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• W4301493225 abstract "No AccessJournal of UrologyClinical Urology: Original Article1 Nov 1996The Role of Renal Scintigraphy in the Evaluation of Spinal Cord Injury Patients with Presumed Urosepsis Michael D. Fabrizio, Michael B. Chancellor, David A. Rivas, Michael D. Richard, and Charles M. Intenzo Michael D. FabrizioMichael D. Fabrizio More articles by this author , Michael B. ChancellorMichael B. Chancellor More articles by this author , David A. RivasDavid A. Rivas More articles by this author , Michael D. RichardMichael D. Richard More articles by this author , and Charles M. IntenzoCharles M. Intenzo More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65493-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We attempted to differentiate pyelonephritis, defined as upper urinary tract parenchymal infection, from fever due to other sources in patients with spinal cord injury by radioisotope renal scintigraphy. Materials and Methods: A total of 13 consecutive spinal cord injury patients 21 to 54 years old (level of injury C4 to cauda equina) was hospitalized with urosepsis. The diagnosis was based on medical history, physical examination and laboratory evaluation, including blood, urine, sputum and wound fluid culture and sensitivity, and a99m technetium glucoheptonate renal scan for pyelonephritis. Renal scan results were compared to 1 or more of several studies performed in each case, including ultrasonography, excretory urography and axial computerized tomography. Results: Glucoheptonate renal scintigraphy accurately diagnosed pyelonephritis in all 7 patients with a scintigraphic B lesion. In 2 patients with a C lesion on scintigraphy, representing a cortical scar, other sources of sepsis were identified. In the 4 patients with negative renal scans pyrexia was attributed to active decubitus wound infection and osteomyelitis. Positive and negative predictive values of renal scanning were each 100 percent. Conclusions: Nuclear medicine renal scanning is a valuable adjunct in the evaluation of sepsis and presumed urosepsis in the spinal cord injury population. References 1 : The detection of pyelonephritic scarring in children by radioisotope imaging. Brit. J. Rad.1980; 53: 544. Google Scholar 2 : Nuclear renal imaging in acute pyelonephritis. Sem. Nucl. Med.1982; 12: 246. Google Scholar 3 : Dimercaptosuccinic acid scintigraphy for the evaluation of pyelonephritis and scarring: a review of experimental and clinical studies. J. Urol., part 21992; 148: 1726. Abstract, Google Scholar 4 : Urography versus DMSA scan in children with vesicoureteric reflux. Ped. Nephrol.1989; 3: 1. Google Scholar 5 : Evaluation of acute urinary tract infection in children by dimercaptosuccinic acid scintigraphy: a prospective study. J. Urol., part 21992; 148: 1746. Abstract, Google Scholar 6 : sup 99m Tc-dimercapto-succinic acid (DMSA) scan as first investigation of urinary tract infection. Arch. Dis. Child.1988; 63: 1322. Google Scholar 7 : Renal scarring following reflux and nonreflux pyelonephritis in children: evaluation with sup 99m technetium-dimercapto-succinic acid scintigraphy. J. Urol.1992; 147: 1327. Abstract, Google Scholar 8 : Renal pathology and the sup 99m Tc-DMSA image before and after treatment of the evolving pyelonephritic scar: an experimental study. J. Urol.1994; 152: 1260. Google Scholar 9 : Commentary on clinical relevance of sup 99m Tc-DMSA scintigraphy. J. Urol.1994; 152: 1068. Google Scholar 10 : Renal pathology and the sup 99m Tc-DMSA image during the evolution of the early pyelonephritic scar: an experimental study. J. Urol.1994; 151: 767. Abstract, Google Scholar 11 : Evaluation of sup 99m technetium-dimercapto-succinic acid renal scans in experimental acute pyelonephritis in piglets. J. Urol., part 21988; 140: 1169. Abstract, Google Scholar 12 : Renal cortical scintigraphy in the diagnosis of acute pyelonephritis. Sem. Nucl. Med.1992; 22: 98. Google Scholar 13 : Renal handling of technetium-99m DMSA: evidence for glomerular filtration and peritubular uptake. J. Nucl. Med.1989; 30: 1219. Google Scholar 14 : The appearance of the intravenous pyelogram during and after acute pyelonephritis. Lancet1965; 1: 1186. Google Scholar 15 : The radiological spectrum of acute pyelonephritis in adults and adolescents. Radiology1976; 118: 65. Google Scholar 16 : . Philadelphia: W. B. Saunders Co.1990: 812. chapt. 21. Google Scholar 17 : Computed tomography in acute pyelonephritis. Brit. J. Urol.1987; 59: 118. Google Scholar Departments of Urology and Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 156Issue 5November 1996Page: 1730-1734 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Michael D. Fabrizio More articles by this author Michael B. Chancellor More articles by this author David A. Rivas More articles by this author Michael D. Richard More articles by this author Charles M. Intenzo More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W4301493225 title "The Role of Renal Scintigraphy in the Evaluation of Spinal Cord Injury Patients with Presumed Urosepsis" @default.
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