COLOR DOPPLER SONOGRAPHY IN PYELONEPHRITIS

Renal sonography detects abnormality in only 40 % of pediatric pyelonephritis. In eight patients shown to have acute pyelonephritis by Tc-99m DMSA renal cortical scintigraphy, five were found to have focal abnormalities of renal perfusion by color Doppler sonography in the same sites as the scintigraphic defects (sensitivity-63 %). Two of the five patients had normal plain sonograms. False positive studies occurred in patients with documented chronic renal scarring. The specificity of vascular asymmetry was 70 %. This preliminary report suggests that, particularly in the patient without pre-existing renal scarring, color Doppler evaluation of the renal vasculature may increase the sensitivity of sonography in the diagnosis of pyelonephritis in children.