Renal Infection and Vesico-Ureteric Reflux

Rossleigh, Monica A.

doi:10.1053/j.semnuclmed.2007.02.006

Cited by 21 publications

(12 citation statements)

References 37 publications

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“…At present, however, there is no consensus on the investigation of children with normal initial DMSA scan. It has been demonstrated that none of the children with a normal initial DMSA study performed during APN had scarring on the follow-up scan [12,[26][27][28]. In our study in 7 children with clinical signs of APN, renal cortical scan was normal, excluding kidney involvement.…”

Section: Discussioncontrasting

confidence: 44%

“…Many pediatric nephrologists make a routine diagnosis of APN based on the clinical and laboratory data only, and DMSA renal scan is not widely used as an initial diagnostic test. Although according to the Procedure Guideline for renal cortical scintigraphy in children from more a decade ago [5] APN is the first indication for DMSA scintigraphy, some controversies still exist about the usefulness of acute renal cortical scan [12].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis

et al. 2010

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Initial DMSA renal scintigraphy is a sensitive method for the early diagnosis of APN in young children and is useful in the assessment of the severity of kidney injury even in patients with negative urine culture. Clinical, biological and ultrasound parameters do not identify children with renal damage. Normal DMSA study, excluding parenchymal involvement and late sequelae, could minimize the use of scintigraphy in the follow-up and reduce the redundancy of cystography.

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Section: Discussioncontrasting

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis

et al. 2010

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“…Although it was well established that VUR might predispose to acute pyelonephritis, there is an ongoing argument about the relationship between VUR and DMSA abnormality [7]. However, recent meta-analyses have not supported a relationship between VUR and renal damage in children with UTI.…”

Section: Discussionmentioning

confidence: 97%

“…In other words, it has not been clarifi ed as yet whether performing acute DMSA imaging can improve outcomes in patient management. The diagnosis of upper tract involvement with UTI can determine further management strategy and DMSA most reliably detects renal cortical involvement [1,7,9,[10][11][12]. For this reason, recently, acute DMSA scans have been undertaken to determine the aggressiveness of antibiotic therapy for UTI in some centers on the basis of the rationale that a child with an abnormal DMSA study may require more intensive antibiotic therapy [1,7].…”

Section: Discussionmentioning

confidence: 98%

Renal cortical involvement in children with first UTI: does it differ in the presence of primary VUR?

2008

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“…In humans, one method for assessing VUR is a voiding cystourethrogram (VCUG), in which a catheterized bladder is filled with radiopaque contrast under fluoroscopy (22). Alternatively, a nuclear cystogram entails filling the bladder with a radioactive isotope that is tracked to look for reflux (5,11).…”

mentioning

confidence: 99%

Assessing vesicoureteral reflux in live inbred mice via ultrasound with a microbubble contrast agent

Paredes¹,

Sims‐Lucas²,

Wang

et al. 2011

American Journal of Physiology-Renal Physiology

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Bates CM. Assessing vesicoureteral reflux in live inbred mice via ultrasound with a microbubble contrast agent. Am J Physiol Renal Physiol 300: F1262-F1265, 2011. First published February 16, 2011 doi:10.1152/ajprenal.00720.2010.-Vesicoureteral reflux (VUR) is a common pediatric anomaly linked to renal scarring and hypertension. Although there are many mouse VUR models, cystograms have previously only been performed in euthanized animals, thus preventing serial assessments for VUR in the same animal and not delineating "live" physiology. Our purpose was to develop a live murine cystogram assay that could be used serially to track reflux. We injected microbubbles via transurethral catheters into bladders of C57BL6/J and C3H/HeJ inbred mouse strains that are known to have low and high VUR rates, respectively. We performed ultrasound to visualize microbubbles in the renal pelvis to determine feasibility of the procedure. We then repeated the microbubble ultrasound using a transducer allowing for visualization of both kidneys and ureters simultaneously and for 3 dimensional (3D) reconstruction. We then performed "euthanized" cystograms on all mice for comparison. C3H/HeJ mice had a strong and persistent microbubble signal in the renal pelvis and ureters bilaterally with low-contrast infusion volumes (Ͻ100 l) and similarly showed bilateral reflux by euthanized cystograms. With larger infused volumes (Ն150 l), C57BL6/J mice had small volumes of microbubbles in the renal pelvis that cleared quickly and did not show reflux on euthanized cystograms. Thus, using animal models of known VUR, we demonstrate the utility of contrastenhanced ultrasound to visualize reflux in live mice.

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Renal Infection and Vesico-Ureteric Reflux

Cited by 21 publications

References 37 publications

Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis

Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis

Renal cortical involvement in children with first UTI: does it differ in the presence of primary VUR?

Assessing vesicoureteral reflux in live inbred mice via ultrasound with a microbubble contrast agent

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