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Article: Evaluating different imaging strategies in children after first febrile urinary tract infection
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TitleEvaluating different imaging strategies in children after first febrile urinary tract infection
 
AuthorsWong, SN3
Tse, NKC2
Lee, KP9
Yuen, SF6
Leung, LCK1
Pau, BCK1
Chan, WKY4
Lee, KW4
Cheung, HM5
Chim, S8
Yip, CMS7
 
Issue Date2010
 
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00467/index.htm
 
CitationPediatric Nephrology, 2010, v. 25 n. 10, p. 2083-2091 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00467-010-1569-z
 
AbstractWe conducted a retrospective multicenter review to estimate the prevalence of urological abnormalities in Chinese children with first febrile urinary tract infection (UTI) and to evaluate the selective imaging strategy recommended by the NICE guideline for detecting underlying abnormalities. Atypical UTI was defined as in the NICE UTI guideline. Overall, 576 boys and 244 girls aged below 24 months were reviewed. All underwent ultrasound (US) and micturating cystourethrogram (MCUG) and 612 underwent DMSA scans. US was abnormal in 73 (8.9%) and vesicoureteral reflux was shown in 195 patients (23.8%). A total of 126 patients were considered to have remediable urological abnormalities requiring additional surgical or medical interventions. The NICE guideline yielded excellent negative predictive values (NPV) of 100-94.4% in girls but 91% in boys. If all boys underwent US and DMSA and only those with atypical UTI or abnormal US or DMSA proceeded to MCUG, then the NPV increased to 95.2% and 97.4% for boys aged below and above 6 months, respectively. These revised strategies would substantially save invasive studies-DMSA and MCUG in 27 and 74% of girls aged below and above 6 months, respectively, or MCUG in 23 and 59% of boys aged below and above 6 months, respectively.
 
ISSN0931-041X
2012 Impact Factor: 2.939
2012 SCImago Journal Rankings: 0.979
 
DOIhttp://dx.doi.org/10.1007/s00467-010-1569-z
 
ISI Accession Number IDWOS:000281110700009
 
DC FieldValue
dc.contributor.authorWong, SN
 
dc.contributor.authorTse, NKC
 
dc.contributor.authorLee, KP
 
dc.contributor.authorYuen, SF
 
dc.contributor.authorLeung, LCK
 
dc.contributor.authorPau, BCK
 
dc.contributor.authorChan, WKY
 
dc.contributor.authorLee, KW
 
dc.contributor.authorCheung, HM
 
dc.contributor.authorChim, S
 
dc.contributor.authorYip, CMS
 
dc.date.accessioned2011-09-23T05:52:05Z
 
dc.date.available2011-09-23T05:52:05Z
 
dc.date.issued2010
 
dc.description.abstractWe conducted a retrospective multicenter review to estimate the prevalence of urological abnormalities in Chinese children with first febrile urinary tract infection (UTI) and to evaluate the selective imaging strategy recommended by the NICE guideline for detecting underlying abnormalities. Atypical UTI was defined as in the NICE UTI guideline. Overall, 576 boys and 244 girls aged below 24 months were reviewed. All underwent ultrasound (US) and micturating cystourethrogram (MCUG) and 612 underwent DMSA scans. US was abnormal in 73 (8.9%) and vesicoureteral reflux was shown in 195 patients (23.8%). A total of 126 patients were considered to have remediable urological abnormalities requiring additional surgical or medical interventions. The NICE guideline yielded excellent negative predictive values (NPV) of 100-94.4% in girls but 91% in boys. If all boys underwent US and DMSA and only those with atypical UTI or abnormal US or DMSA proceeded to MCUG, then the NPV increased to 95.2% and 97.4% for boys aged below and above 6 months, respectively. These revised strategies would substantially save invasive studies-DMSA and MCUG in 27 and 74% of girls aged below and above 6 months, respectively, or MCUG in 23 and 59% of boys aged below and above 6 months, respectively.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationPediatric Nephrology, 2010, v. 25 n. 10, p. 2083-2091 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00467-010-1569-z
 
dc.identifier.citeulike7417771
 
dc.identifier.doihttp://dx.doi.org/10.1007/s00467-010-1569-z
 
dc.identifier.epage2091
 
dc.identifier.hkuros195999
 
dc.identifier.isiWOS:000281110700009
 
dc.identifier.issn0931-041X
2012 Impact Factor: 2.939
2012 SCImago Journal Rankings: 0.979
 
dc.identifier.issue10
 
dc.identifier.pmid20556431
 
dc.identifier.scopuseid_2-s2.0-77956225832
 
dc.identifier.spage2083
 
dc.identifier.urihttp://hdl.handle.net/10722/139584
 
dc.identifier.volume25
 
dc.languageeng
 
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00467/index.htm
 
dc.publisher.placeGermany
 
dc.relation.ispartofPediatric Nephrology
 
dc.rightsThe original publication is available at www.springerlink.com
 
dc.subject.meshDiagnostic Imaging - methods
 
dc.subject.meshFever
 
dc.subject.meshPractice Guidelines as Topic
 
dc.subject.meshRadiopharmaceuticals - diagnostic use
 
dc.subject.meshUrinary Tract Infections - diagnosis
 
dc.titleEvaluating different imaging strategies in children after first febrile urinary tract infection
 
dc.typeArticle
 
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<contributor.author>Tse, NKC</contributor.author>
<contributor.author>Lee, KP</contributor.author>
<contributor.author>Yuen, SF</contributor.author>
<contributor.author>Leung, LCK</contributor.author>
<contributor.author>Pau, BCK</contributor.author>
<contributor.author>Chan, WKY</contributor.author>
<contributor.author>Lee, KW</contributor.author>
<contributor.author>Cheung, HM</contributor.author>
<contributor.author>Chim, S</contributor.author>
<contributor.author>Yip, CMS</contributor.author>
<date.accessioned>2011-09-23T05:52:05Z</date.accessioned>
<date.available>2011-09-23T05:52:05Z</date.available>
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<description.abstract>We conducted a retrospective multicenter review to estimate the prevalence of urological abnormalities in Chinese children with first febrile urinary tract infection (UTI) and to evaluate the selective imaging strategy recommended by the NICE guideline for detecting underlying abnormalities. Atypical UTI was defined as in the NICE UTI guideline. Overall, 576 boys and 244 girls aged below 24 months were reviewed. All underwent ultrasound (US) and micturating cystourethrogram (MCUG) and 612 underwent DMSA scans. US was abnormal in 73 (8.9%) and vesicoureteral reflux was shown in 195 patients (23.8%). A total of 126 patients were considered to have remediable urological abnormalities requiring additional surgical or medical interventions. The NICE guideline yielded excellent negative predictive values (NPV) of 100-94.4% in girls but 91% in boys. If all boys underwent US and DMSA and only those with atypical UTI or abnormal US or DMSA proceeded to MCUG, then the NPV increased to 95.2% and 97.4% for boys aged below and above 6 months, respectively. These revised strategies would substantially save invasive studies-DMSA and MCUG in 27 and 74% of girls aged below and above 6 months, respectively, or MCUG in 23 and 59% of boys aged below and above 6 months, respectively.</description.abstract>
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Author Affiliations
  1. Kwong Wah Hospital
  2. Princess Margaret Hospital Hong Kong
  3. Tuen Mun Hospital
  4. Queen Elizabeth Hospital Hong Kong
  5. Prince of Wales Hospital Hong Kong
  6. Pamela Youde Nethersole Eastern Hospital
  7. United Christian Hospital Hong Kong
  8. Queen Mary Hospital Hong Kong
  9. Alice Ho Miu Ling Nethersole Hospital