Potential utility of MRI in the evaluation of children at risk of renal scarring

Chan, Y. L.; Chan, K. C. Allen; Yeung, Chung‐Kwong; Roebuck, Derek J.; Chu, Winnie Chiu Wing; Lee, Kim-Hung; Metreweli, Constantine

doi:10.1007/s002470050713

Cited by 41 publications

(12 citation statements)

References 23 publications

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“…A utilização da ultra-sonografia com power Doppler mostrou-se inferior ao 99mTc DMSA para detecção de cicatrizes renais 42 , o mesmo ocorrendo com a ressonância magnética 43 . A urografia excretora mostrou-se inadequada para avaliação rotineira da infecção urinária na infância 44 .…”

Section: Como Programar a Investigação De Imagem Da Criança Após A Prunclassified

Urinary tract infection: a search for evidence

Koch¹,

Zuccolotto²

2003

J Pediatr (Rio J)

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ResumoObjetivo: no presente trabalho, visamos abordar o tema infecção do trato urinário à luz da evidência clínica atual.Fonte de dados: realizamos revisão bibliográfica no período de 1996 a 2002, utilizando os bancos de dados Medline e Cochrane, por meio das seguintes palavras-chave: infecção urinária, criança, adolescente, diagnóstico, tratamento e refluxo vesicoureteral. Foram selecionados estudos de coorte e de qualidade, consensos, metaanálises, ensaios randomizados controlados e auditorias.Síntese de dados: os artigos levantados foram selecionados com base em aspectos metodológicos, relevância e aplicabilidade clínica. Parte dos destaques dos artigos baseiam-se nos parâmetros propostos pela Academia Americana de Pediatria, em 1999, para o diagnós-tico e tratamento da infecção urinária febril da criança entre dois meses e dois anos de idade.Conclusão: grande parte das diretrizes para diagnóstico e tratamento da infecção urinária na infância ainda está baseada em opiniões consensuais e dogmáticas. Trabalhos multicêntricos, randomizados, controlados, duplo-cegos para intervenções são necessários para melhoria da qualidade do diagnóstico e da condução da infecção urinária na infância.J Pediatr (Rio J) 2003;79(Supl.1):S97-S106: infecção urinária, criança, adolescente, diagnóstico, tratamento, refluxo vesicoureteral. AbstractObjective: to review urinary tract infection in children taking into consideration evidence-based medicine.Sources of data: search of Medline and Cochrane databases, comprising the period between 1996 and 2002, with the following key words: urinary infection, vesicoureteral reflux, children, adolescents, diagnosis and treatment. Cohort studies, quality assurance studies, consensus, meta-analysis studies, randomized controlled trials and audits were selected.Summary of the findings: the studies were selected according to their methodology, relevance and clinical applicability. Some studies were selected based on the parameters proposed by the American Academy of Pediatrics in 1999 for the diagnosis and treatment of urinary tract infection in children between two months and two years of age.Conclusions: consensus statements on diagnosis and treatment of urinary infection in children and adolescents are still mostly opinion-based. Randomized multicentric controlled trials, with double-blind allocation are necessary to improve quality of diagnosis and management of pediatric urinary tract infection.J Pediatr (Rio J) 2003;79(Supl.1):S97-S106: urinary tract infection, child, adolescent, diagnosis, therapy, vesicoureteral reflux.

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Section: Como Programar a Investigação De Imagem Da Criança Após A Prunclassified

Urinary tract infection: a search for evidence

Koch¹,

Zuccolotto²

2003

J Pediatr (Rio J)

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“…One assessed the diagnostic accuracy of various MRI techniques and reported reasonable diagnostic performance. 132 This study was of reasonable quality. However, it was not conducted in an appropriate spectrum of patients, and neither the criteria used to select participants nor the time elapsing between index test and reference standard (disease progression bias) were reported.…”

Section: Other Imaging Studiesmentioning

confidence: 99%

Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: a systematic review and economic model

Whiting¹,

Westwood²,

Bojke³

et al. 2006

Health Technol Assess

131

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The results of the systematic review were used to derive an algorithm for the diagnosis of UTI in children under 5. This algorithm represents the conclusions of the review in terms of effective practice. There were insufficient data to propose an algorithm for the further investigation of UTI in children under 5. The quality assessment highlighted several areas that could be improved upon in future diagnostic accuracy studies.

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“…MRI may also diagnose other coexisting conditions, such as nephrolithiasis, 35,36 which is not diagnosed by DMSA scintigraphy. Newer imaging methods that show promise in diagnosis of renal scarring include dynamic contrast-enhanced MRI and MRI using a gadolinium-enhanced short-tau inversionrecovery (STIR) sequence.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 97%