The Role of Quantitative DMSA Scan Analysis in Assessing Prognosis of Acute Pyelonephritis in Children.

OBJECTIVE

We assessed the quantitative pattern of Dimercaptosuccinic acid scan (DMSA) in children with acute pyelonephritis.

METHODS

In a retrospective study, we reviewed DMSA of children with APN based on 7 qualitative and quantitative items.

RESULTS

A total of 186 patients (age 27.8 ± 25.9 months, 157 (84%) female) enrolled in the study. The global defect was not found in 90% of children as well differential function ≥40% in 86% of patients. The other 5 items showed abnormal findings in 57% to 67% of children. Abnormality in the extent of defect, total points of involvement, number of involved segments, and differential renal function significantly predict late DMSA disturbances. There was no significant difference between patients with different grades of vesicoureteral reflux in any items on DMSA. We found no significant relationship between any items on DMSA and recurrent urinary tract infection (UTI).

CONCLUSION

Quantitative assessment of DMSA offers at least 4 items that reveal subtle cortical involvements with long-term significance.