Distribution of renal parenchymal damage on 99m-Tc DMSA scintigraphy in vesico-ureteric reflux

During a 2 year period renal scintigraphy was performed in 64 children prior to surgery for vesico-ureteric reflux (VUR). In total 126 kidneys were examined. Renal scintigraphy was performed 3 hours after intravenous injection of 99m-technetium labelled dimercaptosuccinic acid (DMSA). The renal parenchyma was assessed as normal in 64 kidneys and abnormal in 62. Renal parenchymal damage was revealed in the upper pole in 42 cases, the middle lateral part in 27, the lower pole in 47 and the middle medial part in 25. The whole kidney was affected in 21 cases. Damage within one or two poles was present in 59 of the 62 kidneys with parenchymal damage. Renal scintigraphy is regarded a sensitive technique for detection of renal parenchymal damage. The DMSA scintigraphy can reveal even minor scars. It can be recommended as a routine investigation in evaluating children with VUR.