technetium-tc-99m-sulfur-colloid and Urinary-Tract-Infections

This retrospective study documents the findings on nuclear cystography and renal sonography of 455 girls who had urologic imaging for a proved urinary tract infection (UTI). Nuclear cystograms were normal in 313 (69%) of 455 patients. Vesicoureteral reflux was seen in 142 patients (31%): six with grade I, 90 with grade II, 43 with grade III, and three with grade IV. Twelve percent of patients with vesicoureteral reflux had renal parenchymal scars. Increasing grades of reflux were associated with an increase in the severity and number of parenchymal scars. Normal renal sonograms were seen in 83% of patients. Abnormalities noted on sonograms included parenchymal scarring in 31 (7%) of the 455 patients, anomalies in 19 patients (4%), mild to moderate dilatation of the renal pelvis and or ureters in 45 patients (10%), and bladder wall thickening in 45 patients (10%).

Topics: Adolescent; Child; Child, Preschool; Cicatrix; Female; Humans; Infant; Kidney; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Sulfur Colloid; Ultrasonography; Ureterocele; Urinary Bladder; Urinary Tract Infections; Vesico-Ureteral Reflux

A simple technique of manometric scintigraphic retrograde cystography was applied prospectively to 125 patients (85 per cent children) with 142 studies. 99mTechnetium sulfur colloid (0.5 to 1 mCi.) was instilled in the bladder followed by increments of normal saline under manometric control. The sensitivity of the test was increased when the filling phase was concluded at 25 cm. water pressure rather than when the patient complained of fullness (usually at 15 cm.). The studies had a voiding phase that was essential for patients in whom pressures greater than 15 cm. could not be achieved. Reflux was not detected on the voiding phase alone in 5 patients and the voiding phase could not be performed in 5 of 34 positive studies. It was not possible to predict volumes of fluid instilled to achieve satisfactory pressures. Monitoring during the entire study was necessary to diagnose reflux, which may occur at low or high pressure, or while voiding only.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Manometry; Middle Aged; Prospective Studies; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Urinary Bladder; Urinary Tract Infections; Urogenital System