Renal cortical scintigraphy (dimercaptosuccinic acid - DMSA) has been reported to be useful in children for confirmation of the diagnosis of acute pyelonephritis. Subsequent experimental studies demonstrated thatDMSA, when compared directly with the histopathology, is highly reliable for the detection and localization of parenchymal inflammatory changes associated with acute pyelonephritis. DMSA is also the isotope agent of choice for the detection of renal scarring. Clinical studies report a higher sensitivity ofDMSA renal scintigraphy for the detection of renal scarring when compared with the excretory urogram, particularly in infants and young children. Renal scarring only occurs in sites corresponding exactly to previous areas of acute pyelonephritis damage demonstrated by DMSA scintigraphy at the time of infection. Whether or not the DMSA scan can replace or only supplement other routine investigations in the acute phase of children with urinary tract infection is still a matter of debate.

        Key words: acute pyelonephritis, dimercaptosuccinic acid scintigraphy, vesicoureteral reflux, renal scarring, children