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Incidence of renal scarring on technetium-99 m dimercaptosuccinic acid renal scintigraphy after acute pyelonephritis, acute focal bacterial nephritis, and renal abscess

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Abstract

Objective

To evaluate the association between the incidence of renal scarring on technetium-99 m dimercaptosuccinic acid (DMSA) renal scintigraphy and the severity of renal parenchymal infections, such as acute pyelonephritis (APN), acute focal bacterial nephritis (AFBN), and renal abscess, based on computed tomography (CT) diagnosis.

Methods

Sixty-one children with renal parenchymal infections were included and classified into two groups: those with (renal scarring group) and without renal scarring (non-renal scarring group) on chronic-phase DMSA renal scintigraphy. The severity of renal parenchymal infection was classified into three grades using CT: APN, AFBN, and renal abscess as grades 1, 2, and 3, respectively. The severity of renal parenchymal infection, vesicoureteral reflux (VUR) grade, and intrarenal reflux occurrence during voiding cystourethrography (VCUG) were evaluated between the renal and non-renal scarring groups. Fisher’s exact test and Mann–Whitney U test were used for statistical analysis.

Results

Renal scars were detected in 28 (45.9%) of the 61 patients. We found that 2/9 (22.2%), 18/41 (43.9%), and 8/11 (72.7%) patients with APN (grade 1), AFBN (grade 2), and renal abscess (grade 3) had renal scarring, respectively. There was a significant difference in the grade of severity of renal parenchymal infection between the renal (median = 2 [interquartile range, 2–3]) and non-renal (median = 2 [interquartile range, 2–2]) scarring groups (p = 0.023). There was a significant difference in the grade of VUR between the renal (median = 3 [interquartile range, 0–4]) and non-renal (median = 0 [interquartile range, 0–2]) scarring groups (p = 0.004). No significant difference in intrarenal reflux occurrence was observed between the renal (present/absent: 3/25) and non-renal (present/absent: 0/29) scarring groups (p = 0.112).

Conclusion

Our results showed that pediatric patients with renal scarring on chronic-phase DMSA renal scintigraphy tended to have a more severe renal infection.

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Data Availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Editage [http://www.editage.com] for editing and reviewing this manuscript for the English language

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Authors and Affiliations

  1. Department of Radiology, Saitama Children’s Medical Center, 1-2 Shintoshin Chuo-Ku Saitama, Saitama, 330-8777, Japan

    Takahiro Hosokawa, Yutaka Tanami, Yumiko Sato & Eiji Oguma

  2. Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8471, Japan

    Mayuki Uchiyama

  3. Division of Radiological Technology, Saitama Children’s Medical Center, 1-2 Shintoshin Chuo-Ku Saitama, Saitama, 330-8777, Japan

    Yasuharu Wakabayashi

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  1. Takahiro Hosokawa
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Correspondence to Takahiro Hosokawa.

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Hosokawa, T., Uchiyama, M., Tanami, Y. et al. Incidence of renal scarring on technetium-99 m dimercaptosuccinic acid renal scintigraphy after acute pyelonephritis, acute focal bacterial nephritis, and renal abscess. Ann Nucl Med 37, 176–188 (2023). https://doi.org/10.1007/s12149-022-01814-9

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