Skip to main content
SpringerLink
Log in

Power Doppler sonographic evaluation of acute childhood pyelonephritis

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Urinary tract infection is common in children. The available gold standard methods for diagnosis, Tc-99m dimercaptosuccinic acid (DMSA) scan and computed tomography (CT) are invasive and expensive. This study was performed to assess the role of power Doppler ultrasound (PDU) for diagnosis of acute pyelonephritis (APN) compared with Tc-99m DMSA scan. A prospective study was conducted in 34 children with the mean age of 2.8±2.7 years who were hospitalized with the first episode of febrile urinary tract infection. All children were examined in the first 3 days of admission by PDU and Tc-99m DMSA scan. Patients with congenital structural anomaly were excluded. Each kidney was divided into three zones. The comparison between PDU and DMSA scan was performed on the basis of patients and renal units. According to the patient’s number, sensitivity, specificity, positive and negative predictive values, and accuracy of PDU were 89%, 53%, 70%, 80%, and 74%, respectively, but based on the renal units, changed to 66%, 81%, 46%, 91%, and 79%, respectively. Although PDU has the potential for identifying APN in children, it is still soon to replace DMSA scan.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Elder JS (2004) Urologic disorders in infants and children. In: Behrman RE, Kliegman RM, Jenson HB (eds) Nelson textbook of pediatrics. 17th edn. Saunders, Philadelphia, pp 1783–1826

    Google Scholar 

  2. Hansson S, Jodal U (2004) Urinary tract infection In: Avner E D, Harmon WE, Niaudet P (eds) Pediatric nephrology. 5th edn. Lippincott Williams and Wilkins, Philadelphia, pp 1007–1025

    Google Scholar 

  3. Zorc JJ, Kiddoo DA, Shaw KN (2005) Diagnosis and management of pediatric urinary tract infection. Clin Microbiol Rev 18:417–422

    Article  Google Scholar 

  4. Dachr JN, Boillot B, Eurin D, Marguet C, Mitrofanoff P, Le Dosseur P (1993) Rational use of CT in acute pyelonephritis: findings and relationships with reflux. Pediatr Radiol 23:281–285

    Article  Google Scholar 

  5. Stokland E, Helstrom M, Jacobson B, Jodal U, Lundgren P, Sixt R(1996) Early 99mTc dimercaptosuccinic acid (DMSA) scintigraphy in symptomatic first-time urinary tract infection. Acta Pediatr 85:430–436

    Article  CAS  Google Scholar 

  6. Rushton HG, Majd M, Chandra R, Yim D (1988) Evaluation of 99m technetium-dimercaptosuccinic acid renal scans in experimental acute pyelonephritis in piglets. J Urol 140:1169–1174

    Article  CAS  Google Scholar 

  7. Mandell GA, Eggli DF, Gilday DL, Heyman S, Leonard JC, Miller JH, Nadel HR, Treves ST (1997) Procedure guideline for renal cortical scintigraphy in children. Society of Nuclear Medicine. J Nucl Med 38:1644–1646

    CAS  PubMed  Google Scholar 

  8. Piepsz A, Hahn K, Roca I, Ciofetta G, Toth G, Gordon I, Kolinska J, Gwidlet J (1990) A radiopharmaceuticals schedule for imaging in paediatrics. Pediatric Task Group European Association Nuclear Medicine. Eur J Nucl Med 17:127–129

    Article  CAS  Google Scholar 

  9. Piepsz A, Blaufox MD, Gordon I, Granerus G, Majd M, O’Reilly P, Rosenberg AR, Rossleigh MA, Sixt R (1999) Consensus on renal cortical scintigraphy in children with urinary tract infection. Scientific Committee of Radionuclides in Nephrourology. Semin Nucl Med 29:160–174

    Article  CAS  Google Scholar 

  10. Rushton HG (1997) The evaluation of acute pyelonephritis and renal scarring with 99mTc- DMSA renal scintigraphy: evolving concepts and future directions. Pediatr Nephrol 11:108–120

    Article  CAS  Google Scholar 

  11. Majd M, Nussbaum Blask AR, Markle BM, Shalaby-Rana E, Pohl HG, Park JS, Chandra R, Rais-Bahrami K, Pandya N, Patel KM, Rushton HG (2001) Acute pyelonephritis: comparison of diagnosis with 99mTc- DMSA, SPECT, spiral CT, MR imaging and power Doppler US in an experimental pig model. Radiology 218:101–108

    Article  CAS  Google Scholar 

  12. Craig JC, Wheeler DM, Irwig L, Howman-Giles RB (2000) How accurate is dimercaptosuccinic acid scintigraphy for the diagnosis of acute pyelonephritis? A meta-analysis of experimental studies. J Nucl Med 41:986–993

    CAS  PubMed  Google Scholar 

  13. Clautice-Engle T, Jeffrey RB (1997) Renal hypoperfusion: Value of power Doppler imaging. AJR Am J Roentgenol 168:1227–1231

    Article  CAS  Google Scholar 

  14. Majd M, Rushton HG (1992) Renal cortical scintigraphy in the diagnosis of acute pyelonephritis. Semin Nucl Med 22:98–111

    Article  CAS  Google Scholar 

  15. Roberts JA (1991) Etiology and pathophysiology of pyelonephritis. Am J Kidney Dis 17:1–9

    Article  CAS  Google Scholar 

  16. Majd M, Rushton HG, Chandra R, Andrich MP, Tardif CP, Rashti F (1996) Technetium-99m-cortical scintigraphy to detect experimental acute pyelonephritis in piglets: comparison of planar (pinhole) and SPECT imaging. J Nucl Med 37:1731–1734

    CAS  PubMed  Google Scholar 

  17. Bykov S, Chervinsky L, Smolkin V, Halevi R, Garty I (2003) Power Doppler sonography versus Tc-99m DMSA scintigraphy for diagnosing acute pyelonephritis in children: are these two methods comparable?. Clin Nucl Med 28:198–203

    PubMed  Google Scholar 

  18. Halevy R, Smoklin V, Bykov S, Chervinsky L, Sakran W, Koren A (2004) Power Doppler ultrasonography in the diagnosis of acute childhood pyelonephritis. Pediatr Nephrol 19:987–991

    Article  Google Scholar 

  19. Winters WD (1996) Power Doppler sonographic evaluation of acute pyelonephritis in children. J Ultrasound Med 15:91–96

    Article  CAS  Google Scholar 

  20. Sakarya ME, Arslan H, Erkoc R, Bozkurt M, Atilla MK (1998) The role of power Doppler ultrasonography in the diagnosis of acute pyelonephritis. Br J Urol 81:360–363

    Article  CAS  Google Scholar 

  21. Dacher JN, Pfister C, Monroc M, Eurin D, Le Dosseur P (1996) Power Doppler sonographic pattern of acute pyelonephritis in children: comparison with CT. AJR Am J Roentgenol 166:1451–1455

    Article  CAS  Google Scholar 

  22. Berro Y, Baratte B, Seryer D, Boulo G, Slama M, Boudailliez B, Fonroget J, Grumbach Y (2000) Comparison between scintigraphy, B-mode and power Doppler sonography in acute pyelonephritis in children. J Radiol 81:523–527

    CAS  PubMed  Google Scholar 

  23. Morin D, Veyrac C, Kotzki PO, Lopez C, Dalla Vale F, Durand MF, Astruc J, Dumas R (1999) Comparison of ultrasound and dimercaptosuccinic acid scintigraphy changes in acute pyelonephritis. Pediatr Nephrol 13:219–222

    Article  CAS  Google Scholar 

Download references

Acknowledgement

We wish to thank Professor Gholam Hossein Amirhakimi for his excellent advice.

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

    Mitra Basiratnia

  2. Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran

    Amir Hossein Noohi

  3. Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran

    Mehrzad Lotfi

  4. Department of Nuclear Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Mehr Sadat Alavi

Authors
  1. Mitra Basiratnia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amir Hossein Noohi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mehrzad Lotfi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mehr Sadat Alavi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mitra Basiratnia.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Basiratnia, M., Noohi, A.H., Lotfi, M. et al. Power Doppler sonographic evaluation of acute childhood pyelonephritis. Pediatr Nephrol 21, 1854–1857 (2006). https://doi.org/10.1007/s00467-006-0262-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-006-0262-8

Keywords

Search

Navigation