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Updated: Dec 11, 2025

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
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99mTc-dimercaptosuccinic acid scan versus MRI in pyelonephritis: a meta-analysis

Ismet Sarikaya1, Ahmed N Albatineh2, Ali Sarikaya3

  • 1Department of Nuclear Medicine.

Nuclear Medicine Communications
|August 16, 2020
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) and Technetium-99m dimercaptosuccinic acid (DMSA) scans show equivalent effectiveness in detecting pyelonephritis parenchymal changes and scarring. Further research is needed to confirm MRI

Area of Science:

  • Radiology
  • Pediatric Nephrology
  • Diagnostic Imaging

Background:

  • Technetium-99m dimercaptosuccinic acid (DMSA) scan is the established standard for identifying pyelonephritis-related renal parenchymal changes, particularly scarring.
  • Magnetic resonance imaging (MRI) is emerging as a popular alternative diagnostic tool for pyelonephritis.
  • Direct comparative studies between MRI and DMSA scan for pyelonephritis diagnosis are limited.

Purpose of the Study:

  • To conduct a meta-analysis comparing the diagnostic performance of MRI versus DMSA scan in patients diagnosed with pyelonephritis.
  • To evaluate the sensitivity of both imaging modalities in detecting acute pyelonephritis and renal scarring.

Main Methods:

  • Systematic literature searches were conducted in PUBMED and EMBASE databases.
  • Studies directly comparing MRI and DMSA scan in pyelonephritis patients were included based on predefined criteria.
  • Random-effects meta-analysis was employed to calculate pooled sensitivities, with subgroup analyses and publication bias assessments performed.

Main Results:

  • Seven studies comprising 164 patients were analyzed.
  • Overall pooled sensitivities for MRI and DMSA scan were 0.62 (95% CI: 0.44-0.77) and 0.59 (95% CI: 0.48-0.70), respectively, indicating equivalent detection of parenchymal changes.
  • For acute pyelonephritis, sensitivities were 0.73 (MRI) vs. 0.66 (DMSA), and for scar detection, 0.48 (MRI) vs. 0.50 (DMSA), suggesting comparable performance.

Conclusions:

  • MRI and DMSA scan demonstrate equivalent overall sensitivity for detecting parenchymal changes and scarring in pyelonephritis.
  • While preliminary findings suggest MRI may be superior for acute pyelonephritis detection in a limited number of studies, larger trials are warranted.
  • Both imaging techniques are considered comparable for diagnosing pyelonephritis and its sequelae.

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