Ajdinović Boris, Jauković Ljiljana, Krstić Zoran, Dopuda Marija
Institute of Nuclear Medicine, Military Medical Academy, Crnotravska 17, 11 000 Belgrade, Serbia and Montenegro.
Hell J Nucl Med. 2006 Jan-Apr;9(1):27-30.
The aim of this study was to determine the incidence of abnormal dimercaptosuccinic acid-Tc-99m ((99m)Tc-DMSA) renal scintigraphy findings in children with culture proved urinary tract infection (UTI) with or without vesicoureteral reflux (VUR). (99m)Tc-DMSA renal scintigraphy was performed in 343 children with culture documented UTI (247 girls and 96 boys) aged from three months to 14 years (middle age of 4.82 years). The children studied were all those submitted for renal scintiscan to the Institute of Nuclear Medicine, Military Medical Academy, Belgrade during a five-year period (2000-2004). Micturating cystoureterography (MCU) performed in all patients before (99m)Tc-DMSA scan, revealed VUR in 213 children, while in 130 children VUR was not detected by MCU. In 15 of the 213 children the grade of VUR was I, in 88 was II, in 57 was III, in 33 was IV and 20 children had grade V of VUR. Findings of (99m)Tc-DMSA renal scintigraphy were classified as: normal, equivocal and abnormal. Statistical analysis was performed using c(2)test. In all patients abnormal findings were detected in 38% (131/343), normal in 51% (174/343) and equivocal findings in 11% (38/343). In children with UTI and VUR the incidence of abnormal findings was 53% (112/213), of normal 37% (80/213) and of equivocal findings 10% (21/213). In children with UTI without VUR the incidence of abnormal findings was 15% (19/130), of normal findings 72% (94/130), and of equivocal findings 13% (17/130). The incidence of abnormal findings was significantly higher in children with UTI and VUR than in those with UTI without VUR (P<0.001). In children with VUR grades I, II, III, IV and V abnormal findings were 33%, 32%, 60%, 79% and 95% respectively. The incidence of abnormal findings was higher in children with VUR grades IV and V, than in grade I and II (P<0.001). Our results suggest that (99m)Tc-DMSA renal scintigraphy in children can discriminate between grade I-II and IV-V of VUR and also that in children with UTI and VUR abnormal findings in the scintiscan were more than three times higher than in children with UTI alone.
本研究的目的是确定经培养证实患有或未患有膀胱输尿管反流（VUR）的尿路感染（UTI）儿童中，二巯基丁二酸锝-99m（（99m）Tc-DMSA）肾闪烁显像异常结果的发生率。对343例经培养证实患有UTI的儿童（247名女孩和96名男孩）进行了（99m）Tc-DMSA肾闪烁显像，这些儿童年龄从3个月至14岁（中位年龄4.82岁）。所研究的儿童均为在五年期间（2000 - 2004年）到贝尔格莱德军事医学科学院核医学研究所接受肾闪烁扫描的患者。在所有患者进行（99m）Tc-DMSA扫描前均进行了排尿性膀胱输尿管造影（MCU），结果显示213名儿童存在VUR，而130名儿童未被MCU检测到VUR。在213名存在VUR的儿童中，15名VUR分级为I级，88名是II级，57名是III级，33名是IV级，20名儿童的VUR为V级。（99m）Tc-DMSA肾闪烁显像的结果分为：正常、可疑和异常。采用卡方检验进行统计分析。在所有患者中，异常结果占38%（131/343），正常结果占51%（174/343），可疑结果占11%（38/343）。在患有UTI且有VUR的儿童中，异常结果的发生率为53%（112/213），正常结果为37%（80/213），可疑结果为10%（21/213）。在患有UTI但无VUR的儿童中，异常结果的发生率为15%（19/130），正常结果为72%（94/130），可疑结果为13%（17/130）。患有UTI且有VUR的儿童中异常结果的发生率显著高于患有UTI但无VUR的儿童（P<0.001）。在VUR分级为I、II、III、IV和V级的儿童中，异常结果分别为33%、32%、60%、79%和95%。VUR分级为IV和V级的儿童中异常结果的发生率高于I和II级（P<0.001）。我们的结果表明，儿童（99m）Tc-DMSA肾闪烁显像能够区分VUR的I-II级和IV-V级，并且患有UTI且有VUR的儿童闪烁显像中的异常结果比仅患有UTI的儿童高出三倍多。
