Acute childhood pyelonephritis: predictive value of positive sonographic findings in regard to later parenchymal scarring
| Autor: | Sylviane Hanquinet, Jean-Claude Jéquier, Sigrid Jequier |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Male
medicine.medical_specialty Adolescent ddc:616.0757 Sensitivity and Specificity Cicatrix Predictive Value of Tests Parenchyma mental disorders Medicine Humans Radiology Nuclear Medicine and imaging Cicatrix/etiology False Positive Reactions Ultrasonography Doppler Color Kidney infection Child Radionuclide Imaging Chelating Agents Likelihood Functions ddc:618 Chelating Agents/diagnostic use Chi-Square Distribution US.doppler Pyelonephritis business.industry Ultrasound Infant Newborn Infant Ultrasonography Doppler medicine.disease Pyelonephritis/radionuclide imaging/ultrasonography Predictive value Kidney Diseases/etiology Renal scarring Succimer/diagnostic use Surgery Child Preschool Acute Disease Female Kidney Diseases Radiology Doppler ultrasound business Succimer psychological phenomena and processes Follow-Up Studies |
| Zdroj: | Academic Radiology, Vol. 5, No 5 (1998) pp. 344-53 |
| ISSN: | 1076-6332 |
| Popis: | Rationale and Objectives. The authors evaluated the importance of positive sonographic findings in acute childhood pyelonephritis. Materials and Methods. A total of 290 children (91 boys, 199 girls, aged 4 days to 15 years [median, 394 days]) with clinically suspected acute pyelonephritis underwent initial renal gray-scale ultrasound (US) and dimercaptosuccinate scintigraphic examination within 3 days of onset. A total of 173 patients underwent color or energy US examination. One hundred fifteen children with normal scintigraphic or pathologic findings (other than acute pyelonephritis) were excluded from further study; 170 patients with abnormal scintigraphic findings underwent follow-up scintigraphic scanning 60–90 days later. Results. When pathologic structures other than acute pyelonephritis were not considered, the diagnostic value of gray-scale US was poor, with a sensitivity of 45.5%, a specificity of 86.6%, a positive predictive value of 88.8%, and a negative predictive value of only 40.6%. In regard to future renal scarring, gray-scale US had a positive predictive value of 67.7%, a negative predictive value of 40%, and a likelihood ratio of 1.16. Abnormal Doppler findings helped predict future scarring with a positive predictive value of 85.7%, a negative predictive value of 37.2%, a very low sensitivity of 26.9%, a high specificity of 90.6%, and a likelihood ratio of 2.87. Conclusion. Positive US Doppler findings in children with clinically suspected acute pyelonephritis indicate the need for immediate treatment. A positive initial gray-scale US examination does not predict future renal scarring, but a positive Doppler examination indicates a high probability of scarring. Negative gray-scale or Doppler US does not exclude a diagnosis of acute pyelonephritis and it cannot predict an absence of future scarring. |
| Databáze: | OpenAIRE |
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