4th International Conference on Urology
Samileh Noorbaksh
Professor
Center of Pediatric Infectious Diseases
Islamic Republic of Iran
Title: Dynamic magnetic resonance urography vs DMSA scan, IVP, Ultrasonography in children with urinary tract infection
Biography
Biography: Samileh Noorbaksh
Abstract
Background: Urinary tract infection 0 in children causes renal scarring and permanent
damage to the organ. In this study, we compared the diagnostic value of magnetic
resonance urogram for urinary tract anomalies with other conventional imaging
methods in children with UTI.
Methods: In this case-control study, 190 children (mean age 3.23±3.59 yrs) with UTI
were recruited from the Pediatric Ward of Rasul-e-Akram Hospital during 2007-2009.
The patients were divided into two groups based on the applied imaging technique:
MRU (cases) and conventional imaging groups (controls).
Results: Abnormal imaging detection rates for Ultrasonography were 32%, X-ray of
kidneys, ureters and bladder (KUB) 9%, Intravenous Pyelogram (IVP) 26%, Voiding
Cystoure therogram (VCUG) 54%, Dimercaptosuccinic Acid scan (DMSA) indicating
non-obstructive (reflux) uropathy in 76% (mean age 3.5 yrs) and MRU 43% (mean age
1.6 yrs), respectively. A meaningful correlation was observed between MRU and DMSA
scan with IVP results (Kappa=0.75). KUB and Ultrasonography had similar results in
cases with abnormal MRU and DMSA scan (P=0.121). MRU had strong agreement with
VCUG and IVP for the detection of obstructive uropathy and scar due to congenital
malformation even during intrauterine life but not with sonography results.
Conclusion: Sonography had poor results for the diagnosis of urinary tract anomalies in
comparison with MRU. Use of dynamic MRU for the diagnosis of congenital anomalies
(hydronephrosis, obstruction, pyelonephritis, renal scar) in children with UTI seems to
be of better help, although higher costs and the need for sedation during MRU still are
its disadvantages.