Table 4.13Ultrasound compared with DMSA scan for localising UTI

Study detailsTest details; timeDefinition of positive resultReference standard; definition of positive result; timeUnit of analysisSensitivitySpecificityLR+LR−
Andrich (1992)143Standard; not statedNot statedScintigraphy (Tc-99m-DMSA); not stated; not statedPatients11.5%100.0%6.50.88
Benador (1994)143Standard; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients
≥ 1 year, any UTI38.7%66.7%1.10.94
≥ 1 year, 1st UTI27.8%33.3%0.51.89
≥ 1 year, multiple UTI53.8%83.3%2.50.59
< 1 year, any UTI46.5%85.7%3.00.63
< 1 year, 1st UTI45.0%84.6%2.70.66
< 1 year, multiple UTI66.7%100.0%3.80.45
All ages, any UTI43.2%81.1%2.30.70
All ages, 1st UTI39.7%79.3%1.80.77
All ages, multiple UTI56.3%87.5%3.40.53
Biggi (2001)143Standard; not statedRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phaseRenal units27.1%88.9%2.40.82
Bircan (1995)143Standard; acute phaseRenal changes indicative of APN and presence of congenital abnormalitiesScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients24.4%100.0%9.50.76
Boudailliez (1998)143Doppler; not statedNot statedScintigraphy (Tc-99m-DMSA); not stated; acute phaseRenal units33.3%88.2%2.80.76
Girona (1995)143Standard; not statedAbnormal kidney sizeScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; not statedRenal units45.9%72.9%1.70.74
Guermazi (1993)143Standard; not statedRenal changes indicative of APN or renal parenchymal defectScintigraphy (Tc-99m-DMSA); presence of acute or chronic lesions; not statedPatients42.4%92.8%5.90.62
Hajjar (2002)143Doppler; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients53.6%95.2%11.30.49
Hitzel (2002)143Doppler; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients93.6%50.0%1.90.13
Renal units79.6%81.4%4.10.26
Hitzel (2000)143Colour Doppler; not statedNot statedScintigraphy (Tc-99m-DMSA); not stated; acute phaseRenal units84.3%81.7%4.60.19
Ilyas (2002)143Standard; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients9.2%100.0%12.70.91
Jakobsson (1992)143Standard; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phaseRenal units56.5%63.9%1.60.69
Jequier (1998)143Standard; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients40.6%84.3%2.60.70
Doppler; acute phasePatients19.8%98.4%8.40.82
Krzemien (2002)143Doppler; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phaseRenal units46.9%92.3%6.10.58
Lavocat (1997)143Standard; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phaseRenal units50.0%100.0%55.00.50
Morin (1999)143Standard; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients93.5%62.5%2.50.10
Sfakianakis (1989)143Standard; not statedNot statedScintigraphy (Tc-99m-glucoheptonate); not stated; not statedPatients48.0%100.0%23.10.52
Sreenarasimhalah (1995)143Standard; acute phaseNot statedScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phaseRenal units39.6%95.3%8.50.63
Wang (2005)191Standard; acute phaseNot statedScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients49.0%88.0%4.10.58
Ilyas (2002)192Standard; acute phaseNot statedScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients9.0%100.0%N/AN/A
Halevy (2004)193Doppler; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients87.0%92.0%10.90.14
Bykov (2003)194Doppler; acute phaseRenal changes indicative of APNScintigraphy (Tc-99m-DMSA); renal changes indicative of APN; acute phasePatients74.0%94.0%12.30.28

APN = acute pyelonephritis; DMSA = dimercaptosuccinic acid.

From: 4, Diagnosis

Cover of Urinary Tract Infection in Children
Urinary Tract Infection in Children: Diagnosis, Treatment and Long-term Management.
NICE Clinical Guidelines, No. 54.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2007 Aug.
Copyright © 2007, National Collaborating Centre for Women’s and Children’s Health.

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