Comparison of 99mTc- Ethylene Dicysteine and 99mTc-Dimercaptosuccinic Acid Scintigraphy for the Evaluation of Cortical Scarring and Differential Renal Function in Children with Recurrent Urinary Tract Infection

Abstract

ABSTRACT Introduction Urinary tract infection (UTI) is the most common and severe bacterial infection in children. Renal scarring and associated deterioration in the differential renal function is a frequent finding. Scarring may occur even in asymptomatic patients without vesicoureteric reflux. Materials and methods Fifty-three children (43 M:10 F, mean age:5.3 years; range 2-10 years) with evidence of recurrent UTI were enrolled in the study. Patients with duplex or crossed fused ectopic kidneys and with acute or chronic renal failure were excluded from the study protocol. Each patient underwent 99mTc-DMSA and 99mTc-EC renal scintigraphy within a period of 2 weeks. Results Analysis of results was performed by comparing the diagnostic accuracy of the summed 99mTc-EC and 99mTc-DMSA images for the detection of renal cortical scars and correlation (linear regression analysis) between the two renal scintigraphic procedures for the estimation of differential renal function. 99mTc-DMSA imaging demonstrated scarring in 41 kidneys whereas 99mTc-EC scintigraphy revealed scarring in 29/41 kidneys only. The percentage function of both kidneys with 99mTc-EC and 99mTc-DMSA showed good correlation. The r2 for left kidney was 0.95 and for right kidney was 0.94. Conclusion 99mTc-EC scintigraphy has low sensitivity (70%) for the detection of cortical scarring as compared to 99mTc-DMSA (100%) renal imaging. On the hand, 99mTc-DMSA static imaging gives good estimate for the DRF and the values are in good agreement with the corresponding values derived from dynamic 99mTc-EC scanning. How to cite this article Raja S, Pareek V, Singh B, Sharma S, Rao KLN, Mittal BR. Comparison of 99mTc-Ethylene Dicysteine and 99mTc-Dimercaptosuccinic Acid Scintigraphy for the Evaluation of Cortical Scarring and Differential Renal Function in Children with Recurrent Urinary Tract Infection. J Postgrad Med Edu Res 2012;46(4):183-186.