Home > Riviste > The Quarterly Journal of Nuclear Medicine and Molecular Imaging > Fascicoli precedenti > The Quarterly Journal of Nuclear Medicine 1998 June;42(2) > The Quarterly Journal of Nuclear Medicine 1998 June;42(2):119-25

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi PROMO
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Estratti
Permessi

 

ORIGINAL ARTICLES  PEDIATRICS II 

The Quarterly Journal of Nuclear Medicine 1998 June;42(2):119-25

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Assessment of infective urinary tract disorders

Sixt R., Stokland E.

From the Departments of Pediatric Clinical Physiology and of Pediatric Radiology, Sahlgrenska University Hospital/Östra, Göteborg, Sweden


PDF


Urinary ­tract infec­tion (UTI) is com­mon in chil­dren, par­tic­u­lar­ly in the young­est age ­groups. There is a ­risk for pro­gres­sive dete­ri­ora­tion of ­renal func­tion in ­these chil­dren if aggra­vat­ing fac­tors ­such as ­gross ­reflux and/or out­flow obstruc­tion of the uri­nary ­tract are ­present. In ­this ­review the ­pros and ­cons of avail­able scin­ti­graph­ic and radio­log­i­cal imag­ing tech­niques for the ­work-up of ­these chil­dren are pre­sent­ed. Ultrasound can be ­used in the ­acute ­phase to ­exclude obstruc­tion but can not reli­ably ­show tran­sient or per­ma­nent paren­chy­mal ­lesions. The pres­ence of ­reflux can be estab­lished ­with X-ray or ­direct ­nuclide cys­tog­ra­phy. The X-ray tech­nique ­gives ­good mor­pho­log­i­cal infor­ma­tion and has a grad­ing ­system ­with prog­nos­tic rel­e­vance. Both tech­niques are inva­sive and ­great ­care ­must be tak­en to ­keep the radi­a­tion bur­den ­down ­with the X-ray tech­nique. Indirect ­nuclide cys­tog­ra­phy fol­low­ing a ren­o­graph­ic ­study is non-inva­sive but has a low­er sen­si­tiv­ity ­than ­direct tech­niques. More expe­ri­ence is need­ed ­with the indi­rect tech­nique to eval­u­ate the con­se­quenc­es of its appar­ent­ly low sen­si­tiv­ity. Urography has a limited ­place in the ­acute ­work-up of uri­nary ­tract infec­tion but can be ­used to ­look for ­renal scar­ring 1-2 ­years ­after an ­acute pye­lo­neph­ritis. The 99mTc dimer­cap­tos­uc­cin­ic ­acid (­DMSA) ­scan can be ­used dur­ing the ­acute UTI to ­show pye­lon­eph­rit­ic ­lesions ­with ­good accur­a­cy and/or dur­ing the fol­low-up ­after six ­months to ­show per­ma­nent ­lesions. The ­acute ­DMSA ­scan can be omit­ted. An ear­ly treat­ment is ­more impor­tant ­than an ear­ly ­scan!

inizio pagina