Table 6.

Renal imaging modalities

KUB ultrasound	MCUG/VCUG	DMSA scan
Uses
Assess the presence and degree of hydronephrosis or ureteric dilation and signs of urinary tract obstructions or any other renal anomalies Assess the fluid collection and the bladder capacity and postvoid residual	Assess the presence of posterior urethral valves Assess the presence of VUR Assess the bladder capacity, trabeculation and postvoid residual. Gold standard for VUR diagnosis	The gold old standard for renal scar detection and to assess the renal function
Indication
Concurrent bacteremia Atypical UTI organism:  S. aureus  Pseudomonas Infancy age Inadequate response to 48 h of IV antibiotics Abdominal mass Abnormal voiding Recurrent UTI First febrile UTI and no prompt follow done Renal impairment Significant electrolyte disturbance No antenatal renal tract imaging in 2–3 trimester	Abnormal renal ultrasound Hydronephrosis Thick bladder wall Renal scarring Abnormal voiding postfebrile UTI Postsecond febrile UTI Suspicion of VUR and posterior urethral valves	Clinical suspicion of renal injury Reduced renal function Suspicion of VUR And obstructive uropathy
Limitations
Does not assess function Cannot diagnosis VUR	Radiation exposure Invasive Unpleasant to perform postinfancy	Cannot determine old versus new scarring

MCUG: Micturating cystourethrogram, VCUG: Voiding cystourethrography, VUR: Vesicoureteric reflux, IV: Intravenous, UTI: Urinary tract infection, S. aureus: Staphylococcus aureus, DMSA: Dimercapto succinic acid