engleski

Is there a need for spect in paediatric DMSA scintigraphy?

Objectives: 99mTc-DMSA scintigraphy (DMSA) is recognised as a gold standard for kidney analysis especially for detection of possible morphol¬ogy damage after urinary tract infection. There is no consensus on usefulness of single photon emission computed tomography (SPECT) in DMSA studies. The aim of this study was to compare 2 methods of DMSA scintigraphy analysis, currently used planar scintigrams and SPECT. Methods: In 20 children (36 renal units, 4 patients with only one kidney) sequentially referred to our department for DMSA scintigraphy, 3 hours after injection of radiotracer both planar images in four projections (anterior, posterior, both posterior oblique) and SPECT were done. Each planar scintigram was analysed using filtering method developed in our department which allows better recognition of the parenchymal damage. DMSA scans (planar and SPECT) were graded as normal, pathologic with cortical defects and suspected. Results are compared and statistically analyzed. Results: Pathological changes were detected in planar images analysed using our filtration method in 28 of 36 renal units (77%). Cortical defects were found in 12 out of 36 renal units and suspected damage in 16 out of 36. Eight out of 36 (22%) renal units had normal parenchyma. Pathological changes were detected on SPECT scintigraphy in 29 out of 36 (80%) renal units. Cortical defects were found in 9 out of 36 renal units and suspected damage in 20 out of 36. Seven out of 36 (20%) renal units had normal parenchyma. There was no statistically significant difference in two methods of DMSA scintigraphy (p=0.39). Conclusion: Our results confirm SPECT as equal but not superior method in DMSA scintigraphy in paediatric nuclear imaging. SPECT does not improve DMSA analysis and our results confirm its needlessness in children.

pediatric scintigraphy

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