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Journal of the Korean Society of Pediatric Nephrology 2007;11(2): 212-219. doi: https://doi.org/10.3339/jkspn.2007.11.2.212
급성 신우신염의 진단을 위한 영상 검사의 유용성
한혜정, 김지희, 이인실, 이혜선
1국립경찰병원 소아과
2국립경찰병원 소아과
3국립경찰병원 소아과
4국립경찰병원 소아과
The Significance of Renal Imaging Studies in the Diagnosis of Acute Pyelonephritis
Hye-Jung Han, Ji-Hee Kim, In-Sil Lee, Hye-Sun Lee
1Department of Pediatrics, National Police Hospital
2Department of Pediatrics, National Police Hospital
3Department of Pediatrics, National Police Hospital
4Department of Pediatrics, National Police Hospital
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ABSTRACT
Purpose : It is difficult to diagnose acute pyelonephritis(APN) in young children, because of their nonspecific symptoms. The younger the age, the higher the risk of renal scars after APN, which can be prevented by early diagnosis and treatment. We compare the significance of renal imaging studies by age for diagnosis of APN in febrile urinary tract infection(UTI) in children.
Methods : Fifty-three hospitalized children(34 patients under age 2 and 19 patients over age 2) with febrile UTI and who had undergone dimercaptosuccinic acid(DMSA) scan, renal ultra sonography(RUS) and voiding cystourethrography(VCUG) during the acute stage were re-viewed. We compared the renal imaging studies between the different age groups.
Results : The DMSA scan showed cortical defects in 23.5% of patients under age 2, which was significantly lower than 63.2% of patents over age 2(P<0.05). The renal cortical defects on DMSA scan were associated only with a high peripheral leukocyte count, but not with fever duration, erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP). And there was no correlation between the DMSA scan, VCUG or RUS findings.
Conclusions : The DMSA scan is not sensitive for diagnosis of APN in children less than 2 years of age and the findings cannot predict the presence of vesicoureteral reflux(VUR). VCUG may be necessary for proper management in this age group.
Key words: DMSA scan | APN | VCUG
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