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Role of intravenous urogram in investigation of urinary tract infection: an observational study

¹ Renal Unit, Royal Liverpool Children’s Hospital, Liverpool, UK
² Department of Radiology, Royal Liverpool Children’s Hospital, Liverpool, UK

Correspondence to:
Correspondence to:
Dr B Padmakumar
Royal Oldham Hospital, Rochdale Road, Oldham OL12JH, UK; Beena.Padmakumar{at}pat.nhs.uk

Objectives: To examine the value of an intravenous urogram (IVU) in patients with abnormal differential ^99mTc dimercaptosuccinic acid (DMSA) uptake without scarring or ultrasound abnormality.

Study design: Forty patients (age 0–19 years) were identified over a two year period in whom the differential renal uptake was >10%, who had smooth renal outlines, and had no evidence of scarring. All patients had an ultrasound examination. Two had marked urological abnormalities on ultrasound and eight had a duplex system in the kidney with greater DMSA uptake. In 18 patients where no explanation was apparent for the discrepant DMSA uptake, an IVU was performed.

Results: Eight patients had a normal IVU. In the remaining 10 patients, six had duplex systems without scarring and four had appearances of scarring in the kidney with reduced DMSA uptake.

Conclusions: In this small selected group an IVU will identify a significant number of patients with normal kidneys, unrecognised simple duplex systems, or scarring where the DMSA scan has been inconclusive. This will help in planning long term follow up.

Abbreviations: DMSA, ^99mTc dimercaptosuccinic acid; IVU, intravenous urogram

Keywords: DMSA; discrepant function; urinary tract infection; intravenous urography