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AAP Grand Rounds 2:44 (1999)
© 1999 American Academy of Pediatrics

PEDIATRIC UROLOGY

Evaluation of Kidneys in Children with Vesicoureteral Reflux: The Current Role of DMSA Renal Scans and Ultrasound

Source: Merguerian P, Jamal M, Agarwal S, et al. Utility of SPECT DMSA renal scanning in the evaluation of children with primary vesicoureteral reflux. Urology. 1999;53(5):1024–1028.

The first 20% of the full text of this article appears below.

In this retrospective study, 368 Toronto children were evaluated during a 24-month period for primary vesicoureteral reflux with ultrasound and SPECT DMSA renal scans. The data was analyzed to study the accuracy of modern, high-resolution renal ultrasound to detect significant renal scarring and to define when the greater accuracy of the DMSA scans was beneficial to patient care. These tests were done to detect renal scars in kidneys with primary reflux. Scarring, as viewed by DMSA, was categorized as severe if there were more than two focal scars, one large scar or whole kidney involvement(diffuse scarring) and/or if the differential renal function was less than 40%. Focal scarring was defined as one or two small focal scars. Patients were divided into three age groups according to the age at presentation: 128 patients (1 year of age, 185 patients 1–5 years of age, and 55 who were 6 years or older. The patients were studied by grade of reflux (International Grade . . . [Full Text of this Article]

Anthony Casale, MD, FAAP
Pediatric Urology, Riley Hospital, Indianapolis, IN