99mTechnetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux

Hiep T. Nguyen, Stuart B. Bauer, Craig A. Peters, Leonard P. Connolly, Rita Gobet, Joseph G. Borer, Carol E. Barnewolt, Patti L Ephraim, S. Ted Treves, Alan B. Retik, H. Gil Rushton

Research output: Contribution to journalArticle

Abstract

Purpose: Although vesicoureteral reflux associated with bacteriuria may cause renal scarring, sterile reflux is thought not to cause renal injury. We determined the incidence and associated characteristics of renal abnormalities using 99mtechnetium(Tc) dimercapto-succinic acid (DMSA) renal scintigraphy in infants with high grade vesicoureteral reflux but no history of urinary tract infection. Materials and Methods: We retrospectively reviewed the results of 99mTc-DMSA renal scintigraphy and renal ultrasonography performed during the first 6 months of life in infants with vesicoureteral reflux detected during the postnatal evaluation of prenatal hydronephrosis or sibling reflux screening. Those with a history of urinary tract infection, or evidence of ureteropelvic junction or bladder outlet obstruction were excluded from study. Results: Of the 28 male and 6 female infants who met study criteria vesicoureteral reflux was bilateral in 25 and unilateral in 9. Reflux grade was IV or V, II or III and I in 38, 18 and 3 of the 59 refluxing renal units, respectively. 99mTc-DMSA renal scintigraphy revealed parenchymal abnormalities in 24 refluxing renal units (41%) in 22 patients (65%), of whom 19 (86%) were male and 15 (68%) had bilateral reflux. We noted differential uptake less than 40% with and without cortical defects in 10 and 7 refluxing units, respectively, and cortical defects only in 7. Of the 24 refluxing units with abnormalities 21 were associated with grade IV or V and 3 with grade II or III reflux. Ultrasound showed evidence of renal injury in only 7 of the 17 patients (41%) in whom 99mTc-DMSA scintigraphy was abnormal. Conclusions: In our study the majority of infants with high grade reflux had decreased differential function and/or cortical defects. Parenchymal defects detected by 99mTc-DMSA renal scintigraphy were often not identified by renal ultrasound. Therefore, 99mTc-DMSA renal scintigraphy is especially useful for initially evaluating infants with high grade, sterile vesicoureteral reflux.

Original languageEnglish (US)
Pages (from-to)1674-1679
Number of pages6
JournalJournal of Urology
Volume164
Issue number5
StatePublished - 2000
Externally publishedYes

Fingerprint

Vesico-Ureteral Reflux
Succinic Acid
Radionuclide Imaging
Kidney
Urinary Tract Infections
Urinary Bladder Neck Obstruction
Bacteriuria
Hydronephrosis
Wounds and Injuries
Cicatrix
Siblings
Ultrasonography

Keywords

  • Kidney
  • Radionuclide imaging
  • Technetium Tc 99m dimercaptosuccinic acid
  • Urinary tract infections
  • Vesico-ureteral reflux

ASJC Scopus subject areas

  • Urology

Cite this

Nguyen, H. T., Bauer, S. B., Peters, C. A., Connolly, L. P., Gobet, R., Borer, J. G., ... Rushton, H. G. (2000). 99mTechnetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux. Journal of Urology, 164(5), 1674-1679.

99mTechnetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux. / Nguyen, Hiep T.; Bauer, Stuart B.; Peters, Craig A.; Connolly, Leonard P.; Gobet, Rita; Borer, Joseph G.; Barnewolt, Carol E.; Ephraim, Patti L; Treves, S. Ted; Retik, Alan B.; Rushton, H. Gil.

In: Journal of Urology, Vol. 164, No. 5, 2000, p. 1674-1679.

Research output: Contribution to journalArticle

Nguyen, HT, Bauer, SB, Peters, CA, Connolly, LP, Gobet, R, Borer, JG, Barnewolt, CE, Ephraim, PL, Treves, ST, Retik, AB & Rushton, HG 2000, '99mTechnetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux', Journal of Urology, vol. 164, no. 5, pp. 1674-1679.
Nguyen, Hiep T. ; Bauer, Stuart B. ; Peters, Craig A. ; Connolly, Leonard P. ; Gobet, Rita ; Borer, Joseph G. ; Barnewolt, Carol E. ; Ephraim, Patti L ; Treves, S. Ted ; Retik, Alan B. ; Rushton, H. Gil. / 99mTechnetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux. In: Journal of Urology. 2000 ; Vol. 164, No. 5. pp. 1674-1679.
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title = "99mTechnetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux",
abstract = "Purpose: Although vesicoureteral reflux associated with bacteriuria may cause renal scarring, sterile reflux is thought not to cause renal injury. We determined the incidence and associated characteristics of renal abnormalities using 99mtechnetium(Tc) dimercapto-succinic acid (DMSA) renal scintigraphy in infants with high grade vesicoureteral reflux but no history of urinary tract infection. Materials and Methods: We retrospectively reviewed the results of 99mTc-DMSA renal scintigraphy and renal ultrasonography performed during the first 6 months of life in infants with vesicoureteral reflux detected during the postnatal evaluation of prenatal hydronephrosis or sibling reflux screening. Those with a history of urinary tract infection, or evidence of ureteropelvic junction or bladder outlet obstruction were excluded from study. Results: Of the 28 male and 6 female infants who met study criteria vesicoureteral reflux was bilateral in 25 and unilateral in 9. Reflux grade was IV or V, II or III and I in 38, 18 and 3 of the 59 refluxing renal units, respectively. 99mTc-DMSA renal scintigraphy revealed parenchymal abnormalities in 24 refluxing renal units (41{\%}) in 22 patients (65{\%}), of whom 19 (86{\%}) were male and 15 (68{\%}) had bilateral reflux. We noted differential uptake less than 40{\%} with and without cortical defects in 10 and 7 refluxing units, respectively, and cortical defects only in 7. Of the 24 refluxing units with abnormalities 21 were associated with grade IV or V and 3 with grade II or III reflux. Ultrasound showed evidence of renal injury in only 7 of the 17 patients (41{\%}) in whom 99mTc-DMSA scintigraphy was abnormal. Conclusions: In our study the majority of infants with high grade reflux had decreased differential function and/or cortical defects. Parenchymal defects detected by 99mTc-DMSA renal scintigraphy were often not identified by renal ultrasound. Therefore, 99mTc-DMSA renal scintigraphy is especially useful for initially evaluating infants with high grade, sterile vesicoureteral reflux.",
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author = "Nguyen, {Hiep T.} and Bauer, {Stuart B.} and Peters, {Craig A.} and Connolly, {Leonard P.} and Rita Gobet and Borer, {Joseph G.} and Barnewolt, {Carol E.} and Ephraim, {Patti L} and Treves, {S. Ted} and Retik, {Alan B.} and Rushton, {H. Gil}",
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T1 - 99mTechnetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux

AU - Nguyen, Hiep T.

AU - Bauer, Stuart B.

AU - Peters, Craig A.

AU - Connolly, Leonard P.

AU - Gobet, Rita

AU - Borer, Joseph G.

AU - Barnewolt, Carol E.

AU - Ephraim, Patti L

AU - Treves, S. Ted

AU - Retik, Alan B.

AU - Rushton, H. Gil

PY - 2000

Y1 - 2000

N2 - Purpose: Although vesicoureteral reflux associated with bacteriuria may cause renal scarring, sterile reflux is thought not to cause renal injury. We determined the incidence and associated characteristics of renal abnormalities using 99mtechnetium(Tc) dimercapto-succinic acid (DMSA) renal scintigraphy in infants with high grade vesicoureteral reflux but no history of urinary tract infection. Materials and Methods: We retrospectively reviewed the results of 99mTc-DMSA renal scintigraphy and renal ultrasonography performed during the first 6 months of life in infants with vesicoureteral reflux detected during the postnatal evaluation of prenatal hydronephrosis or sibling reflux screening. Those with a history of urinary tract infection, or evidence of ureteropelvic junction or bladder outlet obstruction were excluded from study. Results: Of the 28 male and 6 female infants who met study criteria vesicoureteral reflux was bilateral in 25 and unilateral in 9. Reflux grade was IV or V, II or III and I in 38, 18 and 3 of the 59 refluxing renal units, respectively. 99mTc-DMSA renal scintigraphy revealed parenchymal abnormalities in 24 refluxing renal units (41%) in 22 patients (65%), of whom 19 (86%) were male and 15 (68%) had bilateral reflux. We noted differential uptake less than 40% with and without cortical defects in 10 and 7 refluxing units, respectively, and cortical defects only in 7. Of the 24 refluxing units with abnormalities 21 were associated with grade IV or V and 3 with grade II or III reflux. Ultrasound showed evidence of renal injury in only 7 of the 17 patients (41%) in whom 99mTc-DMSA scintigraphy was abnormal. Conclusions: In our study the majority of infants with high grade reflux had decreased differential function and/or cortical defects. Parenchymal defects detected by 99mTc-DMSA renal scintigraphy were often not identified by renal ultrasound. Therefore, 99mTc-DMSA renal scintigraphy is especially useful for initially evaluating infants with high grade, sterile vesicoureteral reflux.

AB - Purpose: Although vesicoureteral reflux associated with bacteriuria may cause renal scarring, sterile reflux is thought not to cause renal injury. We determined the incidence and associated characteristics of renal abnormalities using 99mtechnetium(Tc) dimercapto-succinic acid (DMSA) renal scintigraphy in infants with high grade vesicoureteral reflux but no history of urinary tract infection. Materials and Methods: We retrospectively reviewed the results of 99mTc-DMSA renal scintigraphy and renal ultrasonography performed during the first 6 months of life in infants with vesicoureteral reflux detected during the postnatal evaluation of prenatal hydronephrosis or sibling reflux screening. Those with a history of urinary tract infection, or evidence of ureteropelvic junction or bladder outlet obstruction were excluded from study. Results: Of the 28 male and 6 female infants who met study criteria vesicoureteral reflux was bilateral in 25 and unilateral in 9. Reflux grade was IV or V, II or III and I in 38, 18 and 3 of the 59 refluxing renal units, respectively. 99mTc-DMSA renal scintigraphy revealed parenchymal abnormalities in 24 refluxing renal units (41%) in 22 patients (65%), of whom 19 (86%) were male and 15 (68%) had bilateral reflux. We noted differential uptake less than 40% with and without cortical defects in 10 and 7 refluxing units, respectively, and cortical defects only in 7. Of the 24 refluxing units with abnormalities 21 were associated with grade IV or V and 3 with grade II or III reflux. Ultrasound showed evidence of renal injury in only 7 of the 17 patients (41%) in whom 99mTc-DMSA scintigraphy was abnormal. Conclusions: In our study the majority of infants with high grade reflux had decreased differential function and/or cortical defects. Parenchymal defects detected by 99mTc-DMSA renal scintigraphy were often not identified by renal ultrasound. Therefore, 99mTc-DMSA renal scintigraphy is especially useful for initially evaluating infants with high grade, sterile vesicoureteral reflux.

KW - Kidney

KW - Radionuclide imaging

KW - Technetium Tc 99m dimercaptosuccinic acid

KW - Urinary tract infections

KW - Vesico-ureteral reflux

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VL - 164

SP - 1674

EP - 1679

JO - Journal of Urology

JF - Journal of Urology

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