The Efficacy of 99mTc-DMSA SPECT in Diagnosis of Renal Scarringn of Vesicoureteral Reflux in Children

Nam, Hyun Cheul; Kwon, Tae Gyun; Chung, Sung Kwang

Abstract

PURPOSE: The diagnosis of renal scarring is very important for the pediatric patient because it has been associated with the later development of hypertension, renal failure, and end-stage kidney disease. Recent studies indicate that the sensitivity and specificity of the99mTc-DMSA single photon emission computerized tomography (SPECT) is better than IVP, USG, and 99mTC-DMSA Planar ThG Purpose Of this Study iS tO Compare 2 types Of 9%nTh DMSA renal scan(planar and SPECT) and IVP/USG in the diagnosis of renal scars. MATERIALS AND METHOD: We reviewed retrospectively the data of 49 children(72 renal units) with vesicoureteral reflux(VUR) who underwent renal cortical imaging with IVP/USG from January 1987 to August 1996. Patient ages ranged from 3 months to 14 years with a mean age 3.7 years. There were 17 boys and 12 girls(44 venal units) with 99mTc-DMSA planar with IVP/USG, and 12 boys and 8 girls(28 renal units) with 99mTc-DMSA SPECT with IVP/USG.
RESULTS
The 99mTc-DMSA planar imaging identified 94.7% sensitivities while 99mTC-DMSA SPECT imaging identified 96.3% Sensitivities. And the IVP/USG identified 75.3% sensitivities.
CONCLUSIONS
Recently, the 99mTc-DMSA renal scan has replaced IVP/USG in detecting renal scarring. And we show that 99mTc-DMSA SPECT studies are superior to IVP/USG, 99mTc-DMSA planar studies in detecting renal scarring. We believe that the role of 99mTc-DMSA SPECT will become increasingly important in detecting renal scarring of VUR.