MRI Abdomen and Pelvis With IV Contrast There is no relevant literature to support the use of MRI abdomen and pelvis with IV contrast in the evaluation of a child with atypical or recurrent febrile UTI for initial imaging. MRI Abdomen and Pelvis Without IV Contrast There is no relevant literature to support the use of MRI abdomen and pelvis without IV contrast in the evaluation of a child with atypical or recurrent febrile UTI for initial imaging. MRU Without and With IV Contrast There is no relevant literature to support the use of MRU in the evaluation of a child with atypical or recurrent febrile UTI for initial imaging. Nuclear Medicine Cystography There is good correlation between nuclear medicine cystography and VCUG for the detection of reflux [19]. For more information, please see the fluoroscopic VCUG section. The literature in this patient population is evolving with a focus on other modalities such as VUS and fluoroscopy VCUG. It should be noted that the primary evidence supporting use of nuclear cystography is generally older than that of other modalities. US Kidneys and Bladder In children with atypical, recurrent, or complicated UTI, the main benefit of US is the detection of underlying abnormalities, calculi, or complications such as a renal or perirenal abscess [82,84]. The potential harm of using US as the only imaging for UTI is the poor sensitivity for VUR and pyelonephritis/scarring [25-30,64]. There are limited data showing inconsistent results on the sensitivity of US in the detection of dilated VUR [65,66]. Grayscale US identifies approximately 25% of the patients with acute pyelonephritis and approximately 40% of the patients with chronic parenchymal scarring [29,31,67-72]. In a retrospective study of 2,259 children <5 years of age, sensitivity was related to criteria for the definition of a normal study.
Urinary Tract Infection Child. MRI Abdomen and Pelvis With IV Contrast There is no relevant literature to support the use of MRI abdomen and pelvis with IV contrast in the evaluation of a child with atypical or recurrent febrile UTI for initial imaging. MRI Abdomen and Pelvis Without IV Contrast There is no relevant literature to support the use of MRI abdomen and pelvis without IV contrast in the evaluation of a child with atypical or recurrent febrile UTI for initial imaging. MRU Without and With IV Contrast There is no relevant literature to support the use of MRU in the evaluation of a child with atypical or recurrent febrile UTI for initial imaging. Nuclear Medicine Cystography There is good correlation between nuclear medicine cystography and VCUG for the detection of reflux [19]. For more information, please see the fluoroscopic VCUG section. The literature in this patient population is evolving with a focus on other modalities such as VUS and fluoroscopy VCUG. It should be noted that the primary evidence supporting use of nuclear cystography is generally older than that of other modalities. US Kidneys and Bladder In children with atypical, recurrent, or complicated UTI, the main benefit of US is the detection of underlying abnormalities, calculi, or complications such as a renal or perirenal abscess [82,84]. The potential harm of using US as the only imaging for UTI is the poor sensitivity for VUR and pyelonephritis/scarring [25-30,64]. There are limited data showing inconsistent results on the sensitivity of US in the detection of dilated VUR [65,66]. Grayscale US identifies approximately 25% of the patients with acute pyelonephritis and approximately 40% of the patients with chronic parenchymal scarring [29,31,67-72]. In a retrospective study of 2,259 children <5 years of age, sensitivity was related to criteria for the definition of a normal study.