Abstract |
Patients with acute pyleonephritis may present with a
spectrum of clinical symptoms and signs. There are few
noninvasive diagnostic studies, however to confirm or
exclude this diagnosis. To evaluate the clinical
utility of 99mTc-DMSA renal scan in diagnosis of acute
pyelonephritis, we performed 99mTc-DMSA renal scan in
37 patients suspected with urinary truct infection.
Simultaneously kidney ultrasonography was done in 21
patients diagnosed with acute pyelonephritis,
clinically. And we performed the followup scan after
treatment in two to six weeks. The results were as
follows. 1) 99mTc-DMSA renal scan disclosed single of
multiple cortical defects and decreased radiouptake
ratio of affected kidney in 23 patients among 25
patients diagnosed with acute pyleonephritis. 2) In the
21 patients with acute pyelonephritis, kidney
ultrasonography showed abnormal findings in the 7
patients. And 99mTc-DMSA renal scan disclosed abnormal
cortical defects in this 7 patients also. 3) Between
the patients with acute pyelonephritis and those with
lower urinary tract infection, asymptomatic bacteriuria
or pyuria, right-to-left radiouptake ratios (R/L ratio
) were significantly different(p<0.001). 4) In two to
six weeks after antibiotic therapy, we performed
followup 99mTc-DMSA renal scan for 5 patients among 25
acute pyelonephritis patients. And we have found the
improvement of cortical defects and the right-to-left
radiouptake ratio. In conclusion, we thought that
99mTc-DMSA renal scan should be useful in diagnosis of
acute pyelonephritis and follow up examination. |