대학교 의과대학 소아과학교실
4포천중문의과대학 소아과학교실
5포천중문의과대학 소아과학교실
Sensitivity of Dimercaptosuccinic Acid(DMSA) Renal Scan in Children with Acute Pyelonephritis
Kyung-Ah Jang, Jeong-A Yang, Tae-Sun Hah, Hye-Won Park, Jun-Ho Lee
1Department of Pediatrics, College of Medicine, Pocheon CHA University
2Department of Pediatrics, College of Medicine, Pocheon CHA University
3Department of Pediatrics, College of Medicine, Chungbuk University School of Medicine
4Department of Pediatrics, College of Medicine, Pocheon CHA University
5Department of Pediatrics, College of Medicine, Pocheon CHA University
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ABSTRACT
Purpose : Accurate diagnosis of acute pyelonephritis(APN) using clinical and laboratory parameters is often difficult in children. Clinical and experimental studies have demonstrated that renal scarring can be prevented or diminished by early diagnosis and aggressive treatment of acute pyelonephritis. dimercaptosuccinic acid(DMSA) renal scan has been reported to be useful in children for confirmation of the diagnosis of acute pyelonephritis. An analysis was undertaken to correlate the clinical and laboratory manifestations of APN With the results of the DMSA renal scan in different age groups.
Methods : We determined the sensitivity of DMSA renal scan in febrile urinary tract infections(UTI) in two groups according to age : group I in less than 2 years; group II in older than 2 years. During the period March 2001 through September 2002, 67 children presented with febrile UTIs. All patients had DMSA renal scan done in the acute period, 55 had voiding cystourethrography(VCUG) and 66 had renal ultrasonogram(RUS) done.
Results : There were no significant difference between the two groups in DMSA renal scan (P>0.05). But, in group I sensitivity of DMSA renal scan was 47%; in group II sensitivity of DMSA renal scan was 70%. The grade of reflux correlated with a positive DMSA renal scan. Vesicoureteral reflux did not correlate with age. RUS did not correlate with a positive DMSA renal scan in any age group. Abnormality of RUS did not correlate with age.
Conclusion : At present, we believe that DMSA renal scan is the prevailing method in differention of the APN. In addition, it is not invasive and less costly. Even though there is no statistical difference in the sensitivity of DMSA renal scan between young and older children, we can observe that in the younger group, the sensitivity of DMSA renal scan seemed to be lower(47%).
Key words: DMSA renal scan | Age | APN
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