以鎝-99m-DMSA腎臟造影追蹤急性腎盂腎炎之變化

Background: The aim of this study was to follow up a group of children with acute pyelonephritis using 99mTc-DMSArenal scintigraphy in order to determine the incidence of renal scarring. Methods: We retrospectively reviewed all children with first culture-documented urinary tract infections from Jan1996 to Feb 1997.All those children who had abnormal 99mTc-DMSA renal scan findings suggestive of acute pyelonephritis during acute infection and a follow-up renal scan at 6 months after treatment were included for analysis. Results: During acute infection,55 patients with 64 kidneys had abnormal 99mTc-DMSA renal scan findings suggestive of acute pyelonephritis. Follow up 99mTc-DMSA renal scans at 6 months after treatment revealed normalization of renal changes in 36 kidneys(56%),much improvement with minimal scarring in 17 kidneys(27%),and prominent renal scarring in 11 kidneys(17%).All renal scars occurred at the sites corresponding to the the acute pyelonephritis lesions seen on the initial 99mTc-DMSA renal scans. Conclusion: Acute pyelonephritis is one of the important causes of renal scarring. The changes of acute pyelonephritis recover completely or much improve in the majority of cases.99mTc-DMSA renal scan is useful in the early diagnosis and follow up of these patients.