Role of Tc99m-Dimercaptosuccinic Acid (DMSA) in Diagnosis of Acute Urinary Tract Infection (UTI) in Sudanese Children Patients

Abstract

Pediatric nuclear medicine, in order to survive, must be innovative in finding ways of competing with other pediatric imaging studies for better health care. In this study a group of thirty-one patients with urinary tract infection confirmed by clinical investigation, (fever, pain...etc), laboratory investigation (RBC & pus cell) and urine culture, were evaluated by nuclear medicine study. The aim of the study was to compare the diagnostic value of cortical scintigraphy using Tc99m dimercaptosuccinic acid (Tc99m-DMSA), with two other routine investigations; the intravenous urographin (IVU), and ultrasonoghraphy (US), for diagnosis of renal parenchymal abnormality in children. The Tc99m-DMSA renal scan was utilized as the gold standard test for renal involvement. All patients had Tc99m-DMSA renal scan, and US, and only 22patients had contrast IVU. The Tc99m-DMSA renal scan showed abnormality renal scanning in about 94% of patients, US abnormalities were detected in about 81% of patient, while the IVU detected defects in about 87%. Because the prevalence of upper UTI in children is high, Tc99m-DMSA renal scan is undoubtedly the available tool for pediatricians as a guide in giving appropriate antibiotic therapy and to prevent further renal damage. The study concludes that, the renal cortical scintigraphy with Tc99m-DMSA has been reported to be a useful children diagnostic study of acute parenchymal renal infections, Moreover, is presently the method of choice to detect acute parenchymal infection.