TC-99M DIMERCAPTOSUCCINIC ACID SCINTIGRAPHY IN THE DIAGNOSIS OF ACUTE PYELONEPHRITIS IN RATS

被引:38
作者
WIKSTAD, I [1 ]
HANNERZ, L [1 ]
KARLSSON, A [1 ]
EKLOF, AC [1 ]
OLLING, S [1 ]
APERIA, A [1 ]
机构
[1] ST GORANS CHILDRENS HOSP,DEPT PAEDIAT,S-11281 STOCKHOLM,SWEDEN
关键词
Escherichia coli; Experimental pyelonephritis; Renal inflammatory changes; Scintigraphy;
D O I
10.1007/BF00862511
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
The use of99mtechnetium dimercaptosuccinic acid (99mTc-DMSA) scintigraphy for the early diagnosis of pyelonephritis has been evaluated in a study performed on adolescent female Sprague-Dawley rats exposed to an ascending Escherichia coli infection. The rats were studied with DMSA scintigraphy either before and 5 days after the infection or 5 and 28 days after the infection. One group of rats received anti-microbial treatment during days 6-11. After the last DMSA scintigraphy the rats were sacrificed and the kidneys prepared for light microscopy study. Kidney morphology was normal and DMSA uptake was high and homogeneous in all control rats. The majority of the rats exposed to E. coli developed inflammatory changes, on light microscopy which extended to various degrees in the renal parenchyma. Five days after the infection the DMSA uptake was consistently reduced, if the inflammatory lesion on light microscopy involved more than 15% of the renal cortex. Twenty-eight days after infection the inflammatory changes were less extensive than at 5 days. The DMSA uptake had usually improved. At this time, however, areas of decreased DMSA uptake could be detected even if the light microscopy changes involved less than 15% of the parenchyma. Microscopical lesions were less frequent and less extensive in the treated than in the untreated rats. The complete return to normal of previously abnormal DMSA uptake was only observed in treated rats. In a few untreated rats cortical scars had formed by day 28. The scars appeared in areas with decreased DMSA uptake at 5 days. The results imply that DMSA scintigraphy is a valuable method for the early diagnosis and for the localization of pyelonephritis. © 1990 IPNA.
引用
收藏
页码:331 / 334
页数:4
相关论文
共 17 条
[1]  
Hodson C.J., Edwards D., Chronic pyelonephritis and vesicoureteric reflux, Clin Radiol, 11, pp. 219-231, (1960)
[2]  
Huland H., Busch R., Pyelonephritic scarring in 213 patients with upper and lower urinary tract infections, Long-term follow-up. J Urol, 132, pp. 936-939, (1984)
[3]  
Smellie J., Edwards D., Hunter N., Normand I.C.S., Prescod N., Vesico-ureteric reflux and renal scarring, Kidney Int, 8, pp. 65-72, (1975)
[4]  
Wikstad I., Aperia A., Broberger O., Ekengren K., Vesicoureteric reflux and pyelonephritis. Long time effect on area of renal parenchyma, Acta Radiol Diagn, 20, pp. 252-259, (1979)
[5]  
Jodal U., Lindberg U., Lincoln K., Level diagnosis of symptomatic urinary tract infections in childhood, Acta Paediatr Scand, 64, pp. 201-208, (1975)
[6]  
Pylkkanen J., Koskimies O., Vilska J., Natural history of symptomatic urinary tract infection in childhood, Paediatric nephrology, pp. 298-301, (1984)
[7]  
Enlander D., Weber P., dos Remedios L., Renal cortical imaging in 35 patients: superior quality with 99m-Tc-DMSA, J Nucl Med, 15, pp. 743-749, (1974)
[8]  
Stoller M.L., Kogan B.A., Sensitivity of 99m-technetium-dimercaptosuccinic acid for the diagnosis of chronic pyelonephritis: clinical and theoretical considerations, J Urol, 135, pp. 977-980, (1986)
[9]  
Hannerz L., Celsi G., Eklof A-C, Olling S., Wikstad I., Aperia A., Ascending pyelonephritis in young rats retards kidney growth, Kidney Int, 35, pp. 1133-1137, (1989)
[10]  
Hannerz L., Wikstad I., Broberger O., Aperia A., Influence of diuresis on the degree of vesicoureteral reflux. An experimental investigation in rats, Acta Radiol Diagn, 24, pp. 395-399, (1983)