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Postgrad Med J 80:424-425 doi:10.1136/pgmj.2003.011148
  • Short report

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

  1. B Padmakumar1,
  2. H M Carty2,
  3. D A Hughes1,
  4. B A Judd1
  1. 1Renal Unit, Royal Liverpool Children’s Hospital, Liverpool, UK
  2. 2Department of Radiology, Royal Liverpool Children’s Hospital, Liverpool, UK
  1. Correspondence to:
 Dr B Padmakumar
 Royal Oldham Hospital, Rochdale Road, Oldham OL12JH, UK; Beena.Padmakumarpat.nhs.uk
  • Received 12 June 2003
  • Accepted 30 July 2003

Abstract

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.

Footnotes