Advertisement

Pediatric Radiology

, Volume 37, Issue 8, pp 826–828 | Cite as

Uncomplicated duplex kidney and DMSA scintigraphy in children with urinary tract infection

  • Eira StoklandEmail author
  • Ulf Jodal
  • Rune Sixt
  • Svante Swerkersson
  • Sverker Hansson
Original Article

Abstract

Background

Renal duplication is the most common malformation of the urinary tract and is frequently seen among children with urinary tract infection (UTI).

Objective

To evaluate problems in the interpretation of dimercaptosuccinic acid (DMSA) scintigraphy and to establish the range of relative function in uncomplicated unilateral duplication.

Materials and methods

Retrospective analysis of 303 children less than 2 years of age with first time non-obstructive urinary tract infection investigated by both urography and DMSA scintigraphy. At DMSA scintigraphy, renal lesions and/or relative function below 45% was considered abnormal. Urography was used as reference for the diagnosis of duplication.

Results

Duplex kidneys were found in 22 of 303 patients (7%). Of the 16 children with unilateral duplication, 10 had bilaterally undamaged kidneys with a range of relative function varying between 51% and 57% in the duplex kidney. In two of the children with unilateral duplication the imaging results were discordant.

Conclusion

There was risk of underdiagnosis as well as overdiagnosis of renal damage at scintigraphy. Although it is important to be aware of this risk, the rate of misinterpretation was low. A range of 51% to 57% can be used as the limit for normality of the relative function of a unilateral duplex kidney.

Keywords

Kidney Duplication Urinary tract infection DMSA 

Notes

Acknowledgements

This work was supported by grants from Frimurare-Barnhusdirektionen and Health and Medical Care Executive Board of the Västra Götaland Region.

References

  1. 1.
    Nation EF (1944) Duplication of the kidney and ureter: a statistical study of 230 new cases. J Urol 51:456–459Google Scholar
  2. 2.
    Campbell MF (1970) Anomalies of the ureter. In: Campbell MF, Harrison JH (eds) Urology. Saunders, Philadelphia, pp 1487–1670Google Scholar
  3. 3.
    Bisset GS, Strife JL (1987) The duplex collecting system in girls with urinary tract infection: prevalence and significance. AJR 148:497–500PubMedGoogle Scholar
  4. 4.
    Siomou E, Papadopoulou F, Kollios KD et al (2006) Duplex collecting system diagnosed during the first 6 years of life after a first urinary tract infection: a study of 63 children. J Urol 175:678–681PubMedCrossRefGoogle Scholar
  5. 5.
    Wennerström M, Hansson S, Jodal U et al (2000) Primary and acquired renal scarring in boys and girls with urinary tract infection. J Pediatr 136:30–34PubMedCrossRefGoogle Scholar
  6. 6.
    Hansson S, Dhamey M, Sigström O et al (2004) Dimercapto-succinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infection. J Urol 172:1071–1073PubMedCrossRefGoogle Scholar
  7. 7.
    Piepsz A, Blaufox MD, Gordon I et al (1999) Consensus on renal cortical scintigraphy in children with urinary tract infection. Semin Nucl Med 29:160–174PubMedCrossRefGoogle Scholar
  8. 8.
    Lebowitz RL, Olbing H, Parkkulainen KV et al (1985) International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr Radiol 15:105–109PubMedCrossRefGoogle Scholar
  9. 9.
    Thimothy RP, Decter A, Perlmutter AD (1971) Ureteral duplication: clinical findings and therapy in 46 children. J Urol 105:445–451Google Scholar
  10. 10.
    Privett JT, Jeans WD, Roylance J (1976) The incidence and importance of renal duplication. Clin Radiol 4:521–530CrossRefGoogle Scholar
  11. 11.
    Piepsz A, Colarinha PI, Gordon I et al (2001) Guidelines for 99mTc-DMSA scintigraphy in children. Eur J Nucl Med 28:37–41Google Scholar
  12. 12.
    Davidovits M, Eisenstein B, Ziv N et al (2004) Unilateral duplicated system: comparative length and function of the kidneys. Clin Nucl Med 29:99–102PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Eira Stokland
    • 1
    • 2
    Email author
  • Ulf Jodal
    • 3
  • Rune Sixt
    • 4
  • Svante Swerkersson
    • 3
  • Sverker Hansson
    • 3
  1. 1.Department of Paediatric RadiologyThe Sahlgrenska Academy at Göteborg UniversityGöteborgSweden
  2. 2.Department of Paediatric RadiologyThe Queen Silvia Children’s HospitalGöteborgSweden
  3. 3.Department of PaediatricsThe Sahlgrenska Academy at Göteborg UniversityGöteborgSweden
  4. 4.Department of Paediatric Clinical PhysiologyThe Sahlgrenska Academy at Göteborg UniversityGöteborgSweden

Personalised recommendations