Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Power Doppler Sonography for the Upper Urinary Tract Infection in Children

소아 상부요로감염의 진단을 위한 출력 도풀러 초음파조영술

  • Choi, Jung-Youn (Department of Pediatrics, College of Medicine, Yeungnam University) ;
  • Cho, Jae-Ho (Department of Diagnostic Radiology, College of Medicine, Yeungnam University) ;
  • Park, Yong-Hoon (Department of Pediatrics, College of Medicine, Yeungnam University)
  • 최정연 (영남대학교 의과대학 소아청소년과학교실) ;
  • 조재호 (영남대학교 의과대학 영상의학과학교실) ;
  • 박용훈 (영남대학교 의과대학 소아청소년과학교실)
  • Published : 2007.12.30
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Abstract

Backgroud : Urinary tract infection (UTI) is common in children. The available gold standard methods for diagnosis, Tc-99m dimercaptosuccinic acid (DMSA) scan and computed tomography (CT) are invasive and expensive. This study was performed to assess the role of power Doppler ultrasound (PDU) for diagnosis of acute pyelonephritis (APN). Materials and Methods : A prospective study was conducted in 25 children with aged 2 weeks to 5 years who were hospitalized with the first episode of febrile UTI suggesting acute pyelonephritis. All children were examined in the first 3-5 days of admission by PDU and Tc-99m DMSA scan. The comparison between PDU and DMSA scan was performed on the basis of patients. Results : The sensitivity and specificity of PDU for the detection of affected kidneys were 38.1% and 50.0%, and the positive predictive value and negative predictive value were 61.9% and 50.0%, respectively. Vesicoureteral refluxes (VUR) were identified in 11 patients (44.4%) and 18 kidneys (36%). The PDU and DMSA scan showed a matching perfusion defect in 23.8% and 50.0% respectively. Conclusion : These data indicate the PDU has a relatively low sensitivity and specificity for differentiating APN from lower UTI but may be a complement tool to DMSA scan for the prediction of VUR in infants and children.

결론적으로 출력 도플러 신초음파는 급성신우신염의 병변을 찾는데에 특이도나 민감도가 그리 높지 않았으나 하부요로감염과 급성신우신염을 감별하는데에 어느 정도 유용하였으며, 특히 DMSA 스캔을 같이 실시하는 경우에는 신손상을 찾는데 더 도움이 될 수 있었다. 소아들의 상부요로감염의 진단을 위하여 출력 도플러 신초음파가 DMSA 스캔을 대체하는 영상검사로서는 한계가 있어 향후 보다 많은 시술로 진단을 위한 검사의 질을 높이는 방법을 찾아보아야 할 것이다.

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