Retrospective evaluation of voiding cystourethrography and / or dimercaptosuccinic acid (DMSA) imaging in children with urinary tract infection

The urinary system infections in children may cause acute pyelonephritis by involving kidney parenchyma and can result in renal scarring in the following periods. For this purpose, patients referred to Zonguldak Bülent Ecevit University Medical Faculty Hospital Pediatric Emergency Service and Pediatric Outpatient Clinic with urinary tract infection or diagnosed in other clinics between January 2013 and January 2019 and voiding cystourethrography (VCUG) and/or dimercaptosuccinic acid (DMSA) imagings were performed evaluated. A total of 226 patients between the ages of 1 month and 18 years were included in the study retrospectively. We evaluated both DMSA and VCUG findings of the patients and found no significant difference between the age and gender groups. We evaluated complaint of the patients and found that complaint of fever has a significant meaning. In blood tests we found that CRP value is significantly higher in patients with pathological DMSA and VCUG findings. We compared the imaging methods in patients and we found no significance between ultrasound and vesiculourethral reflux but we found significance between USG and DMSA, and between DMSA and VUR. In addition, we observed that the probability of VUR was very low in patients who did not have renal scarring in DMSA. In our study, we concluded that both USG and DMSA tests can not be used instead of VCUG for detecting VUR due to their insufficient sensitivity and specificity in detecting VUR. But unnecessary VCUG should not be done in patients without pathology in USG and DMSA, and consequently, results such as radiation exposure, cost and family anxiety can be avoided.