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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 3/2023

21-12-2022 | Vesicorenal Reflux | Original Article

Incidence of renal scarring on technetium-99 m dimercaptosuccinic acid renal scintigraphy after acute pyelonephritis, acute focal bacterial nephritis, and renal abscess

Authors: Takahiro Hosokawa, Mayuki Uchiyama, Yutaka Tanami, Yumiko Sato, Yasuharu Wakabayashi, Eiji Oguma

Published in: Annals of Nuclear Medicine | Issue 3/2023

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Abstract

Objective

To evaluate the association between the incidence of renal scarring on technetium-99 m dimercaptosuccinic acid (DMSA) renal scintigraphy and the severity of renal parenchymal infections, such as acute pyelonephritis (APN), acute focal bacterial nephritis (AFBN), and renal abscess, based on computed tomography (CT) diagnosis.

Methods

Sixty-one children with renal parenchymal infections were included and classified into two groups: those with (renal scarring group) and without renal scarring (non-renal scarring group) on chronic-phase DMSA renal scintigraphy. The severity of renal parenchymal infection was classified into three grades using CT: APN, AFBN, and renal abscess as grades 1, 2, and 3, respectively. The severity of renal parenchymal infection, vesicoureteral reflux (VUR) grade, and intrarenal reflux occurrence during voiding cystourethrography (VCUG) were evaluated between the renal and non-renal scarring groups. Fisher’s exact test and Mann–Whitney U test were used for statistical analysis.

Results

Renal scars were detected in 28 (45.9%) of the 61 patients. We found that 2/9 (22.2%), 18/41 (43.9%), and 8/11 (72.7%) patients with APN (grade 1), AFBN (grade 2), and renal abscess (grade 3) had renal scarring, respectively. There was a significant difference in the grade of severity of renal parenchymal infection between the renal (median = 2 [interquartile range, 2–3]) and non-renal (median = 2 [interquartile range, 2–2]) scarring groups (p = 0.023). There was a significant difference in the grade of VUR between the renal (median = 3 [interquartile range, 0–4]) and non-renal (median = 0 [interquartile range, 0–2]) scarring groups (p = 0.004). No significant difference in intrarenal reflux occurrence was observed between the renal (present/absent: 3/25) and non-renal (present/absent: 0/29) scarring groups (p = 0.112).

Conclusion

Our results showed that pediatric patients with renal scarring on chronic-phase DMSA renal scintigraphy tended to have a more severe renal infection.
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Metadata
Title
Incidence of renal scarring on technetium-99 m dimercaptosuccinic acid renal scintigraphy after acute pyelonephritis, acute focal bacterial nephritis, and renal abscess
Authors
Takahiro Hosokawa
Mayuki Uchiyama
Yutaka Tanami
Yumiko Sato
Yasuharu Wakabayashi
Eiji Oguma
Publication date
21-12-2022
Publisher
Springer Nature Singapore
Published in
Annals of Nuclear Medicine / Issue 3/2023
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-022-01814-9

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