Abstract：
OBJECTIVE: Vesicoureteral reflux (VUR) is a common complication after urinary tract infection (UTI) and can lead to irreversible renal scar. Voiding cystourethrogram is the most reliable technology to detect VUR and its severity, but it is restricted in children\'s examinations for various shortcomings. This study aimed to evaluate and compare the efficiency of Tc-99m DMSA renal scintigraphy and conventional ultrasonography (USG) in predicting VUR with the gold standard of cystourethrogram results.
METHODS: This retrospective study consisted of 285 first febrile UTI children under the age of 24 months who completed inflammatory indicator examinations, USG, Tc-99m DMSA renal scintigraphy and underwent cystourethrography after controlling infection with prophylactic antibiotics. The efficiency of Tc-99m DMSA renal scintigraphy and USG in predicting VUR was calculated and compared.
RESULTS: Abnormal USG (40.23% vs. 21.72%, P = 0.001) and Tc-99m DMSA renal scintigraphy results (87.36% vs. 71.72%, P = 0.004) were more common in VUR children. The sensitivity of USG in predicting VUR was only 40.23%, whereas the sensitivity and negative predictive value of Tc-99m DMSA renal scintigraphy reached 87.63 and 83.58%, respectively. Tc-99m DMSA renal scintigraphy had a higher efficacy than USG in predicting high-grade reflux kidneys (73.87% vs. 33.33%; P < 0.001), but there was no significant difference in predicting low-grade reflux kidneys ( P = 0.703).
CONCLUSIONS: Tc-99m DMSA renal scintigraphy had a significant higher efficiency in predicting VUR (a common cause of renal scarring, detected on DMSA) in first febrile urinary tract infection children under the age of 24 months as compared with USG, especially in high-grade reflux.
METHODS: This retrospective study consisted of 285 first febrile UTI children under the age of 24 months who completed inflammatory indicator examinations, USG, Tc-99m DMSA renal scintigraphy and underwent cystourethrography after controlling infection with prophylactic antibiotics. The efficiency of Tc-99m DMSA renal scintigraphy and USG in predicting VUR was calculated and compared.
RESULTS: Abnormal USG (40.23% vs. 21.72%, P = 0.001) and Tc-99m DMSA renal scintigraphy results (87.36% vs. 71.72%, P = 0.004) were more common in VUR children. The sensitivity of USG in predicting VUR was only 40.23%, whereas the sensitivity and negative predictive value of Tc-99m DMSA renal scintigraphy reached 87.63 and 83.58%, respectively. Tc-99m DMSA renal scintigraphy had a higher efficacy than USG in predicting high-grade reflux kidneys (73.87% vs. 33.33%; P < 0.001), but there was no significant difference in predicting low-grade reflux kidneys ( P = 0.703).
CONCLUSIONS: Tc-99m DMSA renal scintigraphy had a significant higher efficiency in predicting VUR (a common cause of renal scarring, detected on DMSA) in first febrile urinary tract infection children under the age of 24 months as compared with USG, especially in high-grade reflux.
摘要：
目的：膀胱输尿管反流（VUR）是尿路感染（UTI）后常见的并发症，可导致不可逆的肾瘢痕。排尿膀胱尿道造影是检测VUR及其严重程度的最可靠技术，但它在儿童考试中受到各种缺点的限制。这项研究旨在评估和比较Tc-99mDMSA肾脏闪烁显像和常规超声检查（USG）在预测膀胱尿道造影结果的金标准中的VUR的效率。
方法：这项回顾性研究包括285名24个月以下的首次发热UTI儿童，他们完成了炎症指标检查，USG,Tc-99mDMSA肾脏闪烁显像术，并在用预防性抗生素控制感染后进行了膀胱尿道造影。计算并比较了Tc-99mDMSA肾脏闪烁显像和USG预测VUR的效率。
结果：USG异常（40.23%vs.21.72%,P=0.001）和Tc-99mDMSA肾脏闪烁显像结果（87.36％vs.71.72%,P=0.004）在VUR儿童中更常见。USG预测VUR的敏感性仅为40.23%,而Tc-99mDMSA肾闪烁显像的敏感性和阴性预测值分别达到87.63％和83.58％，分别。Tc-99mDMSA肾脏闪烁显像在预测高级别反流肾脏方面的功效高于USG（73.87％vs.33.33%；P<0.001），但在预测低度反流肾脏方面没有显著差异(P=0.703).
结论：Tc-99mDMSA肾脏闪烁显像在预测VUR（肾脏瘢痕形成的常见原因，在DMSA上检测到），与USG相比，在24个月以下的首次高热尿路感染儿童中，特别是在高等级的反流。
方法：这项回顾性研究包括285名24个月以下的首次发热UTI儿童，他们完成了炎症指标检查，USG,Tc-99mDMSA肾脏闪烁显像术，并在用预防性抗生素控制感染后进行了膀胱尿道造影。计算并比较了Tc-99mDMSA肾脏闪烁显像和USG预测VUR的效率。
结果：USG异常（40.23%vs.21.72%,P=0.001）和Tc-99mDMSA肾脏闪烁显像结果（87.36％vs.71.72%,P=0.004）在VUR儿童中更常见。USG预测VUR的敏感性仅为40.23%,而Tc-99mDMSA肾闪烁显像的敏感性和阴性预测值分别达到87.63％和83.58％，分别。Tc-99mDMSA肾脏闪烁显像在预测高级别反流肾脏方面的功效高于USG（73.87％vs.33.33%；P<0.001），但在预测低度反流肾脏方面没有显著差异(P=0.703).
结论：Tc-99mDMSA肾脏闪烁显像在预测VUR（肾脏瘢痕形成的常见原因，在DMSA上检测到），与USG相比，在24个月以下的首次高热尿路感染儿童中，特别是在高等级的反流。
