Validity of 99m Tc-dimercaptosuccinic acid scan for detection of renal scarring

Yang, Sang Kook; Choi, Seung Kang

Abstract

The early radiological investigations of urinary tract infection are justified nowadays in order to identify those whose kidneys are already damaged, those who may be at risk of progressive damage, and those in whom a treatment program is indicated. 42 children who performed 99mTc-dimercaptosuccinic acid scan in the diagnostic step of recurrent urinary tract infection for recent 3 years at Severance Hospital were evaluated to access the validity of 99 m Tc-dimercaptosuccinic acid scan in detection of pyelonephritic scarring. The results were as follows: 1. Renal cortical defects were detected in 34 kidneys among 84 kidneys(40.5%) by DMSA scan, intravenous pyelography and ultrasonography 2. DMSA scan was significantly more valuable in detecing renal defect than intravenous pyelography (P<0.05). 3. The presence of reflux on voiding cystourethrography showed a significant correlation with renal cortical defects seen on DMSA scan (P<0.05). 4. The sensitivity of the DMSA scan in screening for all grades of reflux was estimated 0.9 and DMSA scan never missed renal defects in high grade (III-V/V) reflux. So we conclude that 99 m Tc-DMSA scan is more useful than other upper urinary tract imaging technique in detecting renal defects and consideration should be given to their use as first line of study for screening of renal defect in urinary tract infection and vesicoureteral reflux.