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  • Title: Vesicoureteral reflux: an accurate predictor of acute pyelonephritis in childhood urinary tract infection?
    Author: Ditchfield MR, De Campo JF, Cook DJ, Nolan TM, Powell HR, Sloane R, Grimwood K, Cahill S.
    Journal: Radiology; 1994 Feb; 190(2):413-5. PubMed ID: 8284391.
    Abstract:
    PURPOSE: To determine the association between vesicoureteral reflux (VUR) and the presence of acute pyelonephritis in children with urinary tract infections. MATERIALS AND METHODS: The authors studied 150 consecutive patients less than 5 years of age with their first proved urinary tract infection. All patients underwent renal cortical scintigraphy (with technetium-99m dimercaptosuccinic acid or Tc-99m gluconate) and voiding cystourethrography (VCUG) to identify the presence of cortical defects and VUR, respectively. RESULTS: Of 300 kidneys, 88 (29.3%) had a cortical defect at scintigraphy. Fifty-four of the 88 patients (61%) did not have VUR demonstrated at VCUG. Conversely, 72 of the 300 kidneys (24%) had VUR; of these, 38 (53%) had no cortical defect. The sensitivity of VCUG in helping predict a defect was 38.6%, and the specificity was 82.1%. CONCLUSION: VUR (as shown by VCUG) and renal cortical scintigraphic defects frequently occur independently of each other. Renal cortical scintigraphy may be a more accurate predictor of patients at risk for scarring.
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