Is Imaging Time Between two Tc 99m DMSA Scans Sufficient for Reporting as Renal Parenchymal Scarring? Healed Parenchymal Renal Defect After 6 Years

Abstract

We aimed to report a healed renal parenchymal defect after 6 years in a 9-year-old girl who was being followed for recurrent urinary tract infection (UTI). The first UTI was at the age of two. She was being followed with ultrasonography, urine analysis and urine culture since the first UTI. Technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy was repeated four times up to the present day. She had a renal parenchymal defect reported as parenchymal scarring, which healed 6 years after the first DMSA scintigraphy.

Conflict of interest: None declared.

Keywords: Kidney cortex necrosis; technetium Tc-99m dimercaptosuccinic acid; urinary tract infections.

Figure 1. At the age of 2.5, anterior, posterior and oblique projections ofthe Tc 99m DMSA scan show a hypoactive area in the superior-lateral ofthe right kidney more prominent in the posterior image

Figure 2. At the age of 3, Tc 99m DMSA scan 6 months later shows thatthe same hypoactive area in the superior-lateral of the right kidney is stillseen in the posterior image

Figure 3. At the age of 5, Tc 99m DMSA scan two years after the secondscan reveals that the same hypoactive area in the superior-lateral of theright kidney is persistent and it was reported as renal parencymal scarring.There is also hypoactivity on the upper pole of the left kidney

Figure 4. At the age of 9, 4th Tc 99m DMSA scan shows the superior-lateralof the right kidney is near normal in the posterior image, however thereis a mild hypoactive area that can be noticed in the anterior image