Journal of the Korean Pediatric Society 2002;45(1):72-78.
Published online January 15, 2002.
Diagnostic Value of 99mTc-DMSA Pinhole Imaging in Childhood Urinary Tract Infection with Renal Cortical Defect
Tae Won Lee1, Seung Jun Seong1, Byung Moon Ahn1, Ie Ryung Yoo2, Il Soo Kim1, Eun Ryoung Kim1, Sung Hoon Kim2, Yong-Whee Bahk3
1Departments of Pediatric, Sung-Ae General Hospital, Seoul, Korea
1Departments of Pediatric, Sung-Ae General Hospital, Seoul, Korea
2Department of Nuclear Medicine, Kangnam St. Mary`s Hospital, Catholic University M edical School, Seoul, Korea
3Departments of Nuclear Medicine, Sung-Ae General Hospital, Seoul, Korea
요로감염에서 99mTc-DMSA Pinhole 영상의 유용성
이태원1, 성승준1, 안병문1, 유이령2, 김일수1, 김은령1, 김성훈2, 박용휘3
1성애병원 소아과
1성애병원 소아과
2강남성모병원 핵의학과
3성애병원 핵의학과
Correspondence: 
Eun Ryoung Kim, Email: NICU@chollian.net
Abstract
Purpose
: The aim of this study was to assess the diagnostic value of the 99mTc-DMSA pinhole imaging by comparing the detection rate of cortical defects identified from planar and pinhole imaging.
Methods
: 99mTc-DMSA planar and pinhole imaging, voiding cystoureth-rogram(VCUG), renal ultrasonography were performed in 67 patients diagnosed with urinary tract infection at the Department of Pediatrics, Sung-Ae General Hospital, from September, 1999 to Feburary, 2001. The follow-up of 99mTc-DMSA pinhole imaging was performed on 25 patients.
Results
: Overall detection rate of 99mTc-DMSA planar imaging was 41.8%(28 patients/67 patients), but 99mTc-DMSA pinhole imaging showed cortical defects in 62.7%(42 patients/67 patients) and the patients with renal cortical defects in planar imaging showed all definite or more additional cortical defects in pinhole imaging. The detection rate of cortical defect by 99mTc- DMSA pinhole imaging in patients with vesicoureteral reflux(VUR) was 80%(24 kidneys/30 kidneys). Those without VUR, however, also presented high detection rate as 25.9%(27 kidneys/ 104 kidneys). Out of 25 patients, improvement of cortical defect was presented in 19, no change in 4, and aggravation in 2 from the follow-up studies by 99mTc-DMSA pinhole imaging.
Conclusion
: This study indicates that 99mTc-DMSA pinhole imaging is superior to planar imaging and, hence, that pinhole imaging is a useful initial diagnostic tool for children suspected of urinary tract infection, irrespective of VUR, and to identify patients who need more extensive radiological studies and early treatment.
Key Words: 99mTc-DMSA, Pinhole, Planar, Urinary tract infection


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