Yeungnam Univ J Med.  2007 Dec;24(2):179-185.

Power Doppler Sonography for the Upper Urinary Tract Infection in Children

• Choi JY
• Cho JH
• Park YH

Abstract

BACKGROUND: Urinary tract infection (UTI) is common in children. The available gold standard methods for diagnosis, Tc-99m dimercaptosuccinic acid (DMSA) scan and computed tomography (CT) are invasive and expensive. This study was performed to assess the role of power Doppler ultrasound (PDU) for diagnosis of acute pyelonephritis (APN).
MATERIALS AND METHODS
A prospective study was conducted in 25 children with aged 2 weeks to 5 years who were hospitalized with the first episode of febrile UTI suggesting acute pyelonephritis. All children were examined in the first 3-5 days of admission by PDU and Tc-99m DMSA scan. The comparison between PDU and DMSA scan was performed on the basis of patients.
RESULTS
The sensitivity and specificity of PDU for the detection of affected kidneys were 38.1% and 50.0%, and the positive predictive value and negative predictive value were 61.9% and 50.0%, respectively. Vesicoureteral refluxes (VUR) were identified in 11 patients (44.4%) and 18 kidneys (36%). The PDU and DMSA scan showed a matching perfusion defect in 23.8% and 50.0% respectively.
CONCLUSION
These data indicate the PDU has a relatively low sensitivity and specificity for differentiating APN from lower UTI but may be a complement tool to DMSA scan for the prediction of VUR in infants and children.

Keyword

Acute pyelonephritis; Dimercaptosuccinic acid scintigraphy; Power Doppler ultrasonography

MeSH Terms

Child*
Complement System Proteins
Diagnosis
Humans
Infant
Kidney
Perfusion
Prospective Studies
Pyelonephritis
Succimer
Technetium Tc 99m Dimercaptosuccinic Acid
Ultrasonography
Urinary Tract Infections*
Urinary Tract*
Vesico-Ureteral Reflux
Complement System Proteins
Succimer
Technetium Tc 99m Dimercaptosuccinic Acid