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Yeungnam Univ J Med > Volume 24(2); 2007 > Article
Yeungnam University Journal of Medicine 2007;24(2):179-185.
DOI:    Published online December 31, 2007.
Power Doppler Sonography for the Upper Urinary Tract Infection in Children.
Jung Youn Choi, Jae Ho Cho, Yong Hoon Park
1Department of Pediatrics, College of Medicine, Yeungnam University, Daegu, Korea.
2Department of Diagnostic Radiology, College of Medicine, Yeungnam University, Daegu, Korea.
BACKGROUND: Urinary tract infection (UTI) 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). MATERIALS AND METHODS: A prospective study was conducted in 25 children with aged 2 weeks to 5 years who were hospitalized with the first episode of febrile UTI suggesting acute pyelonephritis. All children were examined in the first 3-5 days of admission by PDU and Tc-99m DMSA scan. The comparison between PDU and DMSA scan was performed on the basis of patients. RESULTS: The sensitivity and specificity of PDU for the detection of affected kidneys were 38.1% and 50.0%, and the positive predictive value and negative predictive value were 61.9% and 50.0%, respectively. Vesicoureteral refluxes (VUR) were identified in 11 patients (44.4%) and 18 kidneys (36%). The PDU and DMSA scan showed a matching perfusion defect in 23.8% and 50.0% respectively. CONCLUSION: These data indicate the PDU has a relatively low sensitivity and specificity for differentiating APN from lower UTI but may be a complement tool to DMSA scan for the prediction of VUR in infants and children.
Key Words: Acute pyelonephritis, Dimercaptosuccinic acid scintigraphy, Power Doppler ultrasonography


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