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Journal of the Korean Society of Pediatric Nephrology 2013;17(2): 110-116. doi: https://doi.org/10.3339/jkspn.2013.17.2.110
요로감염 소아에서 입원 초기 시행한 DMSA 신 스캔 결 과에 따른 임상양상의 차이에 대한 연구: DMSA 신 스 캔의 임상적 의미
김동욱, 이상민, 이정봉, 고영빈, 김수진
명지병원 소아청소년과
Differences in the Clinical Characteristics of Children with Urinary Tract Infections Based on the Results of 99mTc-Dimercaptosuccinic Acid Renal Scanning
Dong Ouk Kim, Sang Min Lee, Jeong Bong Lee, Young Bin Ko, Su Jin Kim
Department of Pediatrics, Myongji Hospital, Goyang, Korea
Corresponding Author: Su Jin Kim ,Tel: 031-810-5114, Fax: 031-969-0500, Email: sjkim0128@mjh.or.kr
Received: September 15, 2013;  Accepted: October 16, 2013.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons. org/licenses/bync/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Purpose: The 99mTc-Dimercaptosuccinic acid (DMSA) renal scan is used primarily for the diagnosis of renal scarring and acute pyelonephritis in children with urinary tract infections (UTI). This study aimed to evaluate clinical differences based on the positive or negative results of DMSA scans and kidney ultrasonography (US) in pediatric UTI.

Method :
We retrospectively reviewed 142 pediatric patients with UTI who were admitted to Myongji Hospital from January 2004 to December 2012. We performed a comparative analysis of clinical parameters such as age, sex, white blood cell (WBC) count, neutrophil count, blood urea nitrogen (BUN) level, creatinine (Cr) level, C-reactive protein (CRP) level, and durations of hospitalization and fever, grouped by the results of the DMSA scans and kidney US.

Results :
The mean age of the patients was 33.8±48.3 months, and 78 (55%) were male. Fifty-two patients had abnormal DMSA findings, and 71 patients had abormal kidney US findings (test positive groups). In the DMSA scan positive group, there were significant differences in age, WBC counts, neutrophil counts, CRP level, BUN level, Cr level, hospitalization duration, number of abnormal findings on kidney US, and incidence of vesicoureteral reflux (VUR) compared with the scan negative group. The kidney US positive group had significant differences in age, neutrophil count, CRP level, BUN level, Cr level, hospitalization duration, number of abnormal findings on the DMSA scans, and more frequent VUR compared with the US negative group.

Conclusion :
Our data suggest that there were no major differences in clinical parameters based on the results of the DMSA scans compared with kidney US in pediatric UTI. However, as kidney US and DMSA scan were performed to predict VUR, the sensitivity and negative predictive value was increased.
Key words: DMSA scan | Urinary tract infection | Kidney ultrasonography
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