The Journal of Pediatrics
Volume 151, Issue 6 , Pages 581-584.e1 , December 2007

Normal Dimercaptosuccinic Acid Scintigraphy Makes Voiding Cystourethrography Unnecessary after Urinary Tract Infection

  • Iulian Preda, MD

      Affiliations

    • Department of Pediatrics, The Queen Silvia Children’s Hospital, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
    • ,
  • Ulf Jodal, MD, PhD

      Affiliations

    • Department of Pediatrics, The Queen Silvia Children’s Hospital, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
    • ,
  • Rune Sixt, MD, PhD

      Affiliations

    • Department of Pediatric Clinical Physiology, The Queen Silvia Children’s Hospital, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
    • ,
  • Eira Stokland, MD, PhD

      Affiliations

    • Department of Pediatric Radiology, The Queen Silvia Children’s Hospital, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    • ,
  • Sverker Hansson, MD, PhD

      Affiliations

    • Department of Pediatrics, The Queen Silvia Children’s Hospital, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
    • Corresponding Author InformationReprint requests: Sverker Hansson, The Queen Silvia Children’s Hospital, SE-416 85 Göteborg, Sweden.

Received 8 February 2007 ,Revised 10 April 2007 ,Accepted 1 May 2007.

References 

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  2. Hoberman A, Charron M, Hickey RW, Baskin M, Kearney DH, Wald ER. Imaging studies after a first febrile urinary tract infection in young children. N Engl J Med. 2003;348:195–202
  3. Hansson S, Dhamey M, Sigström O, Sixt R, Stokland E, Wennerström M, et al. Dimercapto-succinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infection. J Urol. 2004;172:1071–1073
  4. Moorthy I, Easty M, McHugh K, Ridout D, Biassoni L, Gordon I. The presence of vesicoureteric reflux does not identify a population at risk for renal scarring following a first urinary tract infection. Arch Dis Child. 2005;90:733–736
  5. Tseng MH, Lin WJ, Lo WT, Wang SR, Chu ML, Wang CC. Does a normal DMSA obviate the performance of voiding cystourethrography in evaluation of young children after their first urinary tract infection?. J Pediatr. 2007;150:96–99
  6. Winberg J. Management of primary vesico-ureteric reflux in children—operation ineffective in preventing progressive renal damage. Infection. 1994;22:s4–s7
  7. Wheeler D, Vimalachandra D, Hodson EM, Roy LP, Smith G, Craig JC. Antibiotics and surgery for vesicoureteric reflux: a meta-analysis of randomised controlled trials. Arch Dis Child. 2003;88:688–694
  8. Swerkersson S, Andreasson AC, Jodal U, Sixt R, Stokland E, Hansson S. The insignificance of low-grade vesicoureteral reflux. (abstract) Pediatr Nephrol. 2006;10:1511
  9. Lebowitz RL, Olbing H, Parkkulainen K, Smellie JM, Tamminen-Mobius TE. International system of radiographic grading of vesicoureteric reflux (International Reflux Study in Children). Pediatr Radiol. 1985;15:105–109
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  11. Jantunen ME, Siitonen A, Ala-Houhala M, Ashorn P, Fohr A, Koskimies O, et al. Predictive factors associated with significant urinary tract abnormalities in infants with pyelonephritis. Pediatr Infect Dis J. 2001;20:597–601
  12. Rushton HG, Majd M, Chandra R, Yim D. Evaluation of 99m-technetium-dimercaptosuccinic acid renal scans in experimental acute pyelonephritis in piglets. J Urol. 1988;140:1169–1174
  13. Parkhouse HF, Godley ML, Cooper J, Risdon RA, Ransley PG. Renal imaging with 99m-TC-labelled DMSA in the detection of acute pyelonephritis: an experimental study in the pig. Nucl Med Commun. 1989;10:63–70
  14. Majd M, Nussbaum-Blask AR, Markle BM, Shalaby-Rana E, Pohl HG, et al. Acute pyelonephritis: Comparison of diagnosis with 99mTc-DMSA SPECT, Spiral CT, MR imaging, and power doppler US in an experimental pig model. Radiology. 2001;218:101–108
  15. Jacobsson B, Nolstedt L, Svensson L, Soderlundh S, Berg U. 99mTc-dimercaptosuccinic acid (DMSA) in the diagnosis of acute pyelonephritis in children: relation to clinical and radiological findings. Pediatr Nephrol. 1992;6:328–334
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  17. Williams CR, Perez LM, Joseph DB. Accuracy of renal-bladder ultrasonography as a screening method to suggest posterior urethral valves. J Urol. 2001;165:2245–2247
  18. Jodal U, Winberg J. Management of children with unobstructed urinary tract infection. Pediatr Nephrol. 1987;1:647–656
  19. Oostenbrink , van der Heijden AD, Moons KGM, Moll HA. Prediction of vesico-ureteric reflux in childhood urinary tract infection: a multivariate approach. Acta Paediatr. 2000;89:806–810
  20. Leroy S, Marc E, Adamsbaum C, Gendrel D, Bréart G, Chalumeau . Prediction of vesicoureteral reflux after a first febrile urinary tract infection in children: validation of a clinical decision rule. Arch Dis Child. 2006;91:241–244
  21. Leroy S, Romanello C, Galetto-Lacour A, Smolkin W, Korczowski B, Rodrigo C. Procalcitonin to reduce the number of unnecessary cystographies in children with a urinary tract infection: a European validation study. J Pediatr. 2007;150:89–95

PII: S0022-3476(07)00457-X

doi: 10.1016/j.jpeds.2007.05.008

The Journal of Pediatrics
Volume 151, Issue 6 , Pages 581-584.e1 , December 2007

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