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Non-enhanced magnetic resonance imaging versus renal scintigraphy in acute pyelonephritis

Jun Aoyagi1, Takahiro Kanai1, Jun Odaka1

  • 1Department of Pediatrics, Jichi Medical University, Shimotsuke, Tochigi, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|February 24, 2018
PubMed

Insights

Non-enhanced MRI shows promise for diagnosing acute pyelonephritis (APN) in children. This imaging technique may replace technetium-99m DMSA renal scintigraphy for early APN detection within seven days of fever onset.

Area of Science:

  • Pediatric Nephrology
  • Diagnostic Imaging

Background:

  • Acute pyelonephritis (APN) diagnosis in children often relies on imaging.
  • Non-enhanced magnetic resonance imaging (MRI) utility for APN is not well-established.
  • Technetium-99m dimercaptosuccinic acid (99m Tc-DMSA) renal scintigraphy is a common diagnostic tool.

Purpose of the Study:

  • To compare the diagnostic accuracy of non-enhanced MRI with 99m Tc-DMSA renal scintigraphy for APN in children.
  • To evaluate the effectiveness of whole-body diffusion-weighted imaging (DWI) MRI.

Main Methods:

  • A cohort of pediatric patients with suspected APN (fever ≥38°C, positive urine culture) underwent both non-enhanced MRI with DWI and 99m Tc-DMSA scintigraphy.
  • Imaging was performed within 7 days of fever onset.
  • Sensitivity and specificity were calculated against 99m Tc-DMSA findings.

Main Results:

  • Non-enhanced MRI demonstrated 80% sensitivity and 100% specificity in detecting APN lesions.
  • These results were comparable to the established 99m Tc-DMSA scintigraphy.

Conclusions:

  • Non-enhanced MRI, particularly with DWI, is a potentially effective imaging modality for diagnosing APN in children.
  • It may serve as a viable alternative to 99m Tc-DMSA scintigraphy for early detection within seven days of symptom onset.
Keywords:
99mTc-dimercaptosuccinic acid renal scintigraphyacute pyelonephritischildrendiffusion-weighted imagingnon-enhanced magnetic resonance imaging

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