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Urinary tract infection: a comparison of four methods of investigation

J M Smellie1, S P Rigden, N P Prescod

  • 1Department of Paediatrics, University College Hospital, London.

Archives of Disease in Childhood
|March 1, 1995
PubMed

Insights

Ultrasonography is unreliable for diagnosing urinary tract infections (UTI) in children. It often misses key indicators like vesicoureteric reflux and renal scarring, making it inadequate as a standalone diagnostic tool.

Area of Science:

  • Pediatric Nephrology
  • Diagnostic Imaging
  • Urology

Background:

  • Investigating pediatric urinary tract infections (UTI) requires optimal diagnostic strategies.
  • Current imaging modalities for pediatric UTI assessment lack definitive comparative analysis.

Purpose of the Study:

  • To compare the diagnostic efficacy of ultrasonography (US), contrast micturating cystourethrography (MCU), intravenous urography (IVU), and technetium-99m dimercaptosuccinic acid (DMSA) in children with UTI.
  • To determine the reliability of ultrasonography in detecting vesicoureteric reflux (VUR) and renal scarring in pediatric UTI cases.

Main Methods:

  • A comparative study involving 58 children under 14 years with UTI.
  • Utilized ultrasonography, MCU, IVU, and DMSA studies for investigation.
  • Compared results across all four imaging modalities.

Main Results:

  • Ultrasonography showed significant disparities compared to MCU, IVU, and DMSA.
  • Ultrasonography failed to detect VUR in 36 children diagnosed by MCU.
  • Radiological renal scarring was missed or inaccurately reported by ultrasonography in multiple cases.
  • Duplex kidneys identified by IVU were not recognized by ultrasonography or DMSA.

Conclusions:

  • Ultrasonography alone is inadequate for the comprehensive investigation of pediatric UTI.
  • Ultrasonography demonstrates unreliability in detecting VUR, renal scarring, and inflammatory changes.
  • Integrated use of multiple imaging modalities is crucial for accurate pediatric UTI diagnosis.

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