Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

09:42 - 09:45

S5-7

(PP)

ACUTE PYELONEPHRITIS IN CHILDREN: COMPARISON OF TWO METHODS -

STATIC RENAL SCINTIGRAPHY AND MAGNETIC RESONANCE IMAGING

Alice BOSAKOVA

, Jaroslav HAVELKA

, Dana., ŠALOUNOVÁ

, Otakar KRAFT

and Michal HLADÍK

1) University Hospital Ostrava, Department of Pediatric, Ostrava, CZECH REPUBLIC - 2) Radiodiagnostic Institute,

University Hospital Ostrava, Ostrava, CZECH REPUBLIC - 3) VŠB-Technical University of Ostrava,, Faculty of Economics,

Ostrava, CZECH REPUBLIC - 4) 3Department of Nuclear Medicine,, University Hospital Ostrava, Ostrava, CZECH

REPUBLIC - 5) Department of Paediatrics,, University Hospital Ostrava, Ostrava, CZECH REPUBLIC

INTRODUCTION STATING THE AIM OF THE STUDY

Static renal scintigraphy, using

99m

Tc DMSA radiopharmaceutical is regarded since decades as the gold standard for

detection of inflammatory changes in the renal parenchyma in acute pyelonephritis. Diffusion weighted magnetic

resonance imaging examination (DWI-MRI) shows high sensitivity in the localization of inflammatory processes and

changes in soft tissues. We tried to demonstrate these changes in children with acute pyelonephritis. The results of

DWI-MRI examination were subsequently compared with static renal scintigraphy-

99m

Tc DMSA.

PATIENTS AND METHODS

Twenty-three children aged 3-18 years (22 girls), with acute pyelonephritis were examined (diagnosis according Jodal´s

criteria). Both, static renal scintigraphy (using

99m

Tc DMSA) and magnetic resonance (DWI-MRI) were performed to

confirm inflammatory lesions in the kidneys of these patients. Both examinations were carried out in the first 5 days

after the diagnosis. DWI-MRI was performed without application of contrast medium and without general anaesthesia.

RESULTS

DWI-MRI examination confirmed the inflammatory infiltration in kidney parenchyma in all our patients (100 %). On the

other hand, the static renal scintigraphy with

99m

Tc DMSA.confirmed inflammation only in 15 children (60%). Six months

later, none of the two follow-up examinations showed any signs of inflammation or scarring in 17 children examined so

far.

CONCLUSIONS

In conclusion, nuclear magnetic resonance (DWI-MRI) imaging seems more sensitive, beneficial and accurate in the

diagnostics of acute pyelonephritis when compared with

99m

Tc DMSA. Moreover, DWI-MRI provides more accurate

information on the extent of kidney damage.