Imaging

Imaging types

Renal and bladder US within 24 hours is advised in infants with febrile UTI to exclude obstruction of the upper and lower urinary tract.

Renal ultrasound should be performed before and after voiding.

Post-void residual (PVR) urine should be measured in toilet-trained children to exclude voiding abnormalities as a cause of UTI.

In the acute phase of a febrile UTI (up to four to six weeks), DMSA-scans can demonstrate pyelonephritis by perfusion defects.

Renal scars can be detected after three to six months.

Diffusion-weighted MRI has been shown to accurately diagnose acute pyelonephritis and reveal late renal scars, and could be an alternative to DMSA.

The optimum method to exclude or confirm VUR is VCUG. The examination should be performed under sterile urine culture. Performing unnecessary VCUG tests should be avoided.

Guidelines

Published Guidelines for Imaging following the first febrile UTI in children less than 2-3 years of age.

UTI & VUR
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