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Evaluation Of Differential Renal Function Of Children With Urinary Tract Infection Complicated By Hydronephrosis Using Renal Dynamic And Static Imaging Techniques.

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Evaluation Of Differential Renal Function Of Children With Urinary Tract Infection Complicated By Hydronephrosis Using Renal Dynamic And Static Imaging Techniques.

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Evaluation of differential renal function of children with urinary tract infection complicated by hydronephrosis

Xiemei Ruan¹, Ha Wu¹, Zhengguo Chen²

¹Department of Nuclear Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.

Revista Espanola De Medicina Nuclear E Imagen Molecular

|November 29, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Keywords:

Children Differential renal function Función renal diferencial Hidronefrosis Hydronephrosis IU Niños UTI

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Differential renal function (DRF) in children with urinary tract infection (UTI) and hydronephrosis differs significantly between Tc-99m DMSA and Tc-99m DTPA scans. Tc-99m DMSA may overestimate function in severe hydronephrosis, suggesting Tc-99m DTPA for accurate evaluation.

Area of Science:

Pediatric Nephrology
Nuclear Medicine Imaging
Diagnostic Radiology

Background:

Urinary tract infections (UTIs) in children can lead to hydronephrosis, impacting renal function assessment.
Differential renal function (DRF) is crucial for managing pediatric UTIs and hydronephrosis.
Tc-99m dimercaptosuccinic acid (DMSA) and Tc-99m diethylenetriaminepentaacetic acid (DTPA) are common scintigraphy agents for evaluating renal function.

Purpose of the Study:

To compare DRF results from Tc-99m DMSA and Tc-99m DTPA scintigraphy in children with UTI and hydronephrosis.
To evaluate the diagnostic performance of both imaging modalities.
To provide recommendations for selecting appropriate imaging strategies based on hydronephrosis severity.

Main Methods:

Retrospective analysis of 57 children with UTI and ipsilateral hydronephrosis.

Classification of hydronephrosis severity (mild, moderate, severe) based on ultrasound measurements.

Calculation of DRF using both Tc-99m DMSA and Tc-99m DTPA, and assessment of DRF deviation.

Statistical comparison of DRF values and correlation analysis with hydronephrosis parameters using Mann-Whitney U, Spearman, and ROC curve analyses.

Main Results:

Significant differences in median DRF were found between Tc-99m DMSA (50.84%) and Tc-99m DTPA (45%) in affected kidneys (p < 0.000).
DRF deviation correlated positively with renal pelvic dilation, calyceal dilation, and kidney volume ratio.
Renal pelvic dilation >13.5 mm or calyceal dilation >8.8 mm predicted DRF deviations >5% with high sensitivity.

Conclusions:

Tc-99m DMSA-derived DRF can be influenced by the degree of hydronephrosis in children with UTI.
Significant discrepancies exist in DRF assessment between Tc-99m DMSA and Tc-99m DTPA in this cohort.
Tc-99m DTPA is recommended for accurate functional evaluation when hydronephrosis is severe (renal pelvic dilation >13.5 mm or calyceal diameter >23.2 mm) to avoid overestimation of renal function by Tc-99m DMSA.