Institute of Nuclear Medicine, Military Medical Academy, Belgrade, Serbia.
Indian J Pediatr. 2009 Oct;76(10):1023-6. doi: 10.1007/s12098-009-0217-8. Epub 2009 Nov 12.
To determine the incidence and pattern of abnormal scintigraphy findings in children with UTI and VUR.
Data of 118 children who underwent micturating cystourethrography (MCU) and late Tc-99m dimercaptosuccinic acid (DMSA) scan were evaluated. Findings were categorized under the image appearance and relative kidney uptake (RKU) and related to the grade of VUR, sex and child's age.
MCU revealed VUR (78 unilateral and 40 bilateral) of grades I, II, III, IV and V in 2, 47, 35, 19 and 15 patients respectively. There were 52 children with normal and 66 with abnormal DMSA finding. Scarring rate was significantly associated with high grade VUR (p=0.0023) and male gender ( p=0.0412). Bilateral scarring was seen exclusively in children with bilateral VUR. No significant difference was found between renal scarring and child's age in the same gender group. Poor kidney function was shown in 5 patients.
Renal scarring highly correlated with grade of VUR. A strategy to perform MCU only on patients with abnormal DMSA finding is proposed.
确定尿路感染和反流患儿异常闪烁显像的发生率和模式。
对 118 例行排尿性膀胱尿道造影（MCU）和迟发性 Tc-99m 二巯丁二酸（DMSA）扫描的儿童进行了数据分析。将结果根据图像表现和相对肾摄取（RKU）进行分类，并与反流程度、性别和儿童年龄相关联。
MCU 显示 2 例单侧Ⅰ级、47 例单侧Ⅱ级、35 例单侧Ⅲ级、19 例单侧Ⅳ级和 15 例单侧Ⅴ级反流，40 例双侧反流。52 例儿童的 DMSA 检查结果正常，66 例异常。瘢痕形成率与高级反流（p=0.0023）和男性（p=0.0412）显著相关。双侧瘢痕仅见于双侧反流患儿。同一性别组中，肾瘢痕形成与儿童年龄之间无显著差异。5 例患者肾功能不良。
肾瘢痕与反流程度高度相关。提出了仅对 DMSA 检查异常的患者进行 MCU 的策略。
