Restricted accessResearch articleFirst published online 1993-2
Detection of Renal Injury in Patients with Vesicoureteral Reflux Using Dimercaptosuccinic-Acid (Dmsa) - Single Photon Emission Computed Tomography and Magnetic Resonance Imaging - Comparison with Dmsa-Planar Scintigraphy and Intravenous Pyelography
The value of “Technetium (Tc)-dimercaptosuccinic acid (DMSA) planar renal scintigraphy, DMSA single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) for the assessment of renal injury related to vesico-ureterai reflux (VUR) were examined in 60 kidneys of 32 patients (28 bilateral, 4 unilateral) with primary VUR. The results were as follows: 1. Spatial resolution was best in MRI, then DMSA-planar and DMSA-SPECT; 2. For detecting renal injury, DMSA-SPECT (85%) and MRI (83.3%) were better than intravenous pyelography (55%) and DMSA-planar scintigraphy (65%). In conclusion, DMSA-SPECT or MRI should be performed in addition to DMSA-planar and IVP, to detect renal injury due to VUR.
BaileyR.R.: The relationship of vesico-ureteric reflux to urinary tract infection and chronic pyelonephritis-reflux nephropathy. Clin. Nephrol., 1: 132, 1973.
2.
ArantB.S.Jr.: Vesicoureteric reflux and renal injury. Amer. J. Kid. Dis., 17: 491, 1991.
3.
International Reflux Study Committee:Medical versus surgical treatment of primary vesicoureteral reflux: A prospective international reflux study in children. J. Urol., 125: 277, 1981.
4.
SteinhardtG.F.: Reflux nephropathy. J. Urol., 134: 855, 1985.
5.
WeissR.Tamminen-MobiusT.KoskimiesO.OlbingH.SmellieJ.M.HircheH., and Lax-GrossH.: The International Reflux Study in Children: Characteristics at entry of children with severe primary vesicoureteral reflux recruited for a multicentre therapeutic trial compared medical and surgical management. J. Urol., 148: 1644, 1992.
MantelN.: Chi-square tests with one degree of freedom; extension of data from retrospective studies of disease. J. Natl. Canc. Inst., 22: 719, 1963.
8.
WalkerR.D.: Vesicoureteral reflux. In: Adult and pediatric urology. Edited by GillenwaterJ.Y.GrayhackJ.T.HowardsS.S.DuckettJ.W., Chicago-London-Boca Raton: Year book medical publisher Inc., p. 1676, 1987.
9.
BlawfoxM.D.: The current status of renal radiopharmaceuticals. A review. In: Radionuclides in nephrology edited by Bischof-DelaloyeA.BlaufoxM.D.Basel-Munchen-Paris-London-New York-Singapore-Tokyo-Sydney: Karger, p. 31, 1987.
10.
MerrickM.V.UttleyW.S.WildS.R.: The detection of pyelonephritic scarring in children by radioisotope imaging. Brit. J. Radiol., 53: 544, 1980.
11.
VerberI.G.StudleyM.R.MellerS.T.: 99mTc-di-mercaptosuccinic acid (DMSA) scan as first investigation of urinary tract infection. Arch. Dis. Child., 63: 1320, 1988.
12.
KoganB.A.KayR.WasnickR.J.CartyH.: 99mTc-DMSA scanning to diagnose pyelonephritic scarring in children. Urology, 21: 641, 1983.
13.
MorettiJ.L.RapinJ.R.Le PoncinM.LageronA.SaccaviniJ.C.BardyA.: Dimercapto-succinic acid complexes: Their structure, biological behavior and renal localization. In: Radionuclides in Nephrology edited by JokersM.D.London-Toronto-Sydney: Academic press, p. 25, 1982.
14.
MonsourM.AzmyA.F.MacKenzieA.Jr.: Renal scarring due to vesicoureteric reflux. Critical assessment and new grading. Brit. J. Urol., 60: 320, 1987.
15.
FarnsworthR.H.RossleighM.A.BassS.J.RosenbergA.R.: The detection of reflux nephropathy in infants by 99mtechnetium dimercaptosuccinic acid studies. J. Urol., 145: 542, 1991.
16.
KullendorfC.M.EvanderE.: Distribution of renal parenchymal damage on 99mTc-DMSA scintigraphy in vesico-ureteric reflux. Ann. Chir. Gynecol., 79: 153, 1990.
17.
ItohK.AsanoY.TsukamotoE.KatoC.NakadaK.NagaoK.FurudateM.GotohT.NonomuraK.KoyanagiT.RosenthallL.: Single photon emission computed tomography with Tc-99mdimercaptosuccinic acid in patients with upper urinary tract infection and/or vesicoureteric reflux. Ann. Nucl. Med., 5: 29, 1991.
18.
TsugayaM.HiraoN.WataseH.SakagamiH.OkamuraT.OhtaguroK.BannoT.MizutaniH.OhbaS.: Magnetic resonance imaging in the diagnosis of renal scarring. Jap. J. Mag. Res. Med., 8: 88, 1988.
19.
RaynaudC.Trans-DinhS.BourguignonM.SyrotaA.AujardY.BambergerJ.BroyerM.CendronJ.CourtecuisseV.DommerguesJ.P.LandrieuP.LanzaM.MathieuH.MelinY.MselatiJ.C.ValayerJ.: Acute pyelonephritis in children. Preliminary results obtained with NMR imaging. In: Radionuclides in nephrology edited by Bischof-DelaloyeA., and BlaufoxM.D., Basel-Munchen-Paris-London-New York-Singapore-Tokyo-Sydney: Karger, p. 129, 1987.
20.
MasayukiT.YasushiK.TakaashiH.SaitoK.ImaiT., and SatoS.: Study on urinary low molecular protein and enzyme of primary vesico-ureteral reflux patients. Jap. J. Urol., 81: 454, 1990.
