Mucci B, Maguire B
Department of Diagnostic Radiology, West Cumberland Hospital, Whitehaven, Cumbria.
Clin Radiol. 1994 May;49(5):324-5. doi: 10.1016/s0009-9260(05)81797-0.
The results of investigations in children with urinary tract infection (UTI) were studied in a district general hospital in order to assess the relative value of the two most widely used screening tests, namely ultrasound (US) and 99mTc dimercaptosuccinic acid (DMSA) scintigraphy. A total of 193 children had undergone both US and DMSA scintigraphy as part of an investigation of proven single or multiple urinary tract infections over a 27 month period. DMSA scintigraphy revealed abnormalities in 22 of the children (11%). The abnormalities ranged from cortical defects to congenital anatomical abnormalities. US revealed abnormalities in six children (3%) but did not contribute any additional information in any. In our institution, the DMSA scintigram alone would have been an adequate screening test for children with UTI. Hydronephrosis is a common abnormality detected by US. Although none were seen in the study group, several children were examined during the study period with dilated collecting systems detected at ante-natal US. No cases of hydronephrosis presented as UTI. We question whether the use of routine US is justifiable in the investigation of children with UTI, and discuss whether a more selective investigation protocol should be adopted.
为评估两种最常用的筛查检查方法，即超声（US）和99mTc二巯基丁二酸（DMSA）闪烁扫描法的相对价值，在一家区综合医院对患有尿路感染（UTI）的儿童的检查结果进行了研究。在27个月的时间里，共有193名儿童接受了US和DMSA闪烁扫描检查，作为已证实的单一或多重尿路感染调查的一部分。DMSA闪烁扫描显示22名儿童（11%）存在异常。异常情况从皮质缺损到先天性解剖异常不等。US显示6名儿童（3%）存在异常，但未提供任何额外信息。在我们机构，仅DMSA闪烁扫描对于患有UTI的儿童来说就是一种充分的筛查检查。肾积水是US检测到的常见异常情况。虽然研究组中未发现肾积水病例，但在研究期间对几名儿童进行了检查，产前US检测到他们的集合系统扩张。没有肾积水病例表现为UTI。我们质疑在对患有UTI的儿童进行调查时常规使用US是否合理，并讨论是否应采用更具选择性的调查方案。
