الفهرس 
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Abstract
Our purpose was to:
1- evaluate the usefulness of 99m- Technetium-dimercaptosuccinic acid scan (DMSA) performed during the acute phase of first febrile urinary tract infection in children for detection and evaluation of pyelonephrotic changes in the kidney.
2- Identify children at risk of events like vesico-ureteric reflux (VUR), recurrent UTI or renal scarring that may lead to development of progressive renal damage by a follow-up DMSA scan performed after 4 months from febrile UTI.
For a total of 30 patients aged from 2 month to 12 years presented with first episode febrile UTI attending the outpatient clinic of urology in Ismailia Health Insurance Hospital , Laboratory investigation has been done including: urine analysis and culture – CBC- S. creatinine – CRP
RBUS and initial DMSA were done within 5-7 days of acute febrile UTI.
VCUG was done 1 month after resolution of febrile UTI and a second follow up DMSA was repeated after 4 months.
46.7% of sample had abnormal initial DMSA results. VCUG results revealed that 20% of children had VUR. It was seen that 57% of patients with abnormal initial DMSA had no-reflux and 43% had abnormal initial DMSA with different grades of VUR. There was significant difference between initial DMSA results concerning occurrence and grades of VUR (P = 0.036).
On Follow-up DMSA scintigraphy 30% of children had abnormal results and of whom 56% had reflux. There was significant association between abnormal follow-up DMSA results and degree of reflux (P=0.012).
Briefly, in the present study our results confirmed the importance of acute phase DMSA in the assessment of febrile UTI in children with or without VUR and modify the further strategy such as indication for VCUG.