The objective of our study was to evaluate the performance of renal contrast-enhanced ultrasound (CEUS) against the 99m-labeled dimercaptosuccinic acid (DMSA) scan and computed tomography (CT) in children for the diagnosis of acute pyelonephritis. We included children who underwent both renal CEUS and the DMSA scan or CT. A total of 33 children (21 males and 12 females, mean age 26 ± 36 months) were included. Using the DMSA scan as the reference standard, the sensitivity, specificity, positive predictive value, and negative predictive value of CEUS was 86.8%, 71.4%, 80.5%, and 80.0%, respectively. When CT was used as the reference standard, the sensitivity, specificity, positive predictive value, and negative predictive value of CEUS was 87.5%, 80.0%, 87.5%, and 80.0%, respectively. The diagnostic accuracy of CEUS for the diagnosis of acute pyelonephritis was 80.3% and 84.6% compared to the DMSA scan and CT, respectively. Inter-observer (kappa = 0.54) and intra-observer agreement (kappa = 0.59) for renal CEUS was moderate. In conclusion, CEUS had good diagnostic accuracy for diagnosing acute pyelonephritis with moderate inter- and intra-observer agreement. As CEUS does not require radiation or sedation, it could play an important role in the future when diagnosing acute pyelonephritis in children.

我们研究的目的是评估儿童99A标记的二巯基琥珀酸（DMSA）扫描和计算机断层扫描（CT）肾造影增强超声（CEUS）在诊断急性肾盂肾炎方面的表现。我们纳入了同时接受肾脏CEUS和DMSA扫描或CT检查的儿童。总共包括33名儿童（21名男性和12名女性，平均年龄26±36个月）。使用DMSA扫描作为参考标准，CEUS的敏感性，特异性，阳性预测值和阴性预测值分别为86.8％，71.4％，80.5％和80.0％。当CT作为参考标准时，CEUS的敏感性，特异性，阳性预测值和阴性预测值分别为87.5％，80.0％，87.5％和80.0％。与DMSA扫描和CT相比，CEUS对急性肾盂肾炎的诊断准确性分别为80.3％和84.6％。肾脏CEUS的观察者之间（kappa = 0.54）和观察者内部一致性（kappa = 0.59）中等。总之，CEUS对中度观察者与观察者之间的同意具有很好的诊断准确性，可用于诊断急性肾盂肾炎。由于CEUS不需要放射或镇静剂，因此在将来诊断儿童急性肾盂肾炎时可能会发挥重要作用。