CT and 99mTc-DMSA Scintigraphy in Adult Acute Pyelonephritis: A Comparative Study

Sattari, Azadeh; Kampouridis, Stelianos; Damry, Nasroolla; Hainaux, Bernard; Ham, Hamphrey; Vandewalle, J.; Mols, Pierre

doi:10.1097/00004728-200007000-00016

Cited by 16 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The sensitivity ranged from 34.8% to 39.1% when the clinicobiologic information was known (p = 0.31). Uncomplicated urinary tract infection usually does not require radiologic evaluation unless it is recurrent [41] and often does not cause CT abnormalities unless complicated by obstruction, focal bacterial nephritis, or an abscess, especially when CT is performed without contrast administration. Approximately 30% of pyelonephritis cases were assessed with unenhanced CT, which could explain the low sensitivity of our data.…”

Section: Millet Et Almentioning

confidence: 99%

JOURNAL CLUB: Acute Abdominal Pain in Elderly Patients: Effect of Radiologist Awareness of Clinicobiologic Information on CT Accuracy

Millet

Alili

Bouic-Pages

et al. 2013

American Journal of Roentgenology

View full text Add to dashboard Cite

In the care of elderly patients, CT is accurate for diagnosing the cause of acute abdominal pain, particularly when it is of surgical origin, regardless of the availability of clinical and biologic findings. Thus CT interpretation should not be delayed until complete clinicobiologic data are available, and the images should be quickly transmitted to the emergency physician so that appropriate therapy can be begun.

show abstract

Section: Millet Et Almentioning

confidence: 99%

JOURNAL CLUB: Acute Abdominal Pain in Elderly Patients: Effect of Radiologist Awareness of Clinicobiologic Information on CT Accuracy

Millet

Alili

Bouic-Pages

et al. 2013

American Journal of Roentgenology

View full text Add to dashboard Cite

show abstract

“…Renal sonography was normal in 20/48 cases (41.6%), suggestive for APN in 23/48 cases (47.9%), showing unique or multiple hyperechogenic areas (14), kidney enlargement, [6] thickening of pelvic wall. [3] CT scan was normal in 9/28 cases (32.1%), suggestive for APN in 19/28 cases (67.8%), with evidence of unique or multiple areas of parenchymal hypo-attenuation (Fig.…”

Section: Renal Function Was Normal In All Patientsmentioning

confidence: 99%

“…More recent studies show that CT is more accurate than scintigraphy. [6] In order to evaluate the clinical approach to APN in our hospital, we conducted a retrospective analysis of patients affected with APN hospitalized in the years 1998-2000.…”

Section: Introductionmentioning

confidence: 99%

Acute Pyelonephritis: Analysis of 52 Cases

et al. 2002

View full text Add to dashboard Cite

Acute pyelonephritis (APN) is a frequent disease, but diagnostic approach, evolution into abscesses, and indication to hospitalization are still open problems. We have made a retrospective analysis of APN cases observed in our hospital. We identified 58 patients (pt) and selected 52 of these who presented fever and loin pain at the onset (31 were hospitalized in Nephrology and 21 in other units). Urine culture was positive in 11/48 cases (22.9%), blood cultures in 3/26 cases (11.5%) (Escherichia coli). Renal sonography was normal in 20/48 cases (41.6%) and suggestive for APN in 23/48 cases (47.9%). CT with contrast medium was normal in 9/28 cases (32.1%) and positive in 19/28 cases (67.8%), with evidence of unique or multiple hypodense areas; abscesses were found in 8 patients (28.5%). No statistically significant differences were found between patients with positive or negative CT as regards fever, leukocytosis, ESR, CRP, CRP at 20 days, urinary leukocytes, urine culture, duration of symptoms before hospitalization. Moreover no differences were found between patients with and without abscesses. CT was performed more frequently among patients hospitalized in Nephrology than among patients hospitalized in other services (24/31-77.4%-vs. 4/21-19%-, p = 0.05). NMR was abnormal in 6/9 cases. A radiographic documentation of APN was obtained in 61.53% of patients with clinical diagnosis of APN. Of these, only 18.7% had positive urine culture. In conclusion, our data suggest that demonstration of urine infection is not necessary for APN diagnosis, when clinical and/or radiologic diagnosis of APN has been made. Evolution into abscesses is frequent and not easily susceptible on clinical ground; for this reason we think it is advisable to perform CT or NMR systematically. Differences in clinical behavior between different units suggest the need for diagnostic guidelines.

show abstract

“…CT was recently shown to be more accurate than 99m Tc-DMSA in detecting APN lesions in adult patients7) and 99m Tc-DMSA scans were limited in identifying renal cortical lesions detected by CT in pediatric APN patients8). Moreover, new generation CTs showing excellent resolution compared with conventional CT, and improved quality of contrast media have made CT more practical.…”

Section: Introductionmentioning

confidence: 99%

Discordant findings on dimercaptosuccinic acid scintigraphy in children with multi-detector row computed tomography-proven acute pyelonephritis

et al. 2011

View full text Add to dashboard Cite

PurposeThe diagnosis of acute pyelonephritis (APN) is often difficult, as its clinical and biological manifestations are non-specific in children. If not treated quickly and adequately, however, APN may cause irreversible renal damage, possibly leading to hypertension and chronic renal failure. We were suspecting the diagnostic value of 99mTc-dimercaptosuccinic acid (DMSA) scan by experiences and so compared the results of DMSA scan to those of multi-detector row computed tomography (MDCT).MethodsWe retrospectively selected and analyzed 81 patients who were diagnosed as APN by MDCT during evaluation of their acute abdomen in emergency room and then received DMSA scan also for the diagnostic work-up of APN after admission. We evaluated the results of imaging studies and compared the diagnostic value of each method by age groups, <2 years (n=45) and ≥2 years (n=36).ResultsAmong total 81 patients with MDCT-proven APN. DMSA scan was diagnostic only in 55 children (68%), while the remaining 26 children (32%) showed false negative normal findings. These 26 patients were predominantly male with average age of 21 months and most of them, 19 (73.1%) were <2 years of age.ConclusionDMSA scan has obvious limitation compared to MDCT in depicting acute inflammatory lesions of kidney in children with APN, especially in early childhood less than 2 years of age. MDCT showed hidden lesions of APN, those were undetectable through DMSA scan in children.

show abstract

CT and 99mTc-DMSA Scintigraphy in Adult Acute Pyelonephritis: A Comparative Study

Cited by 16 publications

References 14 publications

JOURNAL CLUB: Acute Abdominal Pain in Elderly Patients: Effect of Radiologist Awareness of Clinicobiologic Information on CT Accuracy

JOURNAL CLUB: Acute Abdominal Pain in Elderly Patients: Effect of Radiologist Awareness of Clinicobiologic Information on CT Accuracy

Acute Pyelonephritis: Analysis of 52 Cases

Discordant findings on dimercaptosuccinic acid scintigraphy in children with multi-detector row computed tomography-proven acute pyelonephritis

Contact Info

Product

Resources

About