Retrospective Assessment of Cortical Renal Integrity in Pediatric Patients via Tc-99m DMSA Scan

Background: Tc-99m DMSA scintigraphy is considered the main standard for detecting renal cortical abnormalities and evaluating differential renal function in children [4, 6]. This study aimed to investigate the prevalence and patterns of abnormal DMSA findings in a pediatric cohort and to analyze their association with clinical and demographic factors. Objective: evaluating the use of DMSA for detecting renal cortical damage and assessing differential renal function in pediatric patients according to age, gender and recurrent urinary tract infections Material and Methods: We retrospectively reviewed records of children (≤18 years) who underwent Tc-99m DMSA scans between May 31, 2023, and March 13, 2024. Patients with dysplastic, polycystic, or absent kidneys were excluded [4]. Clinical data and imaging results were analyzed using Chi-square tests, with p < 0.05 considered statistically significant [17]. Results: Of the 100 patients (mean age 6.33 years), 49% had normal cortical scans, while 51% showed abnormalities. Abnormal DMSA findings were significantly associated with female gender (p = 0.004), age ≥6 years (p = 0.003), and recurrent urinary tract infection (UTI) (p = 0.002), but not with vesicoureteric reflux (VUR) or congenital anomalies. Significant renal function impairment was linked to female gender (p = 0.002), older age (p = 0.001), congenital anomalies (p = 0.003), and abnormal cortical scans (p = 0.001). Conclusion: Tc-99m DMSA scintigraphy provides valuable structural and functional information in pediatric renal assessment. Female gender, older age, and recurrent UTI emerged as key predictors of cortical damage, while impaired function was also associated with congenital anomalies. Early detection and focused follow-up in high-risk groups may help prevent long-term renal sequelae [3, 8, 9].