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Renal Scar and Pyelonephritis
Christopher R. McAdams, MD; Paige Bennett, MD
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KEY FACTS

  • Imaging

    • Clinical Issues

      IMAGING

      • General Features

        • Nuclear Medicine Findings

          • Imaging Recommendations

            • Artifacts and Quality Control

              DIFFERENTIAL DIAGNOSIS

                PATHOLOGY

                • General Features

                  CLINICAL ISSUES

                  • Presentation

                    • Demographics

                      • Natural History & Prognosis

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            • Image Interpretation Pearls

                              Selected References

                              1. American College of Radiology. ACR-SPR Practice Parameter for the Performance of Renal Scintigraphy. 2014
                              2. Agras K et al: Resolution of cortical lesions on serial renal scans in children with acute pyelonephritis. Pediatr Radiol. 37(2):153-8, 2007
                              3. Basiratnia M et al: Power Doppler sonographic evaluation of acute childhood pyelonephritis. Pediatr Nephrol. 21(12):1854-7, 2006
                              4. Temiz Y et al: The efficacy of Tc99m dimercaptosuccinic acid (Tc-DMSA) scintigraphy and ultrasonography in detecting renal scars in children with primary vesicoureteral reflux (VUR). Int Urol Nephrol. 38(1):149-52, 2006
                              5. Ataei N et al: Evaluation of acute pyelonephritis with DMSA scans in children presenting after the age of 5 years. Pediatr Nephrol. 20(10):1439-44, 2005
                              6. Kavanagh EC et al: Can MRI replace DMSA in the detection of renal parenchymal defects in children with urinary tract infections? Pediatr Radiol. 35(3):275-81, 2005
                              7. Taskinen S et al: Post-pyelonephritic renal scars are not associated with vesicoureteral reflux in children. J Urol. 173(4):1345-8, 2005
                              8. Ataei N et al: Screening for vesicoureteral reflux and renal scars in siblings of children with known reflux. Pediatr Nephrol. 19(10):1127-31, 2004
                              9. Lin KY et al: Acute pyelonephritis and sequelae of renal scar in pediatric first febrile urinary tract infection. Pediatr Nephrol. 18(4):362-5, 2003
                              10. Mandell et al. Society of Nuclear Medicine Procedure Guideline for Renal Cortical Scintigraphy in Children version 3.0. 195-8, 2003
                              11. Szlyk GR et al: Incidence of new renal parenchymal inflammatory changes following breakthrough urinary tract infection in patients with vesicoureteral reflux treated with antibiotic prophylaxis: evaluation by 99MTechnetium dimercapto-succinic acid renal scan. J Urol. 170(2):1566-8; discussion 1568-9, 2003
                              12. Cascio S et al: Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. J Urol. 168(4 Pt 2):1708-10; discussion 1710, 2002
                              13. McLaren CJ et al: Vesico-ureteric reflux in the young infant with follow-up direct radionuclide cystograms: the medical and surgical outcome at 5 years old. BJU Int. 90(7):721-4, 2002
                              14. Schiepers C et al: Surgical correction of vesicoureteral reflux: 5-year follow-up with 99Tcm-DMSA scintigraphy. Nucl Med Commun. 22(2):217-24, 2001
                              15. Vega-P JM et al: High-pressure bladder: an underlying factor mediating renal damage in the absence of reflux? BJU Int. 87(6):581-4, 2001
                              16. Goldman M et al: The etiology of renal scars in infants with pyelonephritis and vesicoureteral reflux. Pediatr Nephrol. 14(5):385-8, 2000
                              17. Nguyen HT et al: 99m Technetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux. J Urol. 164(5):1674-8; discussion 1678-9, 2000
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Imaging

                                • Clinical Issues

                                  IMAGING

                                  • General Features

                                    • Nuclear Medicine Findings

                                      • Imaging Recommendations

                                        • Artifacts and Quality Control

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      DIAGNOSTIC CHECKLIST

                                                      • Consider

                                                        • Image Interpretation Pearls

                                                          Selected References

                                                          1. American College of Radiology. ACR-SPR Practice Parameter for the Performance of Renal Scintigraphy. 2014
                                                          2. Agras K et al: Resolution of cortical lesions on serial renal scans in children with acute pyelonephritis. Pediatr Radiol. 37(2):153-8, 2007
                                                          3. Basiratnia M et al: Power Doppler sonographic evaluation of acute childhood pyelonephritis. Pediatr Nephrol. 21(12):1854-7, 2006
                                                          4. Temiz Y et al: The efficacy of Tc99m dimercaptosuccinic acid (Tc-DMSA) scintigraphy and ultrasonography in detecting renal scars in children with primary vesicoureteral reflux (VUR). Int Urol Nephrol. 38(1):149-52, 2006
                                                          5. Ataei N et al: Evaluation of acute pyelonephritis with DMSA scans in children presenting after the age of 5 years. Pediatr Nephrol. 20(10):1439-44, 2005
                                                          6. Kavanagh EC et al: Can MRI replace DMSA in the detection of renal parenchymal defects in children with urinary tract infections? Pediatr Radiol. 35(3):275-81, 2005
                                                          7. Taskinen S et al: Post-pyelonephritic renal scars are not associated with vesicoureteral reflux in children. J Urol. 173(4):1345-8, 2005
                                                          8. Ataei N et al: Screening for vesicoureteral reflux and renal scars in siblings of children with known reflux. Pediatr Nephrol. 19(10):1127-31, 2004
                                                          9. Lin KY et al: Acute pyelonephritis and sequelae of renal scar in pediatric first febrile urinary tract infection. Pediatr Nephrol. 18(4):362-5, 2003
                                                          10. Mandell et al. Society of Nuclear Medicine Procedure Guideline for Renal Cortical Scintigraphy in Children version 3.0. 195-8, 2003
                                                          11. Szlyk GR et al: Incidence of new renal parenchymal inflammatory changes following breakthrough urinary tract infection in patients with vesicoureteral reflux treated with antibiotic prophylaxis: evaluation by 99MTechnetium dimercapto-succinic acid renal scan. J Urol. 170(2):1566-8; discussion 1568-9, 2003
                                                          12. Cascio S et al: Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. J Urol. 168(4 Pt 2):1708-10; discussion 1710, 2002
                                                          13. McLaren CJ et al: Vesico-ureteric reflux in the young infant with follow-up direct radionuclide cystograms: the medical and surgical outcome at 5 years old. BJU Int. 90(7):721-4, 2002
                                                          14. Schiepers C et al: Surgical correction of vesicoureteral reflux: 5-year follow-up with 99Tcm-DMSA scintigraphy. Nucl Med Commun. 22(2):217-24, 2001
                                                          15. Vega-P JM et al: High-pressure bladder: an underlying factor mediating renal damage in the absence of reflux? BJU Int. 87(6):581-4, 2001
                                                          16. Goldman M et al: The etiology of renal scars in infants with pyelonephritis and vesicoureteral reflux. Pediatr Nephrol. 14(5):385-8, 2000
                                                          17. Nguyen HT et al: 99m Technetium dimercapto-succinic acid renal scintigraphy abnormalities in infants with sterile high grade vesicoureteral reflux. J Urol. 164(5):1674-8; discussion 1678-9, 2000