Renal pathology and the 99mTc-DMSA image before and after treatment of the evolving pyelonephritic scar: an experimental study.

Abstract

This study reports the effects of 3-weeks' antimicrobial treatment on the pathology and appearance of the 99mTc-DMSA renal image in piglets with pyelonephritis induced by a combination of vesicoureteral reflux (VUR) and urinary infection. Before treatment, either photon-deficient (B1, B2) or photon-absent (C) scintigraphic abnormalities were present in the refluxing kidney in all 22 animals examined. All (100%) of the initially B1 and the majority (71%) of B2 photon deficient defects resolved with treatment, leaving only insignificant residual pathologic lesions. Conversely almost all (93%) of the C photon-absent scintigraphic abnormalities persisted after treatment and were always associated with significant scarred or cratered pathologic lesions in the refluxing kidney at sacrifice.