Korean Journal of Nephrology 1988;7(2):388-394.

소아요로감염증의 4가지 방사선검사에 대한 비교 연구

강충선 , 김병길 , 서진석 , 최승강

Abstract

The Uniqueness of individual radiological studies lead to failure in the detection of an abnormality in one case and success in another, depending on the ages of the patients and the characteristics of anatomical and func- tional abnormalities. This is the reason why selection of the most appropri- ate study is difficult. Hence, the autors analysed the characteristics of the four rdaiological studies widely used in urinary tract infection. These four radiological studies, intravenous pyelo- gram (IVP), sonography, voiding cystourethrogram (VCUG), and dimercapto-succinic acid (DMSA) scan, were performed in 30 patients out of 162 patients diagnosed with urinary tract infection (UTI) in the Pediatric Department of Severance Hospital, Yonsei University, College of Medicine from March 1986 to April 1988. We evaluated the results of these radiological findings. Of the 30 UTI patients, abnormal findings were obser- ved in 18 cases (60%) by IVP, 14 cases (47%) by sonogra- phy, 6 cases (20%) by VCUG and 22 cases (73%) by DMSA scan. In view of the diagnosis of UTI, the test showing the highest detection rate was the DMSA scan. The reason why the detection rate of VCUG was rela- tively low is assumed to be that the patients with vesicoureteral reflux comprised only 6 cases of 30 sub- jects in the study. With respect to age gorup, 3 cases (36%) were detect- ed by IVP in the age group of less than 1 year, but 9 cases (75%) were detected in the age group of 6-15 years. IVP was more diagnostic for the older age group. Sonography and DMSA scan showed the same results, but VCUG did not show a significant difference with regard to age group. With regard to the charcteristics of anatomical and functional abnormalities, duplication was detected, in 3 cases by IVP and DMSA scan, and in 1 case by sonogra- phy. Caliceopelvic ectasia was detected, in 3 cases by IVP and in 2 case by DMSA scan. Renal scar was detected, in 3 cases by IVP and DMSA scan. There were no cases detected by other technique. Thus, IVP and DMSA scan were more diagnostic for duplication, caliceopelvic ectasia and renal scar. Eight cases of hydronephrosis and hydroureter were detected by sono- graphy, and 4 cases by IVP and DMSA scan. Therefore, hydronephrosis and hydroureter were most frequently diagnosed by sonography. All 6 cases of vesicoureteral reflux were detected by VCUG, which proved to be most diagnostic for vesicoureteral reflux. This paper will provided some assistance in choosing the most appropriate radiological study with regard to the characteristics of urinay tract infection, this in turn will save time and reduce cost.