ESPN 50th Annual Meeting

ESPN 2017


 
Diffusion weighted magnetic resonance imaging is more sensitive than DMSA scintigraphy in acute pyelonephritis in children: a prospective study
ALICE BOSAKOVA 1 DANA SALOUNOVA 2 JAROSLAV HAVELKA 3 OTAKAR KARFT 4 PAVEL SIRUCEK 4 HELENA STRMENOVA 1 RADIM KOCVARA 5 HLADIK MICHAL 1

1- PEDIATRIC CLINIC, UNIVERSITY HOSPITAL OSTRAVA
2- VSB-TECHNICAL UNIVERSITY OF OSTRAVA, FACULTY OF ECONOMICS
3- RADIODIAGNOSTIC INSTITUTE,UNIVERSITY HOSPITAL OSTRAVA
4- DEPARTMENT OF NUCLEAR MEDICINE, UNIVERSITY HOSPITAL OSTRAVA
5- DEPARTMENT OF UROLOGY, UNIVERSITY HOSPITAL PRAHA
 
Introduction:

To compare static renal scintigraphy (SRS) using 99mTc-dimercaptosuccinic acid (DMSA) with diffusion-weighted magnetic resonance imaging (DWI-MRI) to detect inflammatory changes in the renal parenchyma of patients with acute pyelonephritis.

 

Material and methods:

Thirthy one (30 girls) aged 3–18 years with acute pyelonephritis were included.. Both SRS (99mTc-DMSA) and DWI-MRI of the kidneys were performed within five days of diagnosis in all patients to confirm the presence of inflammatory lesions. The DWI-MRI examination was performed without contrast agent or general anesthesia.

Results:

DWI-MRI confirmed inflammatory infiltration of the kidney parenchyma in all patients (100%); the impairment was always unilateral. SRS confirmed inflammation in only 22 children (71%). Control examinations were performed in 31 patients after six months with both methods. Scarring was confirmed by DWI-MRI in five and SRS in five patients each.

Conclusions:

DWI-MRI imaging had higher sensitivity during the acute stage of acute pyelonephritis and identified inflammatory lesions in the renal parenchyma better than SRS. Moreover, DWI-MRI also provided more precise information about the extent of kidney damage.