Abstract
Static renal scintigraphy using 99mTc DMSA (dimercaptosuccinic acid) in children with urinary tract infection is a very helpful method for differentiation between acute pyelonephritis (APN) and lower urinary tract infection. Results of examination may influence medical treatment with the goal to inhibit the development of irreversible parenchymal demage. 62 children (32 boys and 30 girls) under 5 years with clinical and laboratory diagnosis of APN were examined.
They were divided into 4 groups: 1) 1 - 6 months, 2) 7 - 12 months, 3) 1 - 2 years, 4) 2 - 5 years. Renal scintigraphy (cortical renal scan)) and ultrasonography were carried out in the period between 7 and 30 days after the clinical onset of the disease.
Scintigraphic changes were divided into three basic types: 1) solitary - mostly found in the upper or lower renal pole, 2) multifocal - unilateral or bilateral, 3) diffusely reduced accumulation of DMSA in enlarged kidney. Pathological scintigraphic changes were found in 26 children (41 %).
Appearance of APN in relation to age and sex of children is discussed, the type of parenchymal damage is evaluated. Static renal scintigraphy using 99mTc DMSA in children with APN should be performed in the acute phase of the disease, i.e. up to 7 - 10 days after the onset of the disease, especially in infants.
In the follow-up of children with abnormal first findings repeated renal scintigraphy after 3 - 6 months is necessary.