대한핵의학회지 (1967년~2009년)
대한핵의학회지 2003;37(4)245~253
급성 요로감염 환아의 신장 반흔 예측요인
(Predictive Factors of Renal Scarring in Children with Acute Urinary Tract Infection)
Author 백준현, 박영하, 황성수, 전정수, 김성훈, 이성용, 정수교,
Jun Hyun Baik, M.D., Young Ha Park, M.D., Sung Su Hwang, M.D., Jung Su Jeon,M.D.,Sung Hoon Kim, M.D., Seong Yong Lee, M.D., Soo Kyo Chung, M.D.
Affiliation 가톨릭대학교 의과대학 방사선과학교실
Department of Radiology and Nuclear Medicine, The Catholic University of Korea, Seoul, Korea
Abstract

Puorpose:The purpose of this study was to evaluate the usefulness of 99mTc DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods:Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. 99mTc DMSA scintigraphy and voiding cystoureterography were performed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s:1;a large hypoactive upper or lower pole. 2;a small hypoactive area. 3;single defect resulting in localized deformity of the outlines. 4;deformed outlines in a small or normal sized kidney. 5;multiple defects. 6;diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results:One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion:In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.

Keyword urinary tract infection, Tc-99m DMSA, renal scarring, vesicoureteral reflux
Full text Article 3704245.pdf 3704245.pdf
(03121)서울시 종로구 지봉로 29 금호팔레스빌딩 1705호
TEL : 02-745-2040 FAX : 02-745-3833 E-mail : ksnm@ksnm.or.kr
Copyright 2012 by The Korean Society of Nuclear Medicine(KSNM)