Radionuclide studies in the evaluation of urinary tract infections
Related Experiment Video
Updated: Nov 3, 2026
Radiosynthesis, Quality Control, and Small Animal Positron Emission Tomography Imaging of 68Ga-Labelled Nano Molecules
Published on: October 4, 2024
Insights
Vesicoureteral reflux (VUR) and renal scarring are common in children with urinary tract infections (UTI). Dimercapto Succinic Acid (DMSA) scans are recommended for detecting scarring in UTI patients.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging in Urology
- Infectious Diseases in Children
Background:
- Urinary tract infections (UTI) are common in children.
- Vesicoureteral reflux (VUR) and renal scarring are significant complications of pediatric UTI.
- Early diagnosis and management are crucial to prevent long-term renal damage.
Purpose of the Study:
- To determine the prevalence of VUR and renal scarring in children diagnosed with UTI.
- To evaluate the effectiveness of different imaging modalities in detecting these conditions.
Main Methods:
- A descriptive study involving 32 children with culture-proven UTI.
- Abdominal ultrasonogram (USG), Technetium-99m Dimercapto Succinic Acid (DMSA) scan, and Direct Radionuclide Cystography (DRCG) were performed.
- Micturating cystourethrogram (MCU) was used to grade VUR and identify structural abnormalities.
Main Results:
- Renal scarring was detected in 42.2% of renal units (16 patients) via DMSA scan, more prevalent in older children (> 2 years).
- VUR was identified in 37.5% of children by DRCG.
- MCU showed lower sensitivity (65%) for VUR detection compared to DRCG but identified cystitis and bladder diverticulum.
Conclusions:
- DMSA scan is recommended as a first-line investigation for UTI patients to detect renal scarring.
- DRCG is valuable for screening VUR, especially in girls, and can be performed concurrently with other investigations.
Objective:
To estimate the prevalence of vesicoureteral reflux (VUR) and renal scarring in children presenting with culture proven urinary tract infections (UTI).
Design:
Descriptive study.
Setting:
Tertiary care hospital-based study.
Subjects:
Thirty-two children with proven UTI were evaluated by means of an abdominal ultrasonogram (USG), Technetium-99m Dimercapto Succinic Acid (DMSA) scan and Direct Radionuclide Cystography (DRCG). A micturating cystourethrogram (MCU) was performed to rule out any structural abnormality and to grade VUR.
Results:
A total of 64 renal units in 32 children were evaluated. DMSA scan showed scarring in 27 renal units (42.2%) in 16 patients. Bilateral renal scarring was more common in older (> 2 yr) children as compared to younger ones (89% Vs 43%; p < 0.05). USG detected abnormalities in 13 renal units (20.3%) in 7 cases. VUR was detected in 37.5% of children of all age group by DRCG. In contrast, MCU showed evidence of VUR in only 13/20 renal units with a sensitivity of 65% as compared to DRCG and did not pick up any additional VUR that could have been missed on the DRCG. Only 3/9 in < 2 yr, in contrast to 10/11 in > 2 yr were positive for VUR on MCU (p < 0.05). However, MCU detected evidence of cystitis in 3 children and a bladder diverticulum in one patient.
Conclusion:
Wherever available, DMSA scan should be considered as a part of the first line investigations in any patient presenting with UTI. DRCG can also be performed in the same sitting to screen for the presence of reflux particularly for girls.
Related Concept Videos
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:27Imaging Studies III: Computed Tomography
01:24Imaging Studies II: Ultrasonography
01:28Imaging Studies I: Kidney, Ureter, and Bladder Studies
01:27Imaging Studies IV: Magnetic Resonance Imaging