Can MRI replace DMSA in the detection of renal parenchymal defects in children with urinary tract infections?

Pediatr Radiol. 2005 Mar;35(3):275-81. doi: 10.1007/s00247-004-1335-0. Epub 2004 Oct 14.

Abstract

Background: Renal parenchymal defects may be a consequence of urinary tract infections (UTI) in childhood. MRI is a non-radiation imaging modality compared with DMSA scanning.

Objective: To compare DMSA with MRI for the detection of renal parenchymal defects in children presenting for radiological investigation after a first UTI.

Materials and methods: Both DMSA and MRI were performed at the same appointment in 37 children (aged 4 months-13 years; mean 4.5 years) with a history of UTI. Both planar and SPECT DMSA were performed. MRI of the kidneys employed axial and coronal T1-, T2- and fat-saturated T1-weighted (T1-W) sequences. Some children had imaging after IV contrast medium.

Results: The coronal fat-saturated T1-W sequence was the best sequence and it detected all the findings on MRI. MRI had a sensitivity of 77% and a specificity of 87% for the detection of a scarred kidney using DMSA as the gold standard. MRI diagnosed pyelonephritis in two children that had been interpreted as scarring on DMSA.

Conclusions: Renal MRI using a single, coronal, fat-saturated T1-W sequence is a rapid, accurate and minimally invasive technique for the detection of renal scarring that does not employ ionizing radiation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Magnetic Resonance Imaging*
  • Male
  • Pyelonephritis / diagnosis*
  • Pyelonephritis / diagnostic imaging
  • Pyelonephritis / etiology
  • Radiopharmaceuticals*
  • Sensitivity and Specificity
  • Technetium Tc 99m Dimercaptosuccinic Acid*
  • Tomography, Emission-Computed, Single-Photon*
  • Urinary Tract Infections / complications*

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Dimercaptosuccinic Acid