Figure 730

Comparative sensitivity of four diagnostic imaging techniques for acute pyelonephritis. Renal cortical scintigraphy using 99mTc-dimethyl succinic acid (DMSA) or 99mTc-gluconoheptonate (GH) is very sensitive for diagnosing acute pyelonephritis. It entails very little irradiation as compared with conventional radiography using contrast medium. Some nephrologists consider 99mTc-DMSA cortical scintigraphy as the first-line diagnostic imaging method for renal infection in children. It is interesting to compare its sensitivity with that of more conventional imaging methods. (From Meyrier and Guibert [5]; with permission.)

FIGURE 7-31 (see Color Plate)

99mTc-DMSA cortical imaging of simple pyelonephritis in a female. The clinical signs implicated the right kidney. (Contrary to conventional radiology, the right kidney appears on the right of the image.) The false colors indicate cortical renal blood supply from red (normal) to blue (ischemia). The right kidney is obviously involved with pyelonephritis, especially its poles. However, contrary to the results of computed tomography, which indicated right-sided pyelonephritis only, a focus of infection also occupies the lower pole of the right kidney. This picture illustrates the greater sensitivity of renal scintigraphy for diagnosing renal infection. It also indicates that clinically unilateral acute pyelonephritis can, in fact, be bilateral.

0 0

Post a comment