前言:本研究針對一群首次罹患急性腎盂腎炎的小兒科病例，利用鎝-99m-DMSA腎臟造影觀察急性腎盂腎炎治療前、後的變化，籍以瞭解腎臟疤痕發生的比率。

方法:本研究回溯性分析1996年1月至1997年2月期間，經由尿液培養證實之首次罹患尿路感染症的兒科病例，其急性期之鎝-99m-DMSA腎臟造影顯示有急性腎盂腎炎病灶，經過抗生素治療後，6個月以後再追踪鎝-99mDMSA腎臟造影，如果病灶持續存在，則視為腎臟疤痕o

結果:急性期，共有55位病童64個腎臟，鎝-99m-DMSA腎臟造彰顯示有急性腎盂腎炎病位，治療以後6個月再追踪鎝-99m-DMSA腎臟造彰，36個腎臟(56%)完全恢復正 常，17個腎臟(27%)明顯改善僅留下輕微疤痕， 11個腎 臟(17%)產生顯著疤痕或萎縮。

結論:急性腎盂腎炎是造成腎臟疤痕的重要原因之一，所幸多數的急性腎盂腎炎經過治療後可完全恢復正常或者明顯改善，因此積極使用鎝-99m-DMSA腎臟造影早期偵測急性腎盂腎炎，並給予適當治療，對於避免或或少腎臟疤痕的發生應該很有幫助。

Background: The aim of this study was to follow up a group of children with acute pyelonephritis using 99"'Tc-DMSA renal scintigraphy in order to determine the incidence of renal scarring.

Methods: We retrospectively reviewed all children with first culture-documented urinary tract infections from Jan 1996 to Feb 1997. All those children who had abnormal 99mTc-DMSA renal scan findings suggestive of acute pyelonephritis during acute infection and a follow-up renal scan at 6 months after treatment were included for analySIS.

Results: During acute infection， 55 patients with 64 kidneys had abnormal 99mTc-DMSA renal scan findings suggestive of acute pyelonephritis. Follow up 99mTc-DMSA renal scans at 6 months after treatment revealed normalization of renal changes in 36 kidneys (56%)， much improvement with minimal scarring in 17 kidneys (27%)， and prominent renal scarring in 11 kidneys (17%). All renal scars occurred at the sites corresponding to the the acute pyelonephritis lesions seen on the initial 99mTc-DMSA renal scans.

Conclusion: Acute pyelonephritis is one of the important causes of renal scarring. The changes of acute pyelonephritis recover completely or much improve in the majority of cases. 99mTc-DMSA renal scan is useful in the early diagnosis and follow up of these patients.