The clinical application of 99Tcm-DMSA renal cortical scintigraphy in children with urinary tract infection

International Nuclear Information System (INIS)

Zhao Ruifang; Zeng Jihua; Xu Hong; Ji Zhiying; Yuan Hong

2002-01-01

Objective: To study the value of 99 Tc m -dimercaptosuccinic acid (DMSA) renal cortical scintigraphy in distinguishing between upper urinary tract infection (UUTI) and lower UTI (LUTI), determining renal scarring, and following-up curative effect for UTI in children. Methods: The authors reviewed 252 results of 99 Tc m -DMSA renal cortical scintigraphy in children with UTIs during a period of the past five years. The age of the patients was from 1 month to 14 years. The ratio of males: females was 94:158. A standard 99 Tc m -DMSA renal cortical scintigraphic protocol was used. The studies were scored as normal (indicating LUTI) and abnormal (indicating acute pyelonephritis or renal scarring). And differential function of renal was calculated. Results: Of 252 children with UTI, 110 cases had normal images diagnosed as with LUTI. 142 cases had abnormal images, 116 cases were diagnosed as with acute pyelonephritis, 26 cases were diagnosed as with renal cortical scars. The differential function range of LUTI was 46%-54%. Of UUTIs, the differential function of single renal involved was less than 45%. Of 142 UUTIs, 17 cases repeatedly underwent renal cortical scan after therapy. 12 of 13 cases with acute pyelonephritis completely recovered normal or obviously ameliorated after 6 months, 1 cases did not show any change after 4 months. Four cases were found with renal scarring, and showed little change on repeated images for the following 6 months. conclusions: 99 Tc m -DMSA renal cortical scintigraphy is of valuable significance in distinguishing between upper and lower UTI, and in estimating renal scarring. The sequelae of renal infection can be monitored by renal cortical scan. A follow-up of 6 months may be recommended after therapy

Parathyroid Scintigraphy in Renal Hyperparathyroidism

Science.gov (United States)

Taïeb, David; Ureña-Torres, Pablo; Zanotti-Fregonara, Paolo; Rubello, Domenico; Ferretti, Alice; Henter, Ioline; Henry, Jean-François; Schiavi, Francesca; Opocher, Giuseppe; Blickman, Johan G.; Colletti, Patrick M.; Hindié, Elif

2015-01-01

Secondary hyperparathyroidism (sHPT) is a major complication for patients with end-stage renal disease on long-term hemodialysis or peritoneal dialysis. When the disease is resistant to medical treatment, patients with severe sHPT are typically referred for parathyroidectomy (PTx), which usually improves biological parameters as well as clinical signs and symptoms. Unfortunately, early surgical failure with persistent disease may occur in 5%–10% of patients and recurrence reaches 20%–30% at 5 years. Presently, the use of parathyroid scintigraphy in sHPT is usually limited to the management of surgical failures after initial PTx. This review describes the strengths and limitations of typical 99mTc-sestamibi imaging protocols, and highlights the potential benefits of using parathyroid scintigraphy in the initial workup of surgical patients. PMID:23751837

Comparison of relative renal function measured with either 99m Tc-DTPA or 99m Tc-EC dynamic scintigraphies with that measured with 99m Tc-DMSA static scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Domingues, F.C.; Fujikawa, G.Y.; Decker, H.; Alonso, G.; Pereira, J.C.; Duarte, P.S. [Centro de Diagnostico Fleury, Sao Paulo, SP (Brazil). Secao de Medicina Nuclear; Sao Paulo Univ. (USP), SP (Brazil). Escola de Saude Publica. Dept. de Epidemiologia]. E-mail: paulo.duarte@fleury.com.br

2006-07-15

Objective: The aim of this study was to compare the renal function measured with either {sup 99m}Tc-DTPA or {sup 99m}Tc-EC dynamic scintigraphies with that measured using {sup 99m}Tc-DMSA static scintigraphy. Methods: the values of relative renal function measured in 111 renal dynamic scintigraphies performed either with {sup 99m}Tc-DTPA (55 studies) or with {sup 99m}Tc-EC (56 studies) were compared with the relative function measured using {sup 99m}Tc-DMSA static scintigraphy performed within a 1-month period. The comparisons were performed using Wilcoxon signed rank test. The number of {sup 99m}Tc-DTPA and {sup 99m}Tc-EC studies that presented relative renal function different by more than 5% from that measured with {sup 99m}Tc-DMSA, using chi square test were also compared. Results: the relative renal function measured with {sup 99m}Tc-EC is not statistically different from that measured with {sup 99m}Tc-DMSA (p = 0.97). The relative renal function measured with {sup 99m}Tc-DTPA was statistically different from that measured using {sup 99m}Tc-DMSA, but with a borderline statistical significance (p = 0.05). The number of studies with relative renal function different by more than 5% from that measured with {sup 99m}Tc-DMSA is higher for the {sup 99m}Tc-DTPA scintigraphy (p 0.04) than for {sup 99m}Tc-EC. Conclusion: the relative renal function measured with {sup 99m}Tc-EC dynamic scintigraphy is comparable with that measured with {sup 99m}Tc-DMSA static scintigraphy, while the relative renal function measured with {sup 99m}Tc-DTPA dynamic scintigraphy presents a significant statistical difference from that measured with {sup 99m}Tc-DMSA static scintigraphy. (author)

Comparison of relative renal function measured with either 99m Tc-DTPA or 99m Tc-EC dynamic scintigraphies with that measured with 99m Tc-DMSA static scintigraphy

International Nuclear Information System (INIS)

Domingues, F.C.; Fujikawa, G.Y.; Decker, H.; Alonso, G.; Pereira, J.C.; Duarte, P.S.; Sao Paulo Univ.

2006-01-01

Objective: The aim of this study was to compare the renal function measured with either 99m Tc-DTPA or 99m Tc-EC dynamic scintigraphies with that measured using 99m Tc-DMSA static scintigraphy. Methods: the values of relative renal function measured in 111 renal dynamic scintigraphies performed either with 99m Tc-DTPA (55 studies) or with 99m Tc-EC (56 studies) were compared with the relative function measured using 99m Tc-DMSA static scintigraphy performed within a 1-month period. The comparisons were performed using Wilcoxon signed rank test. The number of 99m Tc-DTPA and 99m Tc-EC studies that presented relative renal function different by more than 5% from that measured with 99m Tc-DMSA, using chi square test were also compared. Results: the relative renal function measured with 99m Tc-EC is not statistically different from that measured with 99m Tc-DMSA (p = 0.97). The relative renal function measured with 99m Tc-DTPA was statistically different from that measured using 99m Tc-DMSA, but with a borderline statistical significance (p = 0.05). The number of studies with relative renal function different by more than 5% from that measured with 99m Tc-DMSA is higher for the 99m Tc-DTPA scintigraphy (p 0.04) than for 99m Tc-EC. Conclusion: the relative renal function measured with 99m Tc-EC dynamic scintigraphy is comparable with that measured with 99m Tc-DMSA static scintigraphy, while the relative renal function measured with 99m Tc-DTPA dynamic scintigraphy presents a significant statistical difference from that measured with 99m Tc-DMSA static scintigraphy. (author)

Diuretic renal function scintigraphy in the follow-up of pyeloplasty

International Nuclear Information System (INIS)

Rauschmeier, H.; Zechmann, W.; Innsbruck Univ.

1982-01-01

Intravenous pyelography, ultrasonics, standard renography and renal scintigraphy are not always appropriate methods for assessment of pelviureteric junction following pyeloplasty. In an easy and non-invasive way renography can supply such information by administration of furosemide. 112 cases of pyeloplasty were investigated with this method and results compared to other present diagnostic procedures. In 7.4%, intravenous pyelography revealed severe signs of obstruction which were completely disproved by diuretic renal function scintigraphy. Furthermore because of the exact correlation of this method with retrograde pyelography or percutaneous intrapelvic perfusion pressure measurement, the significance of these invasive investigations has been rendered less important. (orig.) [de

Can computed tomography volumetry of the renal cortex replace MAG3-scintigraphy in all patients for determining split renal function?

Science.gov (United States)

Houbois, Christian; Haneder, Stefan; Merkt, Martin; Morelli, John N; Schmidt, Matthias; Hellmich, Martin; Mueller, Roman-Ulrich; Wahba, Roger; Maintz, David; Puesken, Michael

2018-06-01

The current gold standard for determination of split renal function (SRF) is Tc-99m-mercapto-acetyltriglycin (MAG3) scintigraphy. Initial studies comparing MAG3-scintigraphy and CT-based renal cortex volumetry (RCV) for calculation of SRF have shown similar results in highly selected patient collectives with normal renal function (i.e. living kidney donors). This study aims to compare MAG3-scintigraphy and CT-RCV within a large unselected patient collective including patients with impaired renal function. For this assessment, 279 datasets (131 men, 148 women; mean age: 54.2 ± 12.9 years, range: 24-84 years) of patients who underwent MAG3-scintigraphy and contrast-enhanced abdominal CT within two weeks were retrospectively analyzed. Two independent readers assessed the CT-RCV in all CT datasets using a semi-automated volumetry tool. The MAG3-scintigraphy and CT-RCV methods were compared, stratified for the eGFR. Statistical analysis included descriptive statistics as well as inter- observer agreement. The absolute mean difference between the percentage contribution of the left and the right kidneys in total MAG3-clearance was 8.6%. Independent of eGFR, an overall sufficient agreement between both methods was established in all patients. A relatively small, tolerable systemic error resulted in an underestimation (max. 2%) of the left renal contribution to overall RCV. The results demonstrate that CT-RCV is a potential clinical replacement for MAG3-scintigraphy for calculation of SRF: CT-RCV demonstrates clinically tolerable differences with MAG3-scintigraphy, independent of patient eGFR. The relative complexity of the RCV method utilized is a potential limitation and may have contributed to the acceptable but only fair to moderate level of intra-reader reliability. Copyright © 2018 Elsevier B.V. All rights reserved.

Automatic quantitative renal scintigraphy

International Nuclear Information System (INIS)

Valeyre, J.; Deltour, G.; Delisle, M.J.; Bouchard, A.

1976-01-01

Renal scintigraphy data may be analyzed automatically by the use of a processing system coupled to an Anger camera (TRIDAC-MULTI 8 or CINE 200). The computing sequence is as follows: normalization of the images; background noise subtraction on both images; evaluation of mercury 197 uptake by the liver and spleen; calculation of the activity fractions on each kidney with respect to the injected dose, taking into account the kidney depth and the results referred to normal values; edition of the results. Automation minimizes the scattering parameters and by its simplification is a great asset in routine work [fr

Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis

International Nuclear Information System (INIS)

Jaksic, E.; Bogdanovic, R.; Artiko, V.

2011-01-01

Assessment of the first febrile urinary tract infection (UTI) in children has been the subject of debate for many years. Diagnosis of acute pyelonephritis (APN) is usually based on clinical and biological data. The clinical usefulness of early Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy remains controversial, although it may influence the type and duration of treatment. The aim of this study was to assess the role of initial cortical scintigraphy in the detection of early renal parenchymal damage in children highly suspected of having APN and to compare the scintigraphic findings with selected clinical/laboratory parameters and ultrasonography. A prospective study was conducted in 34 infants and young children (18 boys, 16 girls), aged 1.5-36 months (mean 9.8±8.7 months), hospitalized with a first episode of clinically suspected APN. Within the first 5 days after admission, Tc-99m DMSA renal scintigraphy, ultrasonography (US), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell count (WBC) and urine analyses were performed. DMSA scintigraphy showed changes consistent with APN in 27/34 (79%) patients, with a mean age of 10.9 months, including 12 males (44%) and 15 (56%) females. Out of 9 febrile children with negative urine culture and supportive evidence of UTI, scintigraphy showed parenchymal involvement in 8 children (24% in the whole group, 30% in scintigraphically documented APN). There were no statistically significant correlations between the frequency or size of the initial scintigraphic abnormalities and age, sex, body temperature, CRP levels or ESR. A CRP level of >54 mg/L and a WBC of >13,300/mm 3 had sensitivities of 56 and 59% and specificities of 86 and 71%, respectively. US showed changes consistent with APN in 7/34 (21%) in the whole group and in 7/27 (26%) patients with positive cortical scan (p<0.05). Initial DMSA renal scintigraphy is a sensitive method for the early diagnosis of APN in young children and is

Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

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Brader, Peter; Riccabona, Michael [Medical University Graz, Division of Pediatric Radiology, Department of Radiology, Graz (Austria); Schwarz, Thomas [Medical University Graz, Division of Nuclear Medicine, Department of Radiology, Graz (Austria); Seebacher, Ursula [Medical University Graz, Department of Pediatric Surgery, Graz (Austria); Ring, Ekkehard [Medical University Graz, Department of Pediatrics, Graz (Austria)

2008-12-15

The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) {sup 99m}Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

International Nuclear Information System (INIS)

Brader, Peter; Riccabona, Michael; Schwarz, Thomas; Seebacher, Ursula; Ring, Ekkehard

2008-01-01

The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) 99m Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

Tc-99m DTPA perfusion scintigraphy and color coded duplex sonography in the evaluation of minimal renal allograft perfusion

International Nuclear Information System (INIS)

Bair, H.J.; Platsch, G.; Wolf, F.; Guenter, E.; Becker, D.; Rupprecht, H.; Neumayer, H.H.

1997-01-01

Aim: The clinical impact of perfusion scintigraphy versus color coded Duplex sonography was evaluated, with respect to their potential in assessing minimal allograft perfusion in vitally threatened kidney transplants, i.e. oligoanuric allografts suspected to have either severe rejection or thrombosis of the renal vein or artery. Methods: From July 1990 to August 1994 the grafts of 15 out of a total of 315 patients were vitally threatened. Technetium-99m DTPA scintigraphy and color coded Duplex sonography were performed in all patients. For scintigraphic evaluation of transplant perfusion analog scans up to 60 min postinjection, and time-activity curves over the first 60 sec after injection of 370-440 MBq Tc-99m diethylenetriaminepentaacetate acid (DTPA) were used and classified by a perfusion score, the time between renal and iliac artery peaks (TDiff) and the washout of the renogram curve. Additionally, evaluation of excretion function and assessment of vascular or urinary leaks were performed. By color coded Duplex sonography the perfusion in all sections of the graft as well as the vascular anastomoses were examined and the maximal blood flow velocity (Vmax) and the resistive index (RI) in the renal artery were determined by means of the pulsed Doppler device. Pathologic-anatomical diagnosis was achieved by either biopsy or post-explant histology in all grafts. Results: Scintigraphy and color coded Duplex sonography could reliably differentiate minimal (8/15) and not perfused (7/15) renal allografts. The results were confirmed either by angiography in digital subtraction technique (DSA) or the clinical follow up. Conclusion: In summary, perfusion scintigraphy and color coded Duplex sonography are comparable modalities to assess kidney graft perfusion. In clinical practice scintigraphy and colorcoded Doppler sonography can replace digital subtraction angiography in the evaluation of minimal allograft perfusion. (orig.) [de

Renal function study assessed by 99mTc-DMSA renal scintigraphy before and after PNL

International Nuclear Information System (INIS)

Sakurai, Masaki; Hioki, Takuichi; Okuno, Toshiyuki; Sugimura, Yoshiki; Yamakawa, Kensuke; Yanagawa, Makoto; Tajima, Kazuhiro; Tochigi, Hiromi; Kawamura, Juichi

1990-01-01

99m Tc-DMSA renal scintigraphy was carried out in 54 patients with unilateral renal stones before and after PNL. Four to 8 weeks after PNL the DMSA renal uptake significantly decreased to 17.2±6.0% from 18.2±6.7% before PNL. DMSA renal uptake did not change in the contralateral side. Since in some patients changes in the DMSA renal uptake of 5-7% were observed after PNL not only in the PNL side but also in the contralateral side, the renal function was assessed by the formula: DMSA renal uptake in the PNL side/DMSA renal uptake in the contralateral side, and the change of this ratio was evaluated in 44 patients, in whom the renal DMSA uptake in the PNL side was less than two times that in the contralateral side. The DMSA renal uptake ratio decreased to 95.6±8.7% from the base line 4-8 weeks after PNL. This change was statistically significant. Some functional risks such as massive bleeding with PNL, the fever after PNL and the number of nephrostomy tract did not affect the decrease in the renal function. In 29 patients in whom renal function was reevaluated one year after PNL, the DMSA renal uptake ratio significantly decreased to 94.2±9.6% from the base line 4-8 weeks after PNL. But the ratio significantly improved to 99.6±11.6% about one year after PNL. In two patients with a cold area on the renal image, the renal function of the operated side still remained at about 80% levels from the base line even one year after PNL. It is concluded that although renal function slightly decreased 4-8 weeks after PNL, it is expected to improve within one year after PNL. But in the case with a cold area on the renal image, the complete functional recovery would not be expected. 99m Tc-DMSA renal scintigraphy is a useful adjunct to evaluate the renal function before and after PNL. (author)

Dynamic renal scintigraphy at hydronephrosis

International Nuclear Information System (INIS)

Petrov, T.; Chukov, I.; Svrakova, E.

1998-01-01

The aim of the study was to estimate the clinical relevance and accuracy of dynamic renal scintigraphy (DRS) in case of obstructed kidneys as hydronephrosis is among the complications at different renal diseases, like nephrolithiasis and urolithiasis. Twenty-one patients mainly with unilateral hydronephrosis were studied. DRS with 99m Tc-MAG3 or 99m Tc-EC was done and quantitative parameters of the morphological and functional status of every kidney were assessed. At 24 % of the patients accumulation curves typical for obstructed by hydronephrosis kidneys were obtained. At 38 % the type of renograms of the affected kidneys was intermediate one, closer to that at the cases with nephrosclerosis, with lower uptake and severe parenchymal changes. The rest 38 % of the cases showed normal renograms or slightly delayed downslope. DRS is a very precise and sensitive method for evaluation of the degree of kidney damage in cases with hydronephrosis

Renal dynamic functional scintigraphy in children with congenital urinary tract anomalies

International Nuclear Information System (INIS)

Cui Ruixue; Zhou Qian

2000-01-01

Objective: To clarify the characteristics of renal scintigraphy in children with various congenital urinary tract anomalies and to evaluate their clinical significance. Methods: 51 children with congenital urinary tract anomalies were studied by 99 Tc m -DTPA renal dynamic functional scintigraphy (RDFS)). Among them, 8 cases were studied by diuretic renography in addition. Results: RDFS provided: 1) Both the morphological information of anomalies and the split renal function. 2) Localization of the site of urinary tract obstruction. In case of pelviureteric junction obstruction, the hydronephrosis was usually severe but with normal size ureter, whereas in ureterovesical junction obstruction the hydronephrosis was less severe but with dilatation of ureter. In case of lower urinary tract obstruction, the hydronephrosis and hydroureter were bilateral. Diuretic renography differentiated obstructive from non-obstructive hydronephrosis. By comparing pre-and post operative studies, it was easy to evaluate the recovery of renal function. Conclusions: RDFS is a valuable modality for giving both anatomical and functional information in children with congenital urinary tract anomalies and the authors suggest it should be used more popularly in Pediatrics

The grade of vesicoureteral reflux in voiding cystourethrography: comparison with ultrasonography and Tc99m-DMSA renal scintigraphy

International Nuclear Information System (INIS)

1998-01-01

To evaluate the prevalence of abnormalities seen on sonography and renal scintigraphy, according to the grade of vesicoureteral reflux (VUR) on in voiding cystourethrography(VCUG). One hundred and forty-nine patients (age range: 1 months-10 years) with urinary tract infection underwent sonography, VCUG, and renal scans, and 32 showed VUR on VCUG. We retrospectively evaluated the frequency and characteristic findings of sonographic abnormalities according to the grade of VUR, and also the frequency of cortical defects seen on renal scans of 32 patients with VUR. The remaining 117 patients without VUR were also evaluated for the frequency of abnormal findings seen on sonography and renal scans. Among 32 patients (49 kidneys) with VUR, abnormal findings were not detected in 17 (29 kidneys) on sonography; thus, findings were abnormal in 15 (20 kidneys, 41%). Among these 20 kidneys, renal calyceal and/or pelvic dilatation and dilatation of distal ureter were seen in 11, all of which were grade 4-5 VUR. Renal pelvic dilatation only was noted in eight kidneys; two were grade 1-3 and six were grade 4-5 VUR. Nineteen patients (24 kidneys, 49%) showed focal cortical defects on renal scintigraphy. Six kidneys were grade 1-3, and 18 kidneys were grade 4-5 VUR. Of 117 patients without VUR, 34 patients (29%) showed renal pelvic dilatation on sonography and in 14 patients (12%), cortical defects were seen on renal scintigraphy. Among 32 patients with VUR, 41% showed abnormal sonographic findings and in 49%, cortical defects were seen on renal scintigraphy. With a higher grade of VUR, the prevalence of abnormalities increased on both sonography and renal scintigraphy. Sonographic demonstration of renal caliceal and/or pelvic dilatation associated with ipsilateral distal ureteric dilatation was the characteristic finding in high grade VUR.=20

Sequential Tc-99m gluconate scintigraphy following renal transplantation: clinical study in twenty-five cases

International Nuclear Information System (INIS)

Lucsko, M.; Akerman, M.; Tovar, G. de; Aubert, P.; Chaignon, M.; Le Duc, A.; Guedon, J.; Beaufils, H.

1981-01-01

The value of sequential Tc-99m gluconate scintigraphy investigations following renal transplantation is illustrated with reference to 25 cases. Scintigraphy images are recorded on instantaneous photographic paper and radiological film (early vascular images, early and late static images). Results in various clinical situations are analysed: functioning renal transplants, acute postoperative tubulopathy, reversible acute reject hyperacute reject, chronic reject, lower pole arterial thrombosis, renal artery stenosis, ruptured excretory pathway. Isotopic exploration of this type is simple to conduct, and can be repeated without provoking excessive irradiation of the organism. Comparative analysis of several scintigraphic recordings from the same patient is of diagnostic value in cases of acute rejection, renal artery thrombosis, and ruptured excretory pathways. Renal artery stenosis is poorly demonstrated by this type of investigation [fr

Value of renal scintigraphy with captopril test in the exploration of renovascular hypertension: Case report

International Nuclear Information System (INIS)

Ghfir, I.; Berehou, F.Z.; Ben Rais, N.

2007-01-01

Introduction Dynamic renal scintigraphy with 99m Tc-DTPA and captopril test is a non-invasive functional method for the diagnosis of renovascular hypertension. It allows differentiating between hypertension induced by renal arterial stenosis from primary arterial hypertension with an incidental stenosis. Case report A 14-year-old girl, without previous medical history, developed a severe arterial hypertension with cephalalgia and ears buzzing. Auscultation revealed a murmur in the left lumbar pit. Renal angiography objectified a stenosis of the infra renal aorta due to a circumferential parietal thickening associated to renal arteries stenosis more marked in the left side. Dynamic renal scintigraphy after administration of captopril highlighted a marked collapse of the rate of tracer uptake exceeding 40% on the left side with an increase in the time of collecting on the right side testifying a frankly positive test prevailing on the left. A transluminal angioplasty of the left renal artery and a revascularization surgery on the right side were carried out. The evolution was marked by an improvement of blood pressure figures. Discussion Dynamic renal scintigraphy using 99m Tc-DTPA with captopril test constitutes a non-invasive process with a low dosimetry for the patients. Its principal goal is to affirm the role of renovascular stenosis in the origin of arterial hypertension and to determine which hypertensive patients with renal arterial stenosis can be treated successfully by surgical or endoscopic revascularization of the kidney. (authors)

99mTc-DMSA renal scintigraphy in children with urinary tract infections and vesicouretheric reflux

International Nuclear Information System (INIS)

Ajdinovic, B.A.; Baskot, B.B.; Spaic, R.S.; Markovic, S.M.

2002-01-01

Aim: Comparison of results 99mTc-DMSA renal scintigraphy in children with urinary tract infections (UTI) and vesicouretheric reflux (VUR) to results in children with UTI without VUR. Material and Methods: 99mTc-DMSA renal scintigraphy was done in 170 children with UTI, in 88 of whom were presented VUR, proved by micturating cysto-urethrography (MCU). In 13 of them grade of VUR was I, in 30 grade II, in 23 grade was III, in 17 IV, and in 5 grade of was V. In 82 children with UTI, VUR could not be detected by MCU. Findings of 99mTc-DMSA renal scintigraphy were classified as: 1. normal, 2. probably normal, 3. equivocal, 4. probably abnormal, 5. abnormal. Results:In patients with UTI and VUR incidence of abnormal findings was 49% (43/88), normal 43% (38/88), and equivocal findings were 8% (7/88). The highest abnormal finding incidence was found in 5 patients with VUR grade V (100%). In VUR grade IV incidence of abnormal findings was 71%. In patients with VUR grade I 77% findings were normal, in patients with VUR grade II 53% findings were normal, and in patients with VUR grade III 30% findings were normal. In patients with UTI without VUR incidence of abnormal findings was 10% (8/82), normal 83% (68/82), and equivocal findings were 7% (6/82). Conclusion: In patients with UTI and VUR incidence of abnormal 99mTc-DMSA renal scintigraphy findings was significantly higher, particularly in children with higher grade of VUR, than in patients with UTI without VUR (p<0,001). Results of our study confirmed importance of 99mTc-DMSA renal scintigraphy in investigation of children with UTI

Infarction of renal transplant with extrarenal excretion of Tc-99m MAG3 demonstrated by renal scintigraphy

International Nuclear Information System (INIS)

Lim, Seok Tae; Kim, Min Woo; Sohn, Myung Hee

2003-01-01

A 38-year-old woman with end stage renal disease received a living related donor-renal transplant to the right iliac fossa. She developed anuria a week later. Tc-99m MAG 3 renal scintigraphy demonstrated no perfusion, uptake, or excretion of the radioactive tracer from the renal transplant. The expected area of the renal allograft appeared as a photopenic area with increased rim activity. The gallbladder and bowel activities were observed on delayed images at 24 hours. There was no blood flow within the renal artery on renal doppler examination. This case shows total absence of perfusion and function in the infarcted renal transplant with extrarenal excretion of Tc-99m MAG 3 caused by acute renal artery thrombosis

Sequential Scintigraphy in Renal Transplantation

Energy Technology Data Exchange (ETDEWEB)

Winkel, K. zum; Harbst, H.; Schenck, P.; Franz, H. E.; Ritz, E.; Roehl, L.; Ziegler, M.; Ammann, W.; Maier-Borst, W. [Institut Fuer Nuklearmedizin, Deutsches Krebsforschungszentrum, Heidelberg, Federal Republic of Germany (Germany)

1969-05-15

Based on experience gained from more than 1600 patients with proved or suspected kidney diseases and on results on extended studies with dogs, sequential scintigraphy was performed after renal transplantation in dogs. After intravenous injection of 500 {mu}Ci. {sup 131}I-Hippuran scintiphotos were taken during the first minute with an exposure time of 15 sec each and thereafter with an exposure of 2 min up to at least 16 min.. Several examinations were evaluated digitally. 26 examinations were performed on 11 dogs with homotransplanted kidneys. Immediately after transplantation the renal function was almost normal arid the bladder was filled in due time. At the beginning of rejection the initial uptake of radioactive Hippuran was reduced. The intrarenal transport became delayed; probably the renal extraction rate decreased. Corresponding to the development of an oedema in the transplant the uptake area increased in size. In cases of thrombosis of the main artery there was no evidence of any uptake of radioactivity in the transplant. Similar results were obtained in 41 examinations on 15 persons. Patients with postoperative anuria due to acute tubular necrosis showed still some uptake of radioactivity contrary to those with thrombosis of the renal artery, where no uptake was found. In cases of rejection the most frequent signs were a reduced initial uptake and a delayed intrarenal transport of radioactive Hippuran. Infarction could be detected by a reduced uptake in distinct areas of the transplant. (author)

Renal scintigraphy in children with first febrile urinary tract infection

International Nuclear Information System (INIS)

Duarte Perez, Maria Caridad; Guillen Dosal, Ana; Martinez Silva, Magaly; Hernandez Robledo, Ernesto

2012-01-01

The urinary tract infection is one of the most frequent bacterial infections in the childhood. Two hundred eleven children diagnosed as first febrile urinary tract infection patients were studied and performed Tc-DMSA renal scintigraphy in the acute phase of infection. The results were correlated to the duration and intensity of the fever before the diagnosis, to the acute phase reactants (hemogram, erythrosedimentation and reactive-C protein) and to the results of imaging studies (renal ultrasound and mictional uretrocystography)

Quantitative bone scintigraphy in evaluating treatment of renal osteodystrophy

Energy Technology Data Exchange (ETDEWEB)

de Graaf, P.; Schicht, I.M.; te Velde, J.; Pauwels, E.K.J.; Kleiverda, K.; de Graeff, J. (Rijksuniversiteit Leiden (Netherlands). Academisch Ziekenhuis)

1983-01-01

The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 percent). Osteoid excess was reduced in 13 patients (68 percent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 percent). Changes in the TSA correlated significantly with the changes in the biochemical and histological parameters of hyperparathyroidism, but not with the changes in osteoid excess. These results indicate that, during treatment of renal osteodystrophy, changes in (quantitative) bone scintigraphy primarily indicate changes in the degree of hyperparathyroidism.

Monitoring renal function during biphosphonate treatment in patients with bone metastases - role of dynamic kidney scintigraphy

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Chavdarova, L.; Tzonevska, A.

2015-01-01

Full text: Biphosphonates (BP) are very effective in treatment of bone metastatic disease. Their renal excretion defines one of the major side effects - nephrotoxicity. Glomerular filtration rate (GFR) is a basic parameter for its early detection but clinical practice often uses only serum creatinine. Aim of our retrospective study is to assess the role of dynamic kidney scintigraphy (DKS) and the estimated during it GFR in BP-treated patients with bone metastatic disease. 61 patients (53 female, 8 male), aged 33-82, with biphosphonate-treated bone metastases from breast (n53), lung (n1) and prostate (n7) cancer were enrolled for the period 27.04.2012-14.04.2015. Overall 77 studies were made, in 13 patients more than one. GFR was assessed in 57 studies. Results were compared with serum creatinine. All patients with elevated creatinine showed low GFR and decreased renal function at DKS. With normal creatinine and decreased GFR: in 31 studies kidney function was reduced, in 14 function was normal but kidney scintigraphic appearance was disturbed- mostly as in diffuse parenchymal disease. In 5 studies GFR was normal and renal function decreased. In 3 studies both parameters were normal. Zoledronic acid was changed with denosumab in 2 patients because of worsened function and strongly reduced GFR, in one patient BP was stopped after DKS. In 3 patients the interval between BP was extended because of affected renal function. GFR is more sensitive than serum creatinine levels and changes in nephrographic curves. Dynamic kidney scintigraphy is a functional method directing clinical reaction to preserve renal function

Comparative study between intravenous urography and renal scintigraphy with DMSA for the diagnosis of renal scars in children with vesicoureteral reflux

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Clarissa B. Araújo

2003-12-01

Full Text Available PURPOSE: To assess the value of intravenous urography (IVU in detecting and grading the renal scar, comparing its results with those of scintigraphy with dimercaptosuccinic acid (DMSA. MATERIALS AND METHODS: The study included 43 children investigated by DMSA and IVU, who had vesicoureteral reflux diagnosed and classified through voiding cystourethrography. RESULTS: Among the kidneys with reflux, there was agreement between the results of DMSA and IVU concerning the presence and the absence of scars in 82.4% of the cases. Based on the results obtained, IVU would have a sensitivity of 66.6%, specificity of 94.4%; accuracy of 82.5%; positive predictive value (PPV of 90% and negative predictive value (NPV of 79%, when compared with DMSA results. Our data also confirm the close relation between the reflux grade and the presence of renal scar, since 75% of the kidneys with grade IV and V reflux presented scars. In relation to the grading of nephropathy, in 78% of patients the classification of the scar by both methods was identical. The highest disagreement was verified in the group with segmental scar on DMSA, where 41.6% of the kidneys were classified as normal on IVU. CONCLUSION: The data obtained confirm that the scintigraphy with DMSA is essential in the investigation of patients with renal scar, and cannot be replaced by IVU, due to its low sensitivity and lower ability of satisfactory grading.

Renal function study by sup(99m)Tc-DMSA renal scintigraphy in non-obstructive upper urinary tract infection

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Kawamura, Juichi; Itoh, Hitoshi; Wang, Pan-Chin; Hosokawa, Shinichi; Yoshida, Osamu

1979-01-01

Kidney function study was carried out in 90 patients with non-obstructive upper urinary tract infection using sup(99m)Tc-DMSA (dimercaptosuccinic acid) renal scintigraphy. sup(99m)Tc-DMSA renal scintigram demonstrated well pyelonephritic cortical lesions which were not easily visualized on IVP. A variety of sup(99m)Tc-DMSA renal uptake paralleled the grading of pyelonephritic changes in IVP, however, there was a discrepancy between some of grade II pyelonephritic changes in reflux kidneys and DMSA renal uptake. This may be partly attributed to hydrodynamic effects of VUR in addition to inflammatory changes. The severity of reflux and changes in pelviocaliceal system on VCG also paralleled DMSA renal uptake in reflux kidneys. A ratio of sup(99m)Tc-DMSA renal uptake in the healthy side to that in pathological side was observed in 23 cases with VUR before and after the anti-VUR operation was performed. In patients with more than 3.5 of preoperative DMSA uptake ratio, there were few increments postoperatively in kidney functions of the pathological side, while the contralateral healthy kidney showed a compensatory increase in kidney function. This DMSA renal uptake ratio between healthy and pathological side seems to be one of predictable determinants for postoperative recovery of the pathological side. Thus, by comparing the DMSA uptake between right and left kidney in the chronic course or pre- and postoperative periods, an effect of renal function in the pathological side on that in the healthy side was investigated from the point of renal counterbalance. (author)

Influences of renal stone surgeries on renal function; Evaluation of renal function with sup 99m Tc-DMSA renal scintigraphy

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Katayama, Yasushi (Niigata Univ. (Japan). School of Medicine)

1991-10-01

From 1984 to 1990, {sup 99m}Tc-DMSA renal scintigraphy was performed before and after nephrolithotomy (15 cases), pyelolithotomy (15 cases), percutaneous nephrolithotripsy (PNL: 15 cases) and extracorporeal shock wave lithotripsy (ESWL: 16 cases, 17 kidneys) in order to evaluate of influences of renal stone surgeries on split renal function. DMSA renal uptake change ratio of treated kidneys of nephrolithotomy (-24.94{+-}5.60%) was significantly lower than that of PNL (-0.06{+-}3.92%), pyelolithotomy (-4.08{+-}4.79%) (p<0.01) and ESWL (-7.72{+-}3.87%) (p<0.05). The average change ratios of contralateral kidneys were as follows: PNL 4.80{+-}4.21% nephrolithotomy 4.67{+-}4.73%, pyelolithotomy -1.46{+-}5.39% and ESWL -2.02{+-}4.44%. One to 3 weeks after PNL, the cold area on the renal image was found in 10 (66.7%) of 15 cases. In cases of ESWL, DMSA renal uptake decreased even 4-10 weeks (mean 7 weeks) after treatment. In conclusion, possibility of deterioration of renal function after ESWL was suggested. (author).

Renal function assessed by 99mTc-DMSA scintigraphy before and after percutaneous nephrostolithotripsy (PNL)

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Sakurai, Masaki; Hioki, Takuichi; Kitano, Tokio; Nakagawa, Tsuyoshi; Yamaguchi, Nobuo; Kawamura, Juichi

1988-01-01

99m Tc-DMSA scintigraphy was carried out in 43 patients with unilateral renal stones before and after PNL. This study was repeated about one year after PNL in 12 patients. DMSA renal uptake was calculated two hours after injection of 99m Tc-DMSA. The study was performed using the dual type gamma camera. The renal function was assessed by the formula : 99m Tc-DMSA renal uptake of the operated side/ 99m Tc-DMSA renal uptake of the contralateral side. The change (ratio before/after PNL) x 100 was regarded as the percent change of renal function. Local abnormalities in the 99m Tc-DMSA renal scintigram after PNL were observed in 15 patients. The renal function decreased significantly to 95.8 ± 8.7 % from the base line 4 - 8 weeks after PNL. The renal function improved significantly to 98.6 ± 14.7 % from 92.1 ± 11.9 % in 12 patients about one year after PNL. It is concluded that although the renal function slightly decreased 4 - 8 weeks after PNL, it is expected to improve within 1 year after PNL. 99M Tc-DMSA scintigraphy is a useful adjunct to evaluate the renal function before and after PNL. (author)

Prediction of response to revascularization in patients with renal artery stenosis by Tc-99m-ethylene dicysteine captopril scintigraphy

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Ugur, O.; Ergun, E.L.; Peksoy, I.; Cekirge, S. [Hacettepe Univ., Ankara (Turkey). Medical School; Serdengecti, M.; Karacalioglu, O.

1999-04-01

The aim of the present study was to assess the predictive value of captopril scintigraphy with the new renal agent {sup 99m}Tc-ethylene dicysteine ({sup 99m}Tc-EC) for post-interventional improvement in blood pressure. Twelve patients who had persistently high blood pressure with previous demonstration of various degrees of renal artery lesion on angiography were included into the study. Baseline and captopril scintigraphies were performed on the same day at 4 hour intervals after the injection of 74 and 296 MBq of {sup 99m}Tc-EC, respectively. All patients had percutaneous transluminal angioplasty (PTA), and improvement in blood pressure was evaluated 3-6 months after the intervention. {sup 99m}Tc-EC captopril scintigraphy successfully predicted a positive or negative outcome in 11 of 12 patients. In one patient with captopril induced renal function deterioration, scintigraphy failed to predict post-interventional response. Our preliminary findings showed that {sup 99m}Tc-EC captopril scintigraphy can be used to determine patients who will benefit from revascularization. (author)

Iliac renal ectopia explored by {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA scintigraphy. Report of one case; Ectopie renale iliaque exploree par scintigraphie au {sup 99m}Tc-DTPA et au {sup 99m}Tc-DMSA. A propos d'un cas

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Ghfir, I.; Ben Rais, N. [Hopital Ibn Sina, CHU de Rabat, Service de Medecine Nucleaire de Rabat (Morocco)

2008-11-15

Introduction Renal ectopia is a malposition by anomaly of migration during the embryonic development. It can be high, low or crossed. Association with an obstructive malformation is rather frequent. The objective of this work is to highlight the interest of {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA scintigraphy in the exploration of this type of malformation through the observation of a patient presenting an iliac right renal ectopia associated with an ureteral-pelvic junction syndrome. Observation A 38-year-old patient with an ureteral-pelvic junction syndrome on a right iliac renal ectopia revealed by intravenous urography. The dynamic renal scintigraphy using {sup 99m}Tc-DTPA with furosemide test evidenced an organic obstruction in the right urinary tract with a right renal function estimated at 40% on the {sup 99m}Tc-DMSA scintigraphy. A right pyelo-plasty was carried out. The evolution was marked by the disappearance of pain and a remarkable improvement of the permeability of the right urinary tract on the follow-up scintigraphy. Discussion Renal ectopia is not an unfrequent urinary malformation. It is generally low, pelvic or iliac. Association with an ureteral-pelvic junction obstruction is rather frequent. In this purpose, renal scintigraphy intervenes as a means of functional exploration, with low ionizing radiation and non-invasive to assess the permeability of the urinary tracts of the ectopic kidney and to appreciate the relative renal function. This contributes to the orientation of diagnosis and the improvement of therapeutic strategy.

Renal sequence and functional series scintigraphy with o131I-hippuric acid in patients with diabetes mellitus

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Kempken, K.; Heidenreich, P.; Langhammer, H.; Bottermann, P.; Pabst, H.W.; Technische Univ. Muenchen

1974-01-01

The appearance of disturbances of the renal function in diabetes mellitus is a function of the quality of the therapy and control of the patient, the duration of the disease, and the age of manifestation as well as other factors such as the lipide metabolism and unspecific infections. Such infections often lead to pyelonephritis which may be regarded as a real complication and in particular so in connection with the late diabetic syndrome (Lundbaek), i.e. especially in diabetics of advanced age. Apart from the true diabetic nephropathia, gromerulosclerosis, which is more frequently found in younger patients, arterio-arteriolosclerosis of the kidneys and tubular atrophies due to interstitial deposits of proteins and glycogens should also be mentioned. An assessment of the renal function in all stages of diabetes mellitus and in hypertonicity was carried out with the aid of renal sequential and functional series scintigraphy. No similar investigations have been reported in the relevant literature. (orig./AK) [de

Baseline Tc-99m DTPA renal scintigraphy as a predictor of outcome in children with urinary tract infection

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Yun, J. G.; An, Y. S.; Lee, M. H.; Cho, C. W.; Yun, S. N.; Pai, G. S [Ajou University Medical Center, Suwon (Korea, Republic of)

2004-07-01

Tc-99m DTPA renal scintigraphy is useful in detecting urinary tract obstruction in patients with urinary tract infection (UTI). We evaluated the prognostic significance of baseline Tc-99m DTPA renal scintigraphy in children with UTI. Among children, who underwent both baseline/follow-up Tc-99m DMSA scintigraphies and baseline Tc-99m DTP A scintigraphy for evaluation of UTI, 32 patients with unilateral cortical defects on baseline Tc-99m DMSA scintigraphy were included in the study. The outcome of cortical defects was evaluated on follow-up Tc-99m DMSA scintigraphy by visual analysis. ROIs were drawn on the Tc-99m DPTA scintigraphy for calculation of ipsilateral to contralateral kidney ratio (ICR) at blood flow phase (< 60s, BFP) and cortical uptake phase (1-5 min, CUP). Median follow-up period of Tc-99m DMSA scintigraphy was 3.2 months (1.4 - 14 months). There were 24 patients with healing cortical defects and 8 with cortical scarring. Average ICRs of patients with healing defects were 1.11 {+-} 0.18 (0.44 - 1.57) at BFP and 0.97 {+-} 0.21 (0.31 - 1.28) at CUP, while those of patients with cortical scarring were 0.97 {+-} 0.47 (0.21 - 0.89) at BFP and 0.75 {+-} 0.49 (0.19 - 1.65) at CUP. ICR more than 0.9 was determined as a good prognostic indicator. The sensitivity, specificity, positive predictive value, and negative predictive value of ICR was 83.3%, 100%, 100% and 66.7% at BFP, and 79.0%, 62.5%, 86.4% and 50.0% at CUP. Ipsilateral to contralateral kidney ratio on baseline Tc-99m DPTA renal scintigraphy, especially at blood flow phase, is helpful in predicting outcome of children with UTI.

Baseline Tc-99m DTPA renal scintigraphy as a predictor of outcome in children with urinary tract infection

International Nuclear Information System (INIS)

Yun, J. G.; An, Y. S.; Lee, M. H.; Cho, C. W.; Yun, S. N.; Pai, G. S

2004-01-01

Tc-99m DTPA renal scintigraphy is useful in detecting urinary tract obstruction in patients with urinary tract infection (UTI). We evaluated the prognostic significance of baseline Tc-99m DTPA renal scintigraphy in children with UTI. Among children, who underwent both baseline/follow-up Tc-99m DMSA scintigraphies and baseline Tc-99m DTP A scintigraphy for evaluation of UTI, 32 patients with unilateral cortical defects on baseline Tc-99m DMSA scintigraphy were included in the study. The outcome of cortical defects was evaluated on follow-up Tc-99m DMSA scintigraphy by visual analysis. ROIs were drawn on the Tc-99m DPTA scintigraphy for calculation of ipsilateral to contralateral kidney ratio (ICR) at blood flow phase (< 60s, BFP) and cortical uptake phase (1-5 min, CUP). Median follow-up period of Tc-99m DMSA scintigraphy was 3.2 months (1.4 - 14 months). There were 24 patients with healing cortical defects and 8 with cortical scarring. Average ICRs of patients with healing defects were 1.11 ± 0.18 (0.44 - 1.57) at BFP and 0.97 ± 0.21 (0.31 - 1.28) at CUP, while those of patients with cortical scarring were 0.97 ± 0.47 (0.21 - 0.89) at BFP and 0.75 ± 0.49 (0.19 - 1.65) at CUP. ICR more than 0.9 was determined as a good prognostic indicator. The sensitivity, specificity, positive predictive value, and negative predictive value of ICR was 83.3%, 100%, 100% and 66.7% at BFP, and 79.0%, 62.5%, 86.4% and 50.0% at CUP. Ipsilateral to contralateral kidney ratio on baseline Tc-99m DPTA renal scintigraphy, especially at blood flow phase, is helpful in predicting outcome of children with UTI

Value of renal scintigraphy with captopril test in the exploration of renovascular hypertension: Case report; Apport de la scintigraphie renale avec test au captopril dans l'exploration de l'hypertension arterielle renovasculaire: a propos d'un cas

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Ghfir, I.; Berehou, F.Z.; Ben Rais, N. [Centre Hospitalier Universitaire de Rabat, Hopital Ibn-Sina, Service de Medecine Nucleaire (Morocco)

2007-08-15

Introduction Dynamic renal scintigraphy with {sup 99m}Tc-DTPA and captopril test is a non-invasive functional method for the diagnosis of renovascular hypertension. It allows differentiating between hypertension induced by renal arterial stenosis from primary arterial hypertension with an incidental stenosis. Case report A 14-year-old girl, without previous medical history, developed a severe arterial hypertension with cephalalgia and ears buzzing. Auscultation revealed a murmur in the left lumbar pit. Renal angiography objectified a stenosis of the infra renal aorta due to a circumferential parietal thickening associated to renal arteries stenosis more marked in the left side. Dynamic renal scintigraphy after administration of captopril highlighted a marked collapse of the rate of tracer uptake exceeding 40% on the left side with an increase in the time of collecting on the right side testifying a frankly positive test prevailing on the left. A transluminal angioplasty of the left renal artery and a revascularization surgery on the right side were carried out. The evolution was marked by an improvement of blood pressure figures. Discussion Dynamic renal scintigraphy using {sup 99m}Tc-DTPA with captopril test constitutes a non-invasive process with a low dosimetry for the patients. Its principal goal is to affirm the role of renovascular stenosis in the origin of arterial hypertension and to determine which hypertensive patients with renal arterial stenosis can be treated successfully by surgical or endoscopic revascularization of the kidney. (authors)

Diagnostic use of angiotensin converting enzyme (ACE)-inhibited renal scintigraphy in the identification of selective renal artery stenosis in the presence of multiple renal arteries: A case report

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Morton, K.A.; Rose, S.C.; Haakenstad, A.O.; Handy, J.E.; Scuderi, A.J.; Datz, F.L.

1990-01-01

In patients with renovascular hypertension, it is unknown whether the angiotensin converting enzyme-(ACE) inhibited renal scan will identify stenosis of a segmental branch of a single renal artery or of an accessory artery where multiple renal arteries are present. Since multiple renal arteries may be present in approximately 25% of all individuals, it will be important to establish whether the ACE-inhibited renal scan is useful in this population. We report a case of stenosis involving a renal artery in a patient with multiple renal arteries, successfully identified by ACE-inhibited renal scintigraphy

Correlation of immunosuppression scheme with renal graft complications detected by dynamic renal scintigraphy; Correlacao do esquema de imunossupressao com complicacoes pos-operatorias de transplantes renais atraves do uso da cintilografia renal dinamica

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Martins, Flavia Paiva Proenca [Universidade do Rio de Janeiro (UNIRIO), RJ (Brazil). Inst. Biomedico; Goncalves, Renato Teixeira [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Unidade de Transplante Renal; Fonseca, Lea Miriam Barbosa da [Universidade Federal, Rio de Janeiro, RJ (Brazil); Gutfilen, Bianca [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Centro Biomedico]. E-mail: audiocompany@unikey.com.br

2001-10-01

Dynamic renal scintigraphy allows the diagnosis of complications in patients submitted to organ transplantation, such as perfusion abnormalities, acute tubular necrosis and rejection. In this study we employed {sup 99m} Tc-DTPA scintigraphy to study patients submitted to kidney transplantation. The results obtained and the clinical findings were conjunctively analyzed in order to detect graft rejection or other complications. The type of immunosuppressive scheme used was also correlated with the observed complications. Fifty-five patients submitted to kidney transplantation from 1989 to 1999 were evaluated. All patients with nephrotoxicity received a 3-drug immunosuppressive scheme. In this study, acute rejection was the most frequent complication (40.4%) observed following transplantation. Thirteen of 15 recipients of cadaveric kidney grafts presented acute tubular necrosis. Only one false-positive case was observed when scintigraphy and clinical findings were not concordant. We suggest carrying out renal scintigraphy to follow-up post-transplantation patients. (author)

Cintilografia renal com ácido dimercaptossuccínico marcado com tecnécio no diagnóstico da pielonefrite na infância: estudo de 17 casos Renal scintigraphy using technetium dimercaptosuccinic acid in the diagnosis of pyelonephritis in children: study of 17 cases

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Eliana B.M. Guidoni

2001-04-01

Full Text Available OBJETIVO: a infecção do trato urinário é uma das doenças bacterianas mais freqüentes em pediatria. O envolvimento infeccioso renal (pielonefrite pode evoluir com formação de cicatriz renal irreversível com conseqüente perda funcional e dano renal progressivo. Estudos recentes sugerem que até 50-60% das cicatrizes renais poderiam ser evitadas ou atenuadas com o diagnóstico precoce da pielonefrite. O objetivo deste estudo é determinar se a presença de alterações na cintilografia renal com DMSA na fase aguda da infecção urinária pode ser indicadora de pielonefrite. MÉTODOS: empregamos a técnica de washout em 17 meninas portadoras de infecção urinária como padrão-ouro na localização do sítio da infecção. Todas as crianças realizaram cintilografia renal com DMSA na fase aguda da infecção. Os resultados foram analisados pelo teste do qui-quadrado ou de Fisher. RESULTADOS: a cintilografia renal com DMSA detectou alterações em todos os cinco casos de pielonefrite diagnosticados pelo washout sugerindo envolvimento renal. Observamos também que apenas uma das crianças com cistite (total = 12 casos apresentava alterações ao DMSA. Portanto, a sensibilidade e especificidade deste estudo com DMSA na fase aguda da infecção foi de 100% e 92% respectivamente no diagnóstico da pielonefrite. CONCLUSÕES: a cintilografia renal com DMSA mostrou-se método sensível no diagnóstico da pielonefrite aguda em crianças.OBJECTIVE: to determine whether the presence of abnormal results in DMSA renal scintigraphy indicates pyelonephritis. METHODS: we performed the washout test in 17 children with urinary tract infection, as a criterion standard, to locate the infection site. All the children underwent DMSA renal scintigraphy in the acute phase of the disease. The results were analyzed by the chi-square test or Fisher test. RESULTS: DMSA renal scintigraphy revealed changes in all five cases of pyelonephritis, suggesting acute kidney

Differentiation of reversible ischemia from end-stage renal failure in nephrotic children with 131I-hippurate dynamic scintigraphy

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Hattner, R.S.; Maltz, H.E.; Holliday, M.A.

1977-01-01

In renal failure associated with the nephrotic syndrome, therapeutic strategy is highly dependent upon the cause of the renal failure. Dynamic hippurate scintigraphy was studied in five pediatric patients. Four had nephrotic syndrome, and of these, three had acute renal failure. The fifth patient had end-stage renal failure. Specific alteration in renal hippurate kinetics offers a noninvasive assessment of renal failure in this clinical setting

Influence of bladder fullness on the detection of urinary tract obstruction by dynamic renal scintigraphy

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Cosenza, Nathalia Novaes; Lau, Fabio; Lima, Mariana Cunha Lopes; Amorim, Barbara Juarez; Mosci, Camila; Lima, Marcelo Lopes; Ramos, Celso Dario, E-mail: nathalia_cosenza@hotmail.com [Universidade Estadual de Campinas (FCM/UNICAMP), Campinas, SP (Brazil). Faculdade de Ciencias Medicas

2017-07-15

Objective: To investigate the influence of bladder fullness on the diagnosis of urinary tract obstruction during dynamic renal scintigraphy with a diuretic stimulator. Materials and Methods: We studied 82 kidneys in 82 patients submitted to dynamic renal scintigraphy with a diuretic stimulator. We compared the proportional elimination of the radiopharmaceutical {sup 99m}Tc-DTPA from the kidneys before and after bladder emptying in post-diuretic images, classifying each image as representing an obstructed, indeterminate, or unobstructed kidney. Results: The overall elimination of {sup 99m}Tc-DTPA from the kidneys was 10.4% greater after bladder emptying than before. When the analysis was performed with a full bladder, we classified 40 kidneys as obstructed, 16 as indeterminate, and 26 as unobstructed. When the 40 kidneys classified as obstructed were analyzed after voiding, 11 were reclassified as indeterminate and 3 were reclassified as unobstructed. Of the 16 kidneys classified as indeterminate on the full-bladder images, 13 were reclassified as unobstructed after voiding. Conclusion: In dynamic renal scintigraphy with a diuretic stimulator, it is important to obtain images after voiding, in order to perform a reliable analysis of the proportional excretion of {sup 99m}Tc-DTPA from the kidneys, avoiding possible false-positive results for urinary tract obstruction. (author)

Influence of bladder fullness on the detection of urinary tract obstruction by dynamic renal scintigraphy

International Nuclear Information System (INIS)

Cosenza, Nathalia Novaes; Lau, Fabio; Lima, Mariana Cunha Lopes; Amorim, Barbara Juarez; Mosci, Camila; Lima, Marcelo Lopes; Ramos, Celso Dario

2017-01-01

Objective: To investigate the influence of bladder fullness on the diagnosis of urinary tract obstruction during dynamic renal scintigraphy with a diuretic stimulator. Materials and Methods: We studied 82 kidneys in 82 patients submitted to dynamic renal scintigraphy with a diuretic stimulator. We compared the proportional elimination of the radiopharmaceutical "9"9"mTc-DTPA from the kidneys before and after bladder emptying in post-diuretic images, classifying each image as representing an obstructed, indeterminate, or unobstructed kidney. Results: The overall elimination of "9"9"mTc-DTPA from the kidneys was 10.4% greater after bladder emptying than before. When the analysis was performed with a full bladder, we classified 40 kidneys as obstructed, 16 as indeterminate, and 26 as unobstructed. When the 40 kidneys classified as obstructed were analyzed after voiding, 11 were reclassified as indeterminate and 3 were reclassified as unobstructed. Of the 16 kidneys classified as indeterminate on the full-bladder images, 13 were reclassified as unobstructed after voiding. Conclusion: In dynamic renal scintigraphy with a diuretic stimulator, it is important to obtain images after voiding, in order to perform a reliable analysis of the proportional excretion of "9"9"mTc-DTPA from the kidneys, avoiding possible false-positive results for urinary tract obstruction. (author)

Dynamic renal scintigraphy of dissecting aneurysm of abdominal aorta

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Tsukamoto, Eriko; Itoh, Kazuo; Furudate, Masayori

1990-01-01

Dynamic renal scintigraphy on 15 patients with dissecting aneurysm of abdominal aorta extending below the renal arteries were retrospectively studied. The results were reviewed and classified into 3 types according to perfusion images and parenchymal tissue uptake: Type A--symmetric perfusion and parenchymal tissue uptake; Type B--asymmetrical perfusion and parenchymal tissue uptake; Type C--delayed perfusion of one kidney and symmetric parenchymal tissue uptake. The number of patients who showed Type A, Type B, and Type C were 3 cases, 6 cases, and 6 cases, respectively. In all Type A and 3 of Type B, perfusion of bilateral renal arteries was mainly from true lumen. In the remaining 3 cases of Type B, 2 had one renal artery obstructed with thrombus; 1 had a deformity of one kidney (the blood supply was mainly from a false lumen), suggestive of renal infarction. On the other hand, in all 6 Type C cases, the renal artery where perfusion was delayed was apparently supplied from false lumen. It is suggested in this retrospective study that the findings in Type C, where delayed perfusion of one kidney and symmetric parenchymal tissue uptake were found, were due to the presence of delayed flow through the false lumen; and therefore, specific to cases where the main blood supply of one renal artery from false lumen. (author)

Diagnostic value of exercise thallium-201 scintigraphy for ischemic heart disease in patients with chronic renal failure

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Sato, Shigeaki; Ohta, Makoto; Soejima, Michimasa

1991-01-01

Recently, it has been reported that there are considerable difficulties in diagnosing ischemic heart disease by ECG alone in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). This study was designed to evaluate the diagnostic value of exercise thollium-201 myocardial scintigraphy as compared with ECG examination alone in patients with chronic renal failure. The subjects were 26 patients with chronic renal failure, including patients being treated with HD and CAPD, and 7 normal persons who served as controls. Exercise thallium-201 myocardial scintigraphy was performed according to a multistage bicycle ergometer exercise test. Exercise duration times were shorter (p<0.001) and maximum attained heart rates lower (p<0.05) in the HD group than in controls. Since exercise capacities were reduced in the dialysis patients, there were considerable difficulties in diagnosing ischemic heart disease by ECG alone. In our 26 patients, 15 cases (57.7%) had left ventricular hypertrophy, 5 cases (19.2%) had manifestations of ischemic heart disease, and 4 cases with abnormal ECGs had no abnormal findings on exercise thallium-201 myocardial scintigraphy. Thallium washout rates were higher (p<0.001) in the chronic renal failure group than in the control group, and a significant negative correlation (r=-0.70, p<0.001) was found between thallium washout rates and hematocrit values. Exercise thallium-201 myocardial scitigraphy was more accurate than ECG examination and also could be performed repeatedly without invasion. These results indicate that exercise thallium-201 myocardial scintigraphy is a valuable diagnostic method for ischemic heart disease in patients with chronic renal failure. (author)

Early diagnosis of acute postoperative renal transplant rejection by indium-111-labeled platelet scintigraphy

International Nuclear Information System (INIS)

Tisdale, P.L.; Collier, B.D.; Kauffman, H.M.

1986-01-01

A prospective evaluation of 111 In-labeled platelet scintigraphy (IPS) for the early diagnosis of acute postoperative renal transplant rejection (TR) was undertaken. The results of IPS were compared with in vitro biochemical tests, the clinical finding of graft tenderness, and combined [/sup 99m/Tc]DTPA and [ 131 I]orthoiodohippurate scintigraphy. With a sensitivity of 0.93 and a specificity of 0.95, IPS provided otherwise unavailable diagnostic information. Furthermore, postoperative IPS was a good predictor of long-term allograft survival

A case of a desmoid tumor with an uretertumoral fisttula detected on renal scintigraphy

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Yoo, Hyun Woo; Lee, Kyu Taek; Lee, Sang Mi [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

2016-11-15

Desmoid tumors are rare benign tumors with aggressive fibroblastic proliferation. Although desmoid tumors do not metastasize, they have locally aggressive features and can cause a urinary fistula. Here, we report a case of a 35-year-old woman with Gardner syndrome who was diagnosed with an intra-abdominal desmoid tumor 1 year previously and who presented with a newly developed cystic mass lesion on a computed tomography scan. The cystic mass lesion was clinically diagnosed as an urinoma from the right ureterotumoral fistula; thus, surgical resection of the mass lesion was planned. However, Tc-99m diethylenetriamine pentaacetic acid renal scintigraphy revealed bilateral ureterotumoral fistulas; hence, the treatment plan was changed to conservative management.

CLINICAL STUDIES OF RENAL MORPHOLOGICAL CHANGES WITH AGING - DEMONSTRATING BY USING 99mTc-DMSA SCINTIGRAPHY -

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細川, 進一; 川村, 寿一; 友吉, 唯夫; 吉田, 修

1980-01-01

We studied the change of renal shape due to development and aging by using 99mTc-DMSA renal scintigraphy. In pediatric age group, the angle between renal longitudinal axis and the lumbar vertebrae is small but becomes larger with aging. The renal size grows with aging in the adult age group, and becomes largest. In geriatric age group it decreases with aging. The stability of renal position is marked in the adult age group, but in the pediatric and geriatric age group it seemed unstable. Rena...

Cross-Sectional Evaluation of Kidney Function in Hospitalized Patients: Estimated GFR Versus Renal Scintigraphy

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Domenico Santoro

2014-12-01

Full Text Available Background/Aims: Accurate staging of chronic kidney disease (CKD is very important. We tried to identify difference in GFR evaluation between CKD-EPI and Gates method with renal scintigraphy and which variables are associated with these differences. Methods: We retrospectively reviewed the records of 341 patients who underwent dynamic renal scintigraphy in the last 5 years. Patients were categorized according to KDIGO staging I to V, using the eGFR calculated with the CKD-EPI equation. Secondarily, we stratified patients according to treatment with renin-angiotensin system (RAS inhibitors. Results: Gates method tends to underestimate GFR especially in CKD stage I (mean -22.2 ml/min and II (mean -12.5 ml/min. The division in quartiles of ages showed an underestimation of GFR only in the first quartile of age (Conclusion: The assessment of GFR by the Gates method must be carefully considered in the early stages of CKD, especially in younger patients. Moreover, the difference is more pronounced in patients treated with RAS inhibitors. Longitudinal studies will prove which method better predicts cardiovascular or renal events.

The valuation of 99Tcm-DMSA renal cortical scintigraphy for prediction of renal scarring in children with acute pyelonephritis

International Nuclear Information System (INIS)

Zhao Ruifang; Ji Zhiying; Lv Xiaomei; Wu Ha; Li Yiwei; Gu Fanlei; Zhao Xiaofei

2009-01-01

Objective: Acute pyelonephritis (APN) is a common infectious disease in childhood. APN may result in ineversible renal scarring. 99 Tc m -dimercaptsuccinic (DMSA) renal cortical scintigraphy was reported to be highly sensitive and specific for detection APN and renal scarring. The aim of this study was to determine the incidence of renal scarring in a group of children with APN and to evaluate the relative factors at risk of scarring using 99 Tc m -DMSA renal cortical scintigraphy. Methods: One hundred and eighteen patients (44 males, 74 females, age range: 1 month to 14 years) with APN underwent DMSA renal cortical scan before treatment and six month after treatment to identify renal damage and renal scarring. The degree of renal damage was divided to grade I to IV. A directed radionuclide cystography (DRC) was performed in 72 cases to evaluate vesicoureteric reflux (VUR). Statistical analysis between all those relative factors was performed using Spearman grading relational analysis. The software was SPSS 11.5. Results: The follow-up renal cortical scan revealed that 79 normal kidneys on first scan remained normal; of 64 kidneys with grade I damage, 7.81% (5/64) developed renal scar; of 51 kidneys with grade II, 49.02% (25/51) developed renal scar; of 19 with grade III, 68.42% (13/19) developed renal scar; of 23 with grade IV, 100.00% (23/23) developed renal scar. There was a significant relationship between the incidence of renal scar on follow-up and the grade of renal damage on first scan (r=0.877, P<0.01). VUR was found in 54.17% (78/144) per renal unit. Only 4.55% (3/66) of those with non-refluxing ureters developed renal scars on follow-up. One of four patients with mild-refluxing ureters developed renal scars. 46.51% (20/43) of those with moderate-refluxing ureters developed renal scars. 87.10% (27/31) of those with severe-refluxing ureters developed renal scars. There was a significant relationship between the incidence of renal scarring in follow-up and

Myocardial scintigraphy with I-123 labeled fatty acids

International Nuclear Information System (INIS)

Dudczak, R.

1983-01-01

This study presents experimental and clinical data in the use of I-123 labeled aromatic and aliphatic fatty acids. I-123 p-phenylpentadecanoic acid (p-IPPA) and I-123 heptadecanoic acid (HDA) were applied for myocardial scintigraphy. The feasibility of p-IPPA and HDA for myocardial scintigraphy was substantiated in animal experiments. Clinical studies were performed in patients with coronary artery disease (CAD) and cardiomyopathy (CMP). In CAD the results of fatty acid studies were compared with those of Tl-201. I-123 labeled fatty acids proved to be a useful tool for myocardial scintigraphy. The possibility to evaluate non invasively the myocardial metabolic function in man may add a complementary diagnostic tool in the clinical follow up of patients with heart disease. In CAD studies with I-123 p-IPPA and I-123 HDA might provide a means to assess the degree of myocardial viability and to identify a subgroup of patients who are at increased risk for irreversible myocardial damage. In patients with CMP it is probable that these studies may be used as a means of separating groups of patients with this disease. (Author)

Role of renal scintigraphy in the functional evaluation of ectopic kidneys as compared to intravenous urography and ultrasonography

International Nuclear Information System (INIS)

Malhotra, G.; Das, B.K.; Pradhan, P.K.; Kaushik, A.

2002-01-01

Aim: Ectopic kidneys are mainly diagnosed by Ultrasonography (US) and/or Intravenous urography (IVU) but a functional study using a radionuclide can provide much useful additional information. The objective of this retrospective study was to analyze and compare the information obtained from anatomical investigations like IVU and US with that obtained from a functional study. Materials and Methods: 44 patients (26 males and 18 females) in the age ranging from 2-53 yr. and involving 53 ectopic kidney units were included in the study. All patients underwent renal dynamic scintigraphy with either Tc-99m EC or Tc-99m DTPA after adequate hydration. US report was available in 35 and IVU in 31 kidney units. All investigations were evaluated independent of each other. Results: Out of 53 units 31 were left ectopic (26 simple and 5 crossed) while 21 were right ectopic (18 simple and 3 crossed). One grossly hydronephrotic was seen on ultrasound but not on scintigraphy.26/53 units showed adequate or normal function and drainage. 19/53 units showed obstructive uropathy. 7 units had negligible function. 28/35 units that underwent both ultrasonography and scintigraphy showed concordant findings as far as localization of the kidney was concerned while 7/35 units showed discordant findings. 20/31 units showed discordant findings in scintigraphy as compared to IVU. Of these 9 units were non-visualized on I.V.U but showed adequate function and clearance in renal scintigraphy. In 11/31 units Nuclear Medicine findings corroborated with those of IVU. Conclusion: Nuclear Medicine studies provide reliable anatomic information comparable to IVU and USS and more reliable pathophysiological information. Thus in conjunction with USS and IVU, renal dynamic scintigraphy can play a very important role in the evaluation of ectopic kidneys

sup(99m)Tc-DMSA renal scintigraphy in renal failure due to various renal diseases

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Hosokawa, S; Daijo, K; Okabe, T; Kawamura, J; Hara, A [Kyoto Univ. (Japan). Hospital

1979-08-01

Renal contours in renal failure were studied by means of sup(99m)Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy. Renal cortical images were obtained even in renal failure cases. Causes of renal failure were chronic glomerulonephritis in 7, bilateral renal tuberculosis in 2, chronic pyelonephritis in 3, bilateral renal calculi in 3, diabetic nephropathy in 2, polycystic kidney disease in 2 and stomach cancer in 1.

sup(99m)Tc-DMSA renal scintigraphy in renal failure due to various renal diseases

International Nuclear Information System (INIS)

Hosokawa, Shin-ichi; Daijo, Kazuyuki; Okabe, Tatsushiro; Kawamura, Juichi; Hara, Akira

1979-01-01

Renal contours in renal failure were studied by means of sup(99m)Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy. Renal cortical images were obtained even in renal failure cases. Causes of renal failure were chronic glomerulonephritis in 7, bilateral renal tuberculosis in 2, chronic pyelonephritis in 3, bilateral renal calculi in 3, diabetic nephropathy in 2, polycystic kidney disease in 2 and stomach cancer in 1. (author)

The role of dynamic renal scintigraphy on clinical decision making in hydronephrotic children

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Seçil Arslansoyu Çamlar

2017-01-01

Full Text Available Hydronephrosis may be related to an obstructive cause, ureteropelvic/uretero-vesical junction obstruction or nonobstructive [vesicoureteral reflux (VUR]. When an obstructive pathology is considered, dynamic renal scintigraphy may help to predict whether it is a true obstruction or not. In this study, we aimed to determine the contribution of dynamic renal scintigraphy with [99] mTc-MAG-3 to the clinical decision-making for surgery in hydronephrotic children. Files of the patients evaluated by MAG-3 scintigraphy for antenatal (AH/postnatal (PH hydronephrosis between 1992 and 2014 were reviewed. Gender, age, hydronephrosis (HN grade by ultrasound (US, presence of VUR, MAG-3 result (obstructive vs. nonobstructive, ultimate diagnosis, and need for surgery were assessed. Cases with double collecting system and neurogenic bladder were excluded from the study. All of the patients had normal serum creatinine and eGFR. There were a total of 178 patients with 218 hydronephrotic renal units (mean age 34.7 ± 52.7 months; male/ female = 121/57, AH of 62%. MAG-3 was nonobstructive in 134 and obstructive in 84 hydronephrotic renal units. MAG-3 was obstructive in 47 of 121 (39% males and 30 of 57 (53% females (P = 0.058, odds ratio (OR for obstruction was 1.9 for girls. MAG-3 was obstructive in 47 of 135 (35% units with AH and 37 of 83 (45% units with PH (P = 0.137. In 81 units with the society of fetal urology-4 HN by US, MAG-3 was obstructive in 55 (68%, and surgery was required in 52 of 55 (95%. Surgery was required for only two (7% of the remaining 26 units with nonobstructive dilatation (P 16.5 mm was the best cutoff level for predicting obstruction by MAG-3 (sensitivity 75.2%; specificity 71%; OR 3.8. MAG-3 significantly affects clinical decision for surgery in HN. Hydronephrotic girls have more risk in terms of true obstruction. Combining MAG-3 with US improves the discrimination of true obstruction during follow-up.

Thallium-technetium-subtraction scintigraphy in secondary hyperparathyroidism

International Nuclear Information System (INIS)

Adalet, I.; Hawkins, T.; Clark, F.; Wilkinson, R.

1994-01-01

Between 1983 and 1992 thallium-technetium subtraction scintigraphy (TTS) was performed on 74 patients with clinical and biochemical evidence of hyperparathyroidism. Twenty-five of the 53 investigations since 1988 were conducted on patients with renal failure with a suspicion of secondary hyperparathyroidism. In a retrospective study we have evaluated radioisotope scintigraphy for patients with adenoma and for renal failure patients with possible parathyroid hyperplasia. Thirty of 74 patients underwent neck exploration. Scintigraphy detected 17 of 24 parathyroid adenomas (sensitivity 71%). In contrast, in six renal patients who came to operation, scintigraphy localised only 5 of 20 hyperplastic parathyroid glands (sensitivity 25%) and in one renal patient we localised a parathyroid adenoma. A review of the literature shows low detection rates for hyperplasia by TTS to be a common observation. Based on these findings a rational approach is offered for parathyroid localisation in renal patients prior to neck exploration. (orig.)

Uncomplicated duplex kidney and DMSA scintigraphy in children with urinary tract infection

International Nuclear Information System (INIS)

Stokland, Eira; Jodal, Ulf; Swerkersson, Svante; Hansson, Sverker; Sixt, Rune

2007-01-01

Renal duplication is the most common malformation of the urinary tract and is frequently seen among children with urinary tract infection (UTI). To evaluate problems in the interpretation of dimercaptosuccinic acid (DMSA) scintigraphy and to establish the range of relative function in uncomplicated unilateral duplication. Retrospective analysis of 303 children less than 2 years of age with first time non-obstructive urinary tract infection investigated by both urography and DMSA scintigraphy. At DMSA scintigraphy, renal lesions and/or relative function below 45% was considered abnormal. Urography was used as reference for the diagnosis of duplication. Duplex kidneys were found in 22 of 303 patients (7%). Of the 16 children with unilateral duplication, 10 had bilaterally undamaged kidneys with a range of relative function varying between 51% and 57% in the duplex kidney. In two of the children with unilateral duplication the imaging results were discordant. There was risk of underdiagnosis as well as overdiagnosis of renal damage at scintigraphy. Although it is important to be aware of this risk, the rate of misinterpretation was low. A range of 51% to 57% can be used as the limit for normality of the relative function of a unilateral duplex kidney. (orig.)

Uncomplicated duplex kidney and DMSA scintigraphy in children with urinary tract infection

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Stokland, Eira [The Sahlgrenska Academy at Goeteborg University, Department of Paediatric Radiology, Goeteborg (Sweden); The Queen Silvia Children' s Hospital, Department of Paediatric Radiology, Goeteborg (Sweden); Jodal, Ulf; Swerkersson, Svante; Hansson, Sverker [The Sahlgrenska Academy at Goeteborg University, Department of Paediatrics, Goeteborg (Sweden); Sixt, Rune [The Sahlgrenska Academy at Goeteborg University, Department of Paediatric Clinical Physiology, Goeteborg (Sweden)

2007-08-15

Renal duplication is the most common malformation of the urinary tract and is frequently seen among children with urinary tract infection (UTI). To evaluate problems in the interpretation of dimercaptosuccinic acid (DMSA) scintigraphy and to establish the range of relative function in uncomplicated unilateral duplication. Retrospective analysis of 303 children less than 2 years of age with first time non-obstructive urinary tract infection investigated by both urography and DMSA scintigraphy. At DMSA scintigraphy, renal lesions and/or relative function below 45% was considered abnormal. Urography was used as reference for the diagnosis of duplication. Duplex kidneys were found in 22 of 303 patients (7%). Of the 16 children with unilateral duplication, 10 had bilaterally undamaged kidneys with a range of relative function varying between 51% and 57% in the duplex kidney. In two of the children with unilateral duplication the imaging results were discordant. There was risk of underdiagnosis as well as overdiagnosis of renal damage at scintigraphy. Although it is important to be aware of this risk, the rate of misinterpretation was low. A range of 51% to 57% can be used as the limit for normality of the relative function of a unilateral duplex kidney. (orig.)

Renal scintigraphy in insulin-dependent diabetes mellitus: Early glomerular and urologic dysfunction

International Nuclear Information System (INIS)

Poirier, J.Y.; Moisan, A.; Le Cloirec, J.; Siemen, C.; Yaouanq, J.; Edan, G.; Herry, J.Y.

1990-01-01

Glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured by intravenous injection of 99mTc-diethylenetriaminepentaacetic acid (DTPA) and 131I-Hippuran in 115 insulin-dependent diabetic patients with albumin excretion rates (AER) less than 200 micrograms/min, and in 45 normal subjects. Separate kidney function and urinary elimination were estimated by renography. GFR was increased in the diabetic patients (152 +/- 24 ml/min/1.73 m2 vs. 128 +/- 15) and correlated significantly with RPF (r = 0.5; p less than 10(-9)). No relationship was found between GFR and the duration of diabetes, blood glucose, HbA1c, or AER. Fifty patients were hyperfiltering with RPF and filtration fraction higher than those in the normofiltering group. Slow intrarenal or pyeloureteral elimination, either unilateral or bilateral, was observed in 3 controls and 60 diabetic subjects (24 hyperfiltering; 36 normofiltering) and did not disappear with the patient in the standing position. In these 60 patients, mean age, duration of diabetes, blood glucose, HbA1c, 24 h albumin excretion rate, and frequency of peripheral or autonomic neuropathy did not differ from patients with normal scintigraphy; GFR was lower in the group with slow elimination, but not significantly so. 99mTc-DTPA renal uptake was symmetric in all the controls; asymmetric renal uptake with asymmetric GFR was observed in 13 patients (7 hyperfiltering; 6 normofiltering) and often associated with slower elimination. No evidence for renal stenotic atheroma or parenchymatous disease was found on the angiopyleoureterography. The results suggest that incipient uropathy is a very common phenomenon that occurs irrespective of glomerular dysfunction

Investigation in uro-nephrology (2): renal cortical scintigraphy using {sup 99m}Tc-Dmsa in children; Enquete en uro-nephrologie (2): la scintigraphie renale au 99mTc-DMSA chez l'enfant

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Archambaud, F. [Centre Hospitalier Universitaire de Bicetre, 94 - Le Kremlin-Bicetre (France); Olivier, P. [Centre Hospitalier Universitaire Nancy-Brabois, 54 - Vandoeuvre-les-Nancy (France); Guillet, J. [Centre Hospitalier Universitaire, 47 - Agen (France); Wioland, M. [Centre Hospitalier Universitaire Armand Trousseau, 75 - Paris (France); Bonnin, F. [Centre Hospitalier Universitaire Beaujon, 92 - Clichy (France)

2002-08-01

We present the results of a national investigation about the daily practice of renal cortical scintigraphy using {sup 99m}Tc-DMSA in children by comparison with the recommendations of the international consensus from the experts designated by the Scientific Committee of 'Radionuclides in Nephrology'. Questions were related to radiopharmaceutical image acquisition, processing and visualisation, relative renal function determination and indications of renal scan in urinary tract infection. National daily practice are similar to the one suggested by the international consensus about many aspects. However, a controversy exists between the experts in acquiring pinhole or tomographic images. Similarly to the international consensus, {sup 99m}Tc-DMSA renal scan is widely performed for detection of renal sequelae, while its indication in acute pyelonephritis remains to define. (authors)

Captopril 99mTc-DTPA Renal Scintigraphy in Diagnosis of Renovascular Hypertension

International Nuclear Information System (INIS)

Yang, In Hyung; Lee, Dong Soo; Kim, Sung Chul

1992-01-01

To evaluate the sensitivity and specificity of captopril renal scan for renovascular hypertension, we employed the captopril renal scan in conjunction with renal angiography in 81 patients, 159 kidneys, who were referred to evaluate the cause of hypertension. We defined the renovascular hypertension by the criteria of demonstration of renal artery stenosis by angiography, and improvement or cure of hypertension by revascularization. Visual and quantitative evaluation of 99m Tc-DTPA renal scan was performed pre and post captopril administration. The prevalence rate of renovascular hypertension was 40% in comparing with renal angiography, and 70% in confirmed cases. The causes of renovascular hypertension in 81 patients were Takayasu's arteritis, fibromuscular dysplasia, atherosclerosis, essential hypertension, chronic pyelonephritis etc. The sensitivity and specificity of captopril renal scan in comparing with renal angiography were 80%, 86.5%, respectively and also 84.2%, 72.6% in confirmed cases of renovascular hypertension, respectively. The causes of false negative cases were nonfunctioning kidney due to complete obstruction or long duration of disease in basal scan, segmental branch artery stenosis, unknown causes, and suspicious true negative cases without confirmation. The false positive cases were abdominal aortic stenosis or aneurysm, dehydration, unknown causes, and suspicious true positive cases. We conclude that captopril renal scintigraphy is highly sensitive, reasonably specific diagnostic method and comparable to other techniques very favorably.

Quantitative renal cinescintigraphy with iodine-123 hippuran methodological aspects, kit for labeling of hippuran

International Nuclear Information System (INIS)

Mehdaoui, A.; Pecking, A.; Delorme, G.; Mathonnat, F.; Debaud, B.; Bardy, A.; Coornaert, S.; Merlin, L.; Vinot, J.M.; Desgrez, A.; Gambini, D.; Vernejoul, P. de.

1981-08-01

The development of an extemporaneous kit for the labeling of ortho-iodo-hippuric acid (Hippuran) with iodine 123 allows the performance of a routine quantitative renal cinescintigraphy providing in 20 minutes, and in an absolutely non-traumatic way, a very complete renal morphofunctional study including: a cortical renal scintigraphy, sequential scintigraphies of excretory tract, renal functional curves, tubular, global, and separate clearances for each kidney. This functional quantitative investigation method should take a preferential place in the routine renal balance. The methodology of the technique is explained and compared to classical methods for estimation of tubular, global and separate clearances [fr

The clinical utility of indium-111 labelled platelet scintigraphy in the diagnoses of renal transplant rejection

International Nuclear Information System (INIS)

Desir, G.V.; Bia, M.; Lange, R.C.; Smith, E.O.; Flye, W.; Kashgarian, M.; Schiff, M.; Ezekowitz, M.D.

1990-01-01

It is demonstrated that indium-111 labelled platelet scintigraphy is a highly accurate test for detecting acute untreated renal allograft rejection and it is shown that changes in platelet uptake can precede signs and symptoms of rejection by at least 48 hours. (author). 34 refs.; 2 figs.; 1 tab

Comparative scintigraphy in oleic acid pulmonary microvascular injury

International Nuclear Information System (INIS)

Sugerman, H.J.; Hirsch, J.I.; Tatum, J.L.; Strash, A.M.; Sharp, D.E.; Greenfield, L.J.

1982-01-01

Computerized gamma scintigraphy revealed a significant (p less than 0.001) rising lung:heart radioactivity ratio, which has been called ''slope of injury'' or ''slope index'', with both 99mTechnetium-tagged human serum albumin (99mTc-HSA) and 99mTechnetium-tagged red blood cells (99Tc-RBC) after 0.05 or 0.2 ml/kg iv oleic acid administration to dogs. This slope index was significantly greater with 99mTc-HSA than 99mTc-RBC (p less than 0.001). These findings verify that the scintigraphic 99mTc-HSA slope of injury is a result of a pulmonary capillary protein leak and not oleic acid induced changes in pulmonary blood or air volume. The leak of red blood cells noted with scintigraphy was confirmed by light microscopy and examination of the tracheal edema fluid. The leak of albumin, however, was much greater than the leak of red blood cells by microscopy and tracheal fluid examination, confirming the scintigraphic data. This study provides further evidence that computerized gamma scintigraphy will be of value for the diagnosis of permeability pulmonary edema and its response to treatment

Tc-99m DTPA perfusion scintigraphy and color coded duplex sonography in the evaluation of minimal renal allograft perfusion

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Bair, H.J.; Platsch, G.; Wolf, F. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Nuclear Medicine; Guenter, E.; Becker, D. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Internal Medicine 1; Rupprecht, H.; Neumayer, H.H. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Internal Medicine 4

1997-08-01

Aim: The clinical impact of perfusion scintigraphy versus color coded Duplex sonography was evaluated, with respect to their potential in assessing minimal allograft perfusion in vitally threatened kidney transplants, i.e. oligoanuric allografts suspected to have either severe rejection or thrombosis of the renal vein or artery. Methods: From July 1990 to August 1994 the grafts of 15 out of a total of 315 patients were vitally threatened. Technetium-99m DTPA scintigraphy and color coded Duplex sonography were performed in all patients. For scintigraphic evaluation of transplant perfusion analog scans up to 60 min postinjection, and time-activity curves over the first 60 sec after injection of 370-440 MBq Tc-99m diethylenetriaminepentaacetate acid (DTPA) were used and classified by a perfusion score, the time between renal and iliac artery peaks (TDiff) and the washout of the renogram curve. Additionally, evaluation of excretion function and assessment of vascular or urinary leaks were performed. By color coded Duplex sonography the perfusion in all sections of the graft as well as the vascular anastomoses were examined and the maximal blood flow velocity (Vmax) and the resistive index (RI) in the renal artery were determined by means of the pulsed Doppler device. Pathologic-anatomical diagnosis was achieved by either biopsy or post-explant histology in all grafts. Results: Scintigraphy and color coded Duplex sonography could reliably differentiate minimal (8/15) and not perfused (7/15) renal allografts. The results were confirmed either by angiography in digital subtraction technique (DSA) or the clinical follow up. Conclusion: In summary, perfusion scintigraphy and color coded Duplex sonography are comparable modalities to assess kidney graft perfusion. In clinical practice scintigraphy and colorcoded Doppler sonography can replace digital subtraction angiography in the evaluation of minimal allograft perfusion. (orig.) [Deutsch] Ziel der Studie war es, das

The evaluation of 67Ga-scintigraphy in malignant tumor of the urinary tract

International Nuclear Information System (INIS)

Arai, Eishoku; Nishibuchi, Shigeo; Katamura, Eiju

1982-01-01

67 Ga-scintigraphy was performed in 40 patients with tumor of the urinary tract (18 with renal cell carcinoma, 4 with renal pelvic cancer, 18 with bladder cancer). In patients with renal cell carcinoma, 67 Ga-scintigraphy was positive in 46% of those with primary lesions, and in 80% of those with metastatic lesions. In those with renal pelvic cancer, two with only a primary lesion had a negative 67 Ga-scintigraphy, and one with both primary and metastic lesions and one with only a metastatic lesion after nephrectomy showed distinctly positive 67 Ga-scintigraphy. Among patients with bladder cancer only 31% with primary lesions only had positive 67 Ga-scintigraphy. In conclusion, 67 Ga-scintigraphy is of little use as a diagnostic aid in primary tumors of the urinary tract, but may be useful in the diagnosis of metastatic lesions. (author)

Evaluation of renal function in children with vesicoureteral reflux

International Nuclear Information System (INIS)

Hioki, Takuichi

1993-01-01

Renal uptake rate was calculated by 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy in 100 kidneys from 58 patients with pediatric vesicoureteral reflux (VUR) to assess kidney function quantitatively for treatment selection and surgical timing. The conservatively treated group consisted of 42 patients (75 kidneys) who underwent DMSA renal scintigraphy twice at intervals of 2 years during their management. The surgically treated group consisted of 16 patients (25 kidneys) who underwent DMSA renal scintigraphy before and 2 years after surgery, Urine samples were collected at the time of initial DMSA renal scintigraphy for the simultaneous measurement of β 2 -microglobulin (β 2 -MG), α 1 -microglobulin and N-acetyl-β-glucosaminidase. Renal uptake ratio of DMSA did not differ in VUR grades during a 2-year follow-up period in the conservative group. In the age group of patients aged 2 or less, renal uptake ratio decreased 2 years later, with significant difference with that in the other age groups. According to VUR grade, there was no significant difference in DMSA renal kidney ratios between the conservative group and the surgical group. According to age, significant difference in renal uptake ratio was observed between the two groups; i.e., patients aged 2 or less had a significantly decreased renal uptake ratio in the conservative group than the surgical group. However, the renal uptake ratio did not differ in the other age groups. For patients aged 2 or less, surgery was considerd necessary to prevent reflux when urinary β 2 -MG indexes are increased. For those aged 3 years or more, on the other hand, conservative treatment was considered optimal regardless of VUR grades; surgery was considered recommended in the case of repeated urinary infection and decreased renal function. (N.K.)

Pre- and Post-operative cortical function of the kidney with staghorn calculi assessed by sup(99m)Tc-DMSA renal scintigraphy

International Nuclear Information System (INIS)

Kawamura, Juichi

1982-01-01

sup(99m)Tc-DMSA renal scintigraphy consisting of the cortical image and DMSA renal uptake was used to assess the pre- and post-operative renal function in 39 patients with staghorn calculi or complicated calculi occupying more than 2 major calices. Extended pyelolithotomy was performed on 14 patients, nephrolithotomy on 14 patients, pyelolithotomy combined with nephrotomy on 7 patients, and partial nephrectomy on 4 patients. Nine out of 14 patients who underwent pyelolithotomy and 4 out of 14 patients who underwent nephrolithotomy showed an increase or no change in the postoperative DMSA renal uptake in the diseased kidney. However, there was no increase in the postoperative DMSA renal uptake in the patients who underwent pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight percent of the preoperative DMSA renal uptake in the diseased kidney seems to be the absolute level for predicting a postoperative recovery of the kidney function. The contralateral kidney function can affect the postoperative recovery of the function in the operative side. It seems to be hard to expect an increment in the DMSA renal uptake postoperatively when the ratio of DMSA renal uptake in the operative side to the total DMSA renal uptake is less than 20%. At least 6 months of the follow-up period is necessary for the evaluation of the kidney function in the operative side. DMSA renal scintigraphy is a useful modality to assess pre- and post-operative kidney function in nephrolithiasis from the point of both morphological and functional changes in the renal cortex. (author)

Evaluation of renal scintigraphy and renography for the cases of severe allergic reactions to urinary contrast media

International Nuclear Information System (INIS)

Yanagisawa, Munetoshi; Machida, Toyohei; Miki, Makoto; Ohishi, Yukihiko; Ueda, Masataka

1981-01-01

The evaluation of nuclear medical examination had been observed in eight cases who had had severe complications of urinary contrast media. These were 2 ureter calculus, 2 pyelonephritis, 2 idiopathic renal hematuria, 1 renal cell carcinoma and 1 renal tuberculosis. All of the eight cases were performed by renal scintigraphy with sup(99m)Tc-DTPA, four cases by renography with 131 I-Hippuran and one case was performed by renography with sup(99m)Tc-DTPA. Allergie complications were not observed in all of the eight cases with satisfactory informations by the nuclear medical examinations. In conclusion we think that the nuclear medical examinations are helpful in patients with iodine-allergy complication by using other urological examinations together. (author)

Tc-99m-DTPA renal scintigraphy and detection of intrarenal reflux

International Nuclear Information System (INIS)

Poropat, M.; Basic, M.; Dodig, D.; Batinic, D.; Nizic, Lj.

1994-01-01

The intrarenal reflux plays the key role in the etiology of reflux nephropathy and its detection is of utmost importance in evaluating possible damage in kidney with reflux. In 176 kidneys (113 children) with different degree of vesicoureteric reflux (VUR), dynamic renal scintigraphy with Tc-99m-DTPA in zoom mode was performed. From each study 6 functional images of mean time were generated, kidney contour superimposed on each, and time activity curves (TAC) over possible areas of increased mean time were generated. In these study we analyzed only areas of increased mean time over the outer contour of the kidney which corresponds to the renal parenchyma. In later functional images of the mean time we found 53 focal retentions over the part of the kidney which corresponds to the renal cortex (33 in upper, 5 in middle and 15 in lower part of the kidney). TAC-s generated over these areas exhibited a sharp increase of activity on the descending part of the curves. We propose that the return of activity from the collecting system to the kidney cortex represents intrarenal reflux. In our opinion, analysis of functional images of the mean time could be a method for more accurate detection of intrarenal reflux and indicating the children with high risk to acquire renal scarring. (author)

Evaluation of the protective effect of agmatine against cisplatin nephrotoxicity with 99mTc-DMSA renal scintigraphy and cystatin-C.

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Salihoglu, Yavuz Sami; Elri, Tarik; Gulle, Kanat; Can, Murat; Aras, Mustafa; Ozacmak, Hale Sayan; Cabuk, Mehmet

2016-10-01

The aim of the current study was to investigate whether agmatine (AGM) has a protective effect against cisplatin-induced nephrotoxicity. Thirty-two rats were randomly divided into four groups: (1) Saline (control); (2) Cisplatin (CDDP; 7.5 mg/kg intraperitoneally); (3) Agmatine (AGM; 10 mg/kg intraperitoneally); (4) Cisplatin plus agmatine (CDDP + AGM). Agmatine was given before and two consecutive days after cisplatin injection. All the animals underwent renal scintigraphy with 99mTc-DMSA. The levels of serum creatinine, cystatin C, and blood urea nitrogen (BUN) were measured in addition to examination of the tissue samples with light microscopy. Acute renal injury was assessed with biochemical analyses, scintigraphic imaging, and histopathological evaluation. In the cisplatin group, the levels of BUN, creatinine, and cystatin C were significantly higher than that of the controls. Histopathological examination showed remarkable damage of tubular and glomerular structures. Additionally, cisplatin caused markedly decreased renal 99mTc-DMSA uptake. AGM administration improved renal functions. Serum creatinine, BUN, and cystatin C levels had a tendency to normalize and, scintigraphic and histopathological findings showed significantly less evidence of renal toxicity than those observed in animals receiving cisplatin alone. Our data indicate that AGM has a protective effect against cisplatin-induced nephrotoxicity. Therefore, it may improve the therapeutic index of cisplatin. In addition, the early renal damage induced by cisplatin and protective effects of AGM against cisplatin nephrotoxicity was accurately demonstrated with 99mTc-DMSA renal scintigraphy.

Myocardial rest iodine-123-β-methyl-iodophenyl-pentadecanoic acid scintigraphy compared with dipyridamole stress thallium-201 scintigraphy in unstable angina

International Nuclear Information System (INIS)

Misumi, Ikuo; Kimura, Yoshihiro; Hokamura, Youichi; Yamabe, Hiroshige; Ueno, Kazuhiro

1998-01-01

Twelve patients with stable angina and 12 patients with unstable angina underwent rest iodine-123-β-methyl-iodophenyl-pentadecanoic acid (BMIPP), dipyridamole stress thallium scintigraphy and delayed thallium scintigraphy. In stable angina, sensitivity for detecting ischemic segments was higher in dipyridamole thallium (74%) than rest BMIPP (48%) images (p<0.05), but there was no significant difference between the 2 images in unstable angina. In unstable angina, the incidence of segments with higher defect scores on BMIPP images than on delayed thallium images and the opposite pattern was 27 and 5 (p<0.01). In stable angina, there was no difference. The mean defect score on BMIPP (6.3±5.6) was higher than that on delayed thallium scintigraphy (2.9±2.7) and it was almost the same as on the initial dipyridamole stress test (6.5±5.2). In conclusion, BMIPP scintigraphy is safer and may be as useful in detecting myocardial ischemia in patients with unstable angina as thallium scintigraphy. (author)

Contribution of 99mTc-DTPA dynamic renal scintigraphy with furosemide test in the exploration of low grade urethra-pelvic junction syndrome. Report of 17 cases

International Nuclear Information System (INIS)

Ghfir, I.; Ben Rais, N.

2009-01-01

Introduction The renal scintigraphy using 99m Tc-DTPA with furosemide test constitutes a noninvasive and functional method that is of appreciable interest in the exploration of the upper urinary tract and in the evaluation of the separate renal function. It distinguishes the functional character of dilation from organic obstruction needing surgery or endoscopic treatment. Material and methods We report, through this work, the observations of 17 patients with a low grade urethra-pelvic junction syndrome detect by intravenous urography (I.V.U.). 99m Tc-DTPA renal scintigraphy with furosemide test was carried out among all our patients by means of a gamma-camera with large field equipped with a low energy high-resolution parallel collimator. The evaluation of images obtained consisted of analysis of urethra-pelvic permeability taking into account the semiquantitative parameters of time-activity curve or isotopic nephrogram (I.N.) obtained after digital reconstruction of sequential images. Results On the 17 studied cases, the sex-ratio was equal to 1.83; the average age was 18.92 years with extremes spanning from 4 years to 70 years. Renal scintigraphy categorized four patients groups. Group I: two patients (11.76%) with normal aspect of I.N.; group II; seven patients (41.17% of cases) with functional dilation; group III: five patients (29.41%) with organic obstruction and a group IV: three patients (17.64%) with intermediate response. Discussion 99m Tc-DTPA renal scintigraphy with furosemide test allowed, through our study, to obviate the limits of IVU and manometric explorations to distinguish functional dilation of organic obstruction. It permits the improvement of treatment with a favourable dosimetry. (authors)

Role of 99MTc-DTPA renal scintigraphy using gates protocol with extended acquisition time in evaluation of the function of pre-operative donor kidneys and post-operative remaining kidney

International Nuclear Information System (INIS)

Trinh Thi Minh Chau; Nguyen Xuan Canlh; Le Huu tam; Truong Quang Xuan

2004-01-01

Introduction: Radionuclide Methods have been extensively used in kidney transplantation. This non-invasive technique provides quantitative analysis of total and individual renal function as well as assessment of urinary outflow tract. Aim of this study was to evaluate renal function of potential kidney-donors and follow up post-nephrectomy kidney-donors by 99mTc-DTPA renal scintigraphy using Gates protocol with extended acquisition. MATERIALS AND Methods: This study included 72 living kidney donors. In addition to routine laboratory and radiological evaluations, a 99mTc-DTPA dynamic renal scintigraphy was acquired 15 second per frame for 30 minutes. Glomerular filtration rate (GFR) was calculated based on Gates protocol. Urinary outflow tract was assayed by renogram generated and consecutive dynamic renal images of up to 30 minute. Renal scintigraphy was also performed in follow-up of 37 post-nephrectomy kidney donors. Results 6 of 72 (8.3%) living related donors were excluded from nephrectomy due to reduced GFR of either total or individual kidney. One of 6 excluded donors had one non-functional kidney. No donors have shown urinary tract obstruction. In 66 kidney donors who were indicated nephrectomy, pre-nephrectomy mean total GFR, calculated by Gates method, was 108 mi/minute that was significantly higher than GFR result of 94 mi/minute by Cockcroft and Gault prediction equation (p 0.05). These results are not significant, indicative of functional compensation occuring after unilateral nephrectomy. Conclusion: Tc-99m DTPA dynamic renal scintigraphy using Gates protocol with extended acquisition time is a valuable simple radionuclide technique which is able to assess total and individual renal function and urinary outflow tract. This technique should be used as an integral part of the pre-operative evaluation contributing to the choice of nephrectomy side in potential kidney donors and as follow-up of post-operative remaining kidney. (authors)

99MTc - DMSA renal scintigraphy in the diagnosis and follow-up of acute pyelonephritis in children

International Nuclear Information System (INIS)

Wallin, L.

1997-06-01

The aim of the present thesis was to define and evaluate a strategy for identification of children who are at risk of developing progressive renal lesions after acute pyelonephritis. Qualitative and quantitative evaluation standards were elaborated to improve the interpretation of DMSA scintigraphy. The normal DMSA distribution pattern, the average background uptake, and scintigraphic kidney length according to age were assessed in 95 presumably healthy kidneys. Furthermore, typical DMSA distribution patterns in acute pyelonephritis were assessed on 65 kidneys in 38 children, and typical DMSA distribution patterns of 152 kidneys with VUR in 101 children with and without previous pyelonephritis. Measurement of scintigraphic kidney length, width and volume was validated in piglets and on a kidney phantom. The scintigraphic kidney length was found to be an accurate measure of renal size, whereas kidney width and volume were less reliable, at least on small kidneys. Criteria of kidney swelling in acute pyelonephritis were defined, and found to be beneficial for identifying reinfections in the absence of clinical symptoms. In 34 children with acute pyelonephritis quantitative and qualitative DMSA scintigraphic findings were correlated to clinical symptoms and laboratory data, in the acute stage and at follow up. We found that quantitative DMSA scintigraphy in the acute stage of pyelonephritis and again after one year will identify children who are at risk of developing progressive renal lesions. Qualitative assessment of DMSA distribution pattern is not reliable enough in this respect. 116 refs., 7 figs

Three new renal simulators for use in nuclear medicine

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Dullius, Marcos; Fonseca, Mateus; Botelho, Marcelo; Cunha, Clêdison; Souza, Divanízia

2014-03-01

Renal scintigraphy is useful to provide both functional and anatomic information of renal flow of cortical functions and evaluation of pathological collecting system. The objective of this study was develop and evaluate the performance of three renal phantoms: Two anthropomorphic static and another dynamic. The static images of the anthropomorphic phantoms were used for comparison with static renal scintigraphy with 99mTc-DMSA in different concentrations. These static phantoms were manufactured in two ways: one was made of acrylic using as mold a human kidney preserved in formaldehyde and the second was built with ABS (acrylonitrile butadiene styrene) in a 3D printer. The dynamic renal phantom was constructed of acrylic to simulate renal dynamics in scintigraphy with 99mTc-DTPA. These phantoms were scanned with static and dynamic protocols and compared with clinical data. Using these phantoms it is possible to acquire similar renal images as in the clinical scintigraphy. Therefore, these new renal phantoms can be very effective for use in the quality control of renal scintigraphy, and image processing systems.

Three new renal simulators for use in nuclear medicine

International Nuclear Information System (INIS)

Dullius, M.; Fonseca, M.; Botelho, M.; Cunha, C.; Souza, D.

2014-01-01

Renal scintigraphy is useful to provide both functional and anatomic information of renal flow of cortical functions and evaluation of pathological collecting system. The objective of this study was to develop and evaluate the performance of 3 renal phantoms: Two anthropomorphic static and another dynamic. The static images of the anthropomorphic phantoms were used for comparison with static renal scintigraphy with 99m Tc-DMSA in different concentrations. These static phantoms were manufactured in 2 ways: one was made of acrylic using as mold a human kidney preserved in formaldehyde and the second was built with ABS (acrylonitrile butadiene styrene) in a 3D printer. The dynamic renal phantom was constructed of acrylic to simulate renal dynamics in scintigraphy with 99m Tc-DTPA. These phantoms were scanned with static and dynamic protocols and compared with clinical data. Using these phantoms it is possible to acquire similar renal images as in the clinical scintigraphy. Therefore, these new renal phantoms can be very effective for use in the quality control of renal scintigraphy, and image processing systems. (authors)

The value of the renal resistive index in the measurement of renal perfusion before and after extracorporal shock wave lithotripsy in correlation to the scintigraphy, to the magnetic resonance perfusion imaging and to big-endothelin values

International Nuclear Information System (INIS)

Palwein-Prettner, L.

1999-07-01

Purpose: the goal of this study was to evaluate effects of extracorporeal shock wave lithotripsy (ESWL) on the renal perfusion using the resistive index (RI), perfusion scintigraphy, magnetic resonance (MR) perfusion imaging and plasma big-endothelin (big-ET-1) values. Method/materials: In 21 patients divided in 3 age-groups the RI was measured before and 1,3,6 and 24 hours after ESWL. Big-ET-1, a potent vasoconstrictor peptid was correlated with the RI values. The RI and Big-ET-1 results was compared to the results of the MR perfusion imaging and the scintigraphy, the gold-standard method. Results: The RI of the treated kidneys increased significantly from 0,64±0,05 to 0,72±0,08 after the ESWL (p<0,001) and in the untreated kidneys from 0,63±0,05 to 0,68±0,09 (p=0,003). The hightest age group shows the most significant increase. The Big-ET-values also increased only in this age group significantly from 0,78±0,24 fmol/l to 1,58±0,52 fmol/l. In the scintigraphy the decrease of the renal plasma flow (RPF) in this age group was most significant. The MR perfusion Imaging shows in all age groups significant decrease (p<0,001). Conclusion: we conclude that the ESWL causes considerable renal parenchymal damage only in the elderly patients. The following changes in renal perfusion were measured very sensitively with the RI which had a good correlation to the results of the perfusion scintigraphy and the MR perfusion imaging. Further studies with larger series have to evaluate these results. (author)

Donor evaluation of extended time 99mTcDTPA renal scintigraphy for added information to guide donor kidney selection: a technologist perspective

International Nuclear Information System (INIS)

Kale, Chanchala; Tarsaria, Sunita; Jaiswal, R.; Amrita; Roshni; Pallavi

2010-01-01

Full text: 99m Tc-DTPA renal scan exposes the patient to considerably less radiation and the images are of superior quality. In donor patients a short time renal scintigraphy to calculate GFR by gates formula is widely accepted in clinical practice. Apart from kidney GFR, renal scan gives added information regarding size, shape and position of kidney, perfusion, peaking time, peak to T 1/2 ratio, transit time, perfusion, split function, assessment of drainage pattern. Aim: The purpose of this study was to evaluate significance of extended time 99m Tc DTPA renogram for appropriate selection of donor kidney. Materials and Method: A retrospective study on 66 patients (female-40, male-26, age range - 22-70 years, mean 48±24) was carried out in our centre. Patients were adequately hydrated before the study. Diuretic intervention renal dynamic scintigraphy (F+10) was performed after administering 5mCi of DTPA intravenously. Sequential dynamic images (Phase I-2 sec/frame for 1 min, Phase II-1 min/frame for 29 min) were acquired posteriorly on GE Millennium VG gamma camera. Pre and post syringe counts were also taken. Standard protocol was used for processing. Along with other parameters GFR by Gates formula was obtained Result: GFR was found to be in the range of 68.7 ml/min - 135.8 ml/min. (mean GFR = 102.25 ml/min). It was found that in 50 patients (75%) both Kidney GFR was normal. Whereas in 2 patients (3.0%) global GFR was low. There were 7 patients (10.60%) in which pelvicalceal hold up was seen which adequately cleared with lasix. One patient ( 99m Tc-DTPA renal scintigraphy with diuretic (F+10, 30 min study) as a functional modality is significantly useful in the selection of donor kidney

Comparison of glomerular filtration rates by dynamic renal scintigraphy and dual-plasma sample clearance method in diabetic nephropathy

International Nuclear Information System (INIS)

Xie Peng; Huang Jianmin; Pan Liping; Liu Xiaomei; Wei Lingge; Gao Jianqing

2010-01-01

Objective: To evaluate the accuracy of renal scintigraphy for the estimation of glomerular filtration rates (dGFR) in patients with diabetic nephropathy as compared to the conventional dual-plasma sample clearance method (pscGFR). Methods: Forty-six patients with diabetic nephropathy underwent both dynamic renal scintigraphy and dual-plasma sample measurement after 99 Tc m -DTPA injection. Paired student t-test and correlation analysis were performed to compare dGFR and pscGFR (normalized to body surface area, 1.73 m -2 ). Results: The mean dGFR was higher than mean pscGFR ((51.08±26.78)ml·min -1 vs (44.06±29.43)ml·min -1 , t=4.209, P=0.000). The dGFR correlated with pscGFR (r=0.923, P=0.000) linearly (regression equation: pscGFR=1.015 x dGFR -7.773, F=254.656, P=0.000). Conclusions: dGFR correlated well with pscGFR. Although it could not absolutely replace the latter in patients with diabetic nephropathy, dGFR could reasonably evaluate the filtration function for these patients. (authors)

Contribution of {sup 99m}Tc-DTPA dynamic renal scintigraphy with furosemide test in the exploration of low grade urethra-pelvic junction syndrome. Report of 17 cases; Apport de la scintigraphie renale dynamique au {sup 99m}Tc-DTPA avec epreuve au furosemide dans l'exploration du syndrome de la jonction pyelo-uretrale a minima. A propos de 17 cas

Energy Technology Data Exchange (ETDEWEB)

Ghfir, I.; Ben Rais, N. [Hopital Ibn Sina, CHU de Rabat, Service de Medecine Nucleaire, Rabat (Morocco)

2009-10-15

Introduction The renal scintigraphy using {sup 99m}Tc-DTPA with furosemide test constitutes a noninvasive and functional method that is of appreciable interest in the exploration of the upper urinary tract and in the evaluation of the separate renal function. It distinguishes the functional character of dilation from organic obstruction needing surgery or endoscopic treatment. Material and methods We report, through this work, the observations of 17 patients with a low grade urethra-pelvic junction syndrome detect by intravenous urography (I.V.U.). {sup 99m}Tc-DTPA renal scintigraphy with furosemide test was carried out among all our patients by means of a gamma-camera with large field equipped with a low energy high-resolution parallel collimator. The evaluation of images obtained consisted of analysis of urethra-pelvic permeability taking into account the semiquantitative parameters of time-activity curve or isotopic nephrogram (I.N.) obtained after digital reconstruction of sequential images. Results On the 17 studied cases, the sex-ratio was equal to 1.83; the average age was 18.92 years with extremes spanning from 4 years to 70 years. Renal scintigraphy categorized four patients groups. Group I: two patients (11.76%) with normal aspect of I.N.; group II; seven patients (41.17% of cases) with functional dilation; group III: five patients (29.41%) with organic obstruction and a group IV: three patients (17.64%) with intermediate response. Discussion {sup 99m}Tc-DTPA renal scintigraphy with furosemide test allowed, through our study, to obviate the limits of IVU and manometric explorations to distinguish functional dilation of organic obstruction. It permits the improvement of treatment with a favourable dosimetry. (authors)

Diagnostic criteria of 99mTc-diethylenetriaminepentaacetic acid captopril renal scan for the diagnosis of renovascular hypertension by unilateral renal artery stenosis

International Nuclear Information System (INIS)

Choi, Seung Jin; Hong, Il Ki; Chang, Jae Won; Park, Su Kil; Moon, Dae Hyuk

2004-01-01

We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. The study group consisted of 24 patients (m/f = 16/8, age: 39±18 years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with 99m Tc-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0 = normal, and 5 = renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Eight of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age ≤ 38); 92% and 50% (BCfun≥ 1 %); 92% and 75% (CBren≥ 1), and 90% and 60% (CNren≥ 1), respectively. Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis

Immediate renal imaging and renography with /sup 99m/Tc methylene diphosphonate to assess renal blood flow, excretory function, and anatomy

International Nuclear Information System (INIS)

Glass, E.C.; DeNardo, G.L.; Hines, H.H.

1980-01-01

/sup 99m/Tc methylene diphosphonate (/sup 99m/Tc MDP) was evaluated as a clinical renal imaging agent in 20 patients referred for bone scintigraphy. Sequential scintigraphy, which was started immediately after injection, yielded blood flow studies of high quality, and subsequent images accurately delineated renal anatomy and excretion in nonazotemic patients. In comparison with delayed images, early images were vastly superior in quality and demonstrated improved target-to-nontarget activity ratios (p < 0.001) and improved lesion detectability (p < 0.01). Renal imaging performed incidental to bone scintigraphy with MDP can be greatly enhanced by initiating sequential scintigraphy immediately after injection

Non-contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in the patients with refractory renal colic

International Nuclear Information System (INIS)

Kravchick, Sergey; Stepnov, Eugeny; Lebedev, Valery; Linov, Lina; Leibovici, Octavian; Ben-Horin, Clara L. Dosoretz; Trejo, Leonardo; Peled, Ronit; Cytron, Shmuel

2006-01-01

Objectives: To assess the importance of combined use of non-contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in evaluation of patients with refractory flank pain in the emergency department. Methods: The study involved 64 consecutive patients with refractory renal colic. All patients were evaluated with plain abdominal films kidneys, ureters and bladder (KUB), NCCT and DRS. We assessed the accuracy of different diagnostic procedures and their combinations; in addition, we determined their importance for different steps of evaluation. Results: Urololithiasis was diagnosed in 76.6% (n = 49) of the patients. Twenty-nine percent of calculi were >4 mm. Surgical intervention were performed in 20 patients (40.8%). A combination of NCCT plus DRS yielded the greatest sensitivity (96%) in establishing final diagnosis, however clinical, laboratory and KUB data in combination with DRS, yielded greater specificity (93%) and PPV (97%). Sex (male), WBC (mean 10.2 x 10 3 ± 3.1) and KUB (calculus > 4 mm) were chosen in the three-step multi-variant analysis, while only male sex was found to be the strongest predictor (p 3 and calculi > 4 mm on the KUB

{sup 99M}Tc - DMSA renal scintigraphy in the diagnosis and follow-up of acute pyelonephritis in children

Energy Technology Data Exchange (ETDEWEB)

Wallin, L

1997-06-01

The aim of the present thesis was to define and evaluate a strategy for identification of children who are at risk of developing progressive renal lesions after acute pyelonephritis. Qualitative and quantitative evaluation standards were elaborated to improve the interpretation of DMSA scintigraphy. The normal DMSA distribution pattern, the average background uptake, and scintigraphic kidney length according to age were assessed in 95 presumably healthy kidneys. Furthermore, typical DMSA distribution patterns in acute pyelonephritis were assessed on 65 kidneys in 38 children, and typical DMSA distribution patterns of 152 kidneys with VUR in 101 children with and without previous pyelonephritis. Measurement of scintigraphic kidney length, width and volume was validated in piglets and on a kidney phantom. The scintigraphic kidney length was found to be an accurate measure of renal size, whereas kidney width and volume were less reliable, at least on small kidneys. Criteria of kidney swelling in acute pyelonephritis were defined, and found to be beneficial for identifying reinfections in the absence of clinical symptoms. In 34 children with acute pyelonephritis quantitative and qualitative DMSA scintigraphic findings were correlated to clinical symptoms and laboratory data, in the acute stage and at follow up. We found that quantitative DMSA scintigraphy in the acute stage of pyelonephritis and again after one year will identify children who are at risk of developing progressive renal lesions. Qualitative assessment of DMSA distribution pattern is not reliable enough in this respect. 116 refs., 7 figs.

Indications for pediatric 99mTc-dimercaptosuccinic-scintigraphy

International Nuclear Information System (INIS)

Meller, J.; Becker, W.; Zappel, H.

2000-01-01

This paper gives an overview about the diagnostic use of 99m Tc-Dimercaptosuccinic ( 99m Tc-DMSA)-scintigraphy in siblings and children and presents our own results with this tracer in pediatric nephro-urology. 99m Tc-DMSA offers a high renal accumulation and therefore is suited for the diagnosis of renal malformations. Furthermore, a calculation of the tubular renal split function and imaging of the renal cortex is possible due its high tubular retention. The tracer may be used with success in the non invasive diagnostic work up of both renoparenchymal and renovascular hypertension in childhood and especially in the diagnosis of segmental renal artery stenosis. Scintigraphy with 99m Tc-DMSA is a simple and highly effective method in the diagnosis of pyelonephritis and renal scarring. It offers important informations about the further prognosis of a child with urinary tract infection. In upper urinary tract infection 99m Tc-DMSA-scintigraphy may be more specific than available clinical tests. In the diagnosis of pyelonephritis and renal scarring scintigraphic imaging has been proven to be more sensitive than pyelography and ultrasound and its diagnostic power is at least equal compared with computed tomography. Therefore, imaging with 99m Tc-DMSA can be considered as the reference method in these questions. Regarding that reflux is seen in less than 40% of children with a pathologic DMSA-scan and that the prognosis of children with an urinary tract infection without a pathologic DMSA-scan is usually good, one could question the use of micturating cystourethrography in the diagnostic work up of children with symptomatic urinary tract infection and a normal DMSA-scan. (orig.) [de

Gastroesophageal scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Malmud, L.S.; Fisher, R.S.

1980-01-01

The technique of gastroesophageal scintigraphy was developed in order to quantitatively detect reflux from the stomach into the esophagus. The scintigraphic technique was compared to previous diagnostic tests. None of the other techniques is as sensitive as gastroesophageal scintigraphy for the detection of reflux, in comparison to the acid reflux test. Gastroesophageal scintigraphy is able to detect gastroesophageal reflux acurately, rapidly, noninvasively, and more sensitively than other diagnostic techniques. In addition, it is able to be employed to quantitate reflux and is suitable for studying the effects of various therapeutic modalities.

Dynamic scintigraphy of the kidneys in chronic pyelonephritis of patients with artrial hypertension

International Nuclear Information System (INIS)

Kramer, A.A.; Belichenko, O.I.; Arabidze, G.G.

1985-01-01

It has been shown that latent renal diseases are detected by sectoral scintigraphy earlier than by other methods, and the former acquires particular importance when the only sign of disease is arterial hypertension. Early diagnosis of latent pyelonephritis makes this method especially valuable both for the selection of patients for further thorough examination and for the start of adequate therapy. Scintigraphy serves as a reliable criterion for the evaluation of the therapeutic efficacy in patients with chronic pyelonephritis (CP). Changes of scintigraphy parametres coincide quite exactly with the changed level of arterial pressure, concentration and nitrogen clearing function of the kidneys during treatment. This method (sectoral scintigraphy) is very important when used over time in CP patiens with chronic renal insufficiency making it possible to detect with a sufficient deg ree of significance the improvement as well as impairment of renal function which is a crucial point for the choice of further therapeutic tactics

Scintigraphy of parathyroids in secondary hyperparathyroidism

International Nuclear Information System (INIS)

Hublo, D.; Beauchat, V.; Pattou, F.; Lecomte-Houcke, M.; Prangere, T.; Ziegels, P.; Carnaille, B.; Proye, C.; Marchandise, X.; Steiling, M.

1997-01-01

Use of pre-surgery imaging of parathyroids is still questioned. The goal of this study is to evaluate the sensitivity of the scintigraphy in the detection of secondary parathyroid anomalies with renal insufficiency. Thirty two patients (20 F, 12 M) of 14 - 74 years old were operated of secondary hyperparathyroidism with renal insufficiency. It was a matter of re-intervention in 9 cases. The acquisitions were achieved 20 min and 2 h after injection of 550 MBq of MIBI- 99m Tc or of Tetrofosmine - 99m Tc and 2 h after injection of 5.5 MBq of iodine 123. Eighty seven glands of 28 to 3820 mg were pulled out in 23 first surgeries while the parathyroid tissue was found in thymic prolongations in 5 of these patients. The masses of 41 glands, positive by scintigraphy (from 69 to 3829 mg), were significantly higher (Wilcoxon's test, p -8 ) than the 46 not-seen (from 28 to 1050 mg). The sensitivity of total detection is 47%, of 85% for the 33 glands of 500 mg or more and of 24% for the 54 glands of less than 500 mg. In 9 re-interventions, 12 abnormal glands were pulled out: 11 (of 430 to 4500 mg were positive by scintigraphy, while only one gland of 80 mg was not seen. In conclusion, the scintigraphy realised before first surgery for secondary hyperparathyroidism with renal insufficiency presents low sensitivity, related partly, at least, to the low mass of glands and justifies itself only by search for positive ectopic parathyroids. Instead, it appears performing and indispensable in case of re-intervention

Renal damage in vesicoureteral reflux associated to duplex systems

International Nuclear Information System (INIS)

Orellana, P.; Velasquez, C.; Baquedano, P.

2002-01-01

Duplex system (DS) is a common occurrence and it can be associated to a range of ureteral and renal anomalies draining the two poles of the duplex kidneys, as vesicoureteral reflux (VUR) in the lower moiety and ureterocele in the upper moiety. The VUR in a duplex system can be primary or secondary (associated to an ureterocele). The assessment of parenchymal uptake and function of the whole and separate parts of the kidneys is important for therapeutical decisions. Objective: To determine the presence of renal damage, by dimercaptosuccinic acid (DMSA) scintigraphy in children with a refluxing DS and if there any difference between primary and secondary reflux. Patients and Methods: 36 children; 23 girls and 13 boys, with VUR into completely duplicated collecting systems was studied retrospectively (37 RU with DS, 35 unilateral and 1 bilateral), with a mean age of 2.43 y.o. (range: 1 month-11y.o.). All of the children underwent ultrasonography, voiding cystourethrogram and renal static scintigraphy. Among the 37 RU with VUR, 25 had primary VUR and 12 had VUR secondary to the presence of an ureterocele. Ten out of the 36 children (27.8%) were evaluated due to antenatal diagnosis and the remaining 26 (72.2%) after urinary tract infection (UTI). Results: Seventy percent of the 37 RU with VUR into completely duplicated collecting systems had renal damage demonstrated by renal static scintigraphy. Among the 25 RU with primary VUR, 19 (76%) had renal damage, 6 with a complete absence of function in the lower moiety. In this group, 80% of children was studied due to an UTI at a mean age of 3.3 y.o. In the group of children with secondary VUR, we observed a lower moiety with renal damage in 6/12 (50%), in 4 of them associated with an abnormal upper moiety. 7 out of 12 children (58.3%) had an abnormal upper moiety, 4 of them with a damage in lower moiety too. One children presented with renal exclusion. Half of these children were studied due to UTI, at a mean age of 1 y

Plain radiography, renography, and 99mTc-DMSA renal scintigraphy before and after extracorporeal shock wave lithotripsy for urolithiasis

International Nuclear Information System (INIS)

Munck, O.; Gerquari, I.; Moeller, J.T.; Jensen, L.I.; Thomsen, H.S.

1992-01-01

Eighteen patients were evaluated before and 5 weeks after the first treatment with extracorporeal shock wave lithotripsy (ESWL) using abdominal plain radiography, 131 I-hippuran probe renography, and 99m Tc-dimercaptosuccinic acid scintigraphy. In 6 patients no urolithiasis was present on the post ESWL plain radiograph, in 7 the size had decreased, and in 5 the stone mass was unchanged. The renograms were within normal range in the 6 patients who were cured by ESWL, whereas this was the case for only 4 of the 12 who still had renal calculi. In 2 patients pelvic stones had descended into the ureter after ESWL, and the renograms indicated obstruction. Another 3 patients had ureteral stones, whereas in the remaining 7 patients only pelvic stones were found on the plain radiographs. In no patient did the scintigrams reveal scars. It is concluded that abdominal plain radiography of the urinary tract and probe renography are complementary and sufficient in the monitoring of patients with urolithiasis post ESWL. (orig.)

Attenuation correction for renal scintigraphy with 99mTc - DMSA: comparison between Raynaud and the geometric mean methods

International Nuclear Information System (INIS)

Argenta, J.; Brambilla, C.R.; Marques da Silva, A.M.

2009-01-01

The evaluation of the index of renal function (IF) requires soft-tissue attenuation correction. This paper investigates the impact over the IF, when attenuation correction is applied using the Raynaud method and the geometric mean method in renal planar scintigraphy, using posterior and anterior views. The study was conducted with Monte Carlo simulated images of five GSF family voxel phantoms with different relative uptakes in each kidney from normal (50% -50%) to pathological (10% -90%). The results showed that Raynaud method corrects more efficiently the cases where the renal depth is close to the value of the standard phantom. The geometric mean method showed similar results to the Raynaud method for Baby, Child and Golem. For Helga and Donna models, the errors were above 20%, increasing with relative uptake. Further studies should be conducted to assess the influences of the standard phantom in the correcting attenuation methods. (author)

Attenuation correction for renal scintigraphy with 99mTc-DMSA: analysis between Raynaud and the geometric mean methods

International Nuclear Information System (INIS)

Argenta, Jackson; Brambilla, Claudia R.; Silva, Ana Maria M. da

2010-01-01

The evaluation of the index of renal function (IF) requires soft-tissue attenuation correction. This paper investigates the impact over the IF, when attenuation correction is applied using the Raynaud method and the Geometric Mean method in renal planar scintigraphy, using posterior and anterior views. The study was conducted with Monte Carlo simulated images of five GSF family voxel phantoms with different relative uptakes in each kidney from normal (50% -50%) to pathological (10% -90%). The results showed that Raynaud method corrects more efficiently the cases where the renal depth is close to the value of the standard phantom. The geometric mean method showed similar results to the Raynaud method for Baby, Child and Golem. For Helga and Donna models, the errors were above 20%, increasing with relative uptake. Further studies should be conducted to assess the influences of the standard phantom in the correcting attenuation methods. (author)

Physicochemical and biological study of a renal scintigraphy agent: the DMSA - 99mTc complex

International Nuclear Information System (INIS)

Laroche, Dominique

1979-01-01

This research thesis deals with the study of the dimercaptosuccinic acid (DMSA) marked with 99m Tc, a recently developed scintigraphy agent used for the kidney isotopic exploration. The author notably studied the relationships between the physicochemical properties of solutions of dimercaptosuccinic acid marked with 99m Tc and the biological distribution of 99m Tc in order to reach a better understanding of the biological mechanism which results in technetium fixation to the kidney

The localization of urinary tract infection with sup(99m)Tc glucoheptonate scintigraphy

International Nuclear Information System (INIS)

Traisman, E.S.; Conway, J.J.; Traisman, H.S.; Yogev, R.; Firlit, C.; Shkolnik, A.; Weiss, S.; Northwestern Univ., Chicago, IL; Children's Memorial Hospital, Chicago, IL

1986-01-01

A retrospective study was performed of 39 children at the Children's Memorial Hospital, Chicago, Illinois, who underwent technetium-99m glucoheptonate (sup(99m)TcGH) scintigraphy for evaluation of possible urinary tract infection. Clinical and laboratory criteria classified the children as having pyelonephritis, cystitis, or no urinary tract infection. Of 28 children classified as having pyelonephritis, 24 (86%) children had abnormalities on sup(99m)TcGH scintigraphy. Only 8 of 19 (42%) renal ultrasound scans and 4 of 17 (24%) intravenous pyelography studies performed in these children demonstrated findings consistent with parenchymal disease. Only 9 of 19 (47%) cystograms demonstrated vesicoureteral reflux. Three children who underwent gallium-67 citrate scintigraphy had localization at the sites of focal defects with sup(99m)TcGH scintigraphy. sup(99m)TcGH scintigraphy is a sensitive and specific indicator of renal parenchymal involvement that helps localize urinary tract infection to the kidney. (orig.)

Indium-111 labelled platelet scintigraphy can predict the immunological origin of fever in patients on dialysis carrying a non-functioning renal allograft

International Nuclear Information System (INIS)

Fuster, D.; Lomena, F.; Piera, C.; Setoain, F.J.; Laterza, C.; Herranz, R.; Setoain, J.; Torregrosa, J.V.; Oppenheimer, F.

2000-01-01

The purpose of this study was to evaluate the usefulness of labelled platelet scintigraphy in the differential diagnosis of a prolonged febrile syndrome (PFS) in patients on dialysis carrying a non-functioning renal allograft. We prospectively performed an indium-111 mercaptopyridine-labelled platelet scan on 91 patients (54 men, 37 women; mean age 39.6±12 years). The mean duration of PFS was 35 days (range 7-122). Forty-six of the 91 patients underwent steroid therapy (2- 10 mg/day). Platelet labelling was carried out following Thakur's method. Platelet scans were performed 48 h after reinjection of labelled platelets. The platelet uptake index (PUI) was calculated by dividing the cpm/pixel in the allograft ROI by cpm/pixel in a mirror background ROI. The final diagnosis of PFS was established depending on the outcome after treatment. In 61/91 patients the fever had an immunological origin because it disappeared after graft embolisation or transplantectomy. In 30/91 patients the PFS disappeared after antibiotic therapy (non-immunological origin). The PUI in patients with immunological PFS was 1.80±0.7, while in patients with non-immunological PFS it was 1.12±0.1 (P 111 In-labelled platelet scintigraphy can accurately predict an immunological PFS in patients on dialysis carrying a non-functioning renal allograft. Therapy with steroids could reduce the sensitivity of 111 In-labelled platelet scintigraphy in detecting immunological PFS. (orig.)

DMSA-scintigraphy in paediatrics: is the evaluation of the geometric mean necessary for the calculation of the differential renal function?

International Nuclear Information System (INIS)

Porn, U.; Alalp, S.; Fischer, S.; Dresel, S.; Rossmueller, B.; Hahn, K.

2001-01-01

For assessment of differential renal function (PF) by means of static renal scintigraphy with Tc-99m-dimercaptosuccinic acid (DMSA) the calculation of the geometric mean of counts from the anterior and posterior view is recommended. Aim of this retrospective study was to find out, if the anterior view is necessary to receive an accurate differential renal function by calculating the geometric mean compared to calculating PF using the counts of the posterior view only. Methods: 164 DMSA-scans of 151 children (86 f, 65 m) aged 16 d to 16 a (4.7 ± 3.9 a) were reviewed. The scans were performed using a dual head gamma camera (Picker Prism 2000 XP, low energy ultra high resolution collimator, matrix 256 x 256, 300 kcts/view, Zoom: 1.6-2.0). Background corrected values from both kidneys anterior and posterior were obtained. Using region of interest technique PF was calculated using the counts of the dorsal view and compared with the calculated geometric mean [SQR(Cts dors x Cts ventr )]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (p geom and the PF dors was 1.5 ± 1.4%. A difference ≥5% (5.0-9.5%) was obtained in only 6/164 scans (3.7%). Three of 6 patients presented with an underestimated PF dors due to dystopic kidneys on the left side in 2 patients and on the right side in one patient. The other 3 patients with a difference >5% did not show any renal abnormality. Conclusion: The calculation of the PF from the posterior view only will give an underestimated value of the right kidney compared to the calculation of the geometric mean. This effect is not relevant for the calculation of the differential renal function in orthotopic kidneys, so that in these cases the anterior view is not necessary. However, geometric mean calculation to obtain reliable values for differential renal function should be applied in cases with an obvious anatomical abnormality. (orig.) [de

Results of a five-year study of 99mTc DMSA renal scintigraphy in children and adolescents following acute pyelonephritis

International Nuclear Information System (INIS)

Chroustova, D.; Palyzova, D.; Kolska, M.; Urbanova, I.

2006-01-01

Renal scintigraphy, generally using 99' mTc-DMSA, is the accepted reference standard for detection of renal cortical changes. The timing of the test, i.e., whether an acute 99m Tc-DMSA scan, a follow-up only or both scans should be performed, however, remains open to discussion. In our study, a six-month follow- up DMSA scan was performed in all the children diagnosed with a first attack of acute pyelonephritis (APN) in two large paediatric clinics of Charles University's 3 rd School of Medicine in Prague during a five-year period. All diagnoses were confirmed by a paediatric nephrologist. 382 children (267 girls, 115 boys) aged between 7 months and 19 years were included in the study. For analytical purposes, the patients were divided into 4 age groups: I - less than 1 year of age, II - 1-5 years, III - 5-10 years, and IV - 10-19 years. In all children younger than five years, a micturition cystourethrogram (MCUG) for detection of vesicoureteric reflux (VUR) was performed between one and three months after the APN episode. Static renal scintigraphy, using an HR collimator with parallel holes was performed using a planar Gamma camera MB 9200 (Gamma Budapest) in all children six months after APN, with a complement of pinhole images, SPECT or PSPECT of the kidneys. 1. In group I, all four children with positive VUR on MCUG had a pathological DMSA scan, while only two of the 32 patients with negative VUR had a pathological DMSA. 2. In group II, 17 children had VUR on MCUG, six of them with a pathological and 11 with a normal DMSA scan. Most of the 221 children without VUR had a normal DMSA scintigraphy; pathological findings were present in 17 children only. 3. In group III, all children with VUR, but only 5 out of 53 without VUR, had a pathological DMSA scan. 4. Five out of 50 children in group IV had a pathological DMSA. APN occurred most frequently in group II (62.3%, or 238 children) and ranged between 10-15% in the remaining groups. APN was found very frequently

Evaluation of the use of technetium Tc 99m diethylenetriamine pentaacetic acid and technetium Tc 99m dimercaptosuccinic acid for scintigraphic imaging of the kidneys in green iguanas (Iguana iguana).

Science.gov (United States)

Greer, Leah L; Daniel, Gregory B; Shearn-Bochsler, Valerie I; Ramsay, Edward C

2005-01-01

To evaluate the use of scintigraphy involving technetium Tc 99m diethylenetriamine pentaacetic acid ((99m)Tc-DTPA) or technetium Tc 99m dimercaptosuccinic acid ((99m)Tc-DMSA) for the determination of kidney morphology and function in green iguanas (Iguana iguana). 10 healthy iguanas weighing >1.6 kg. Renal scintigraphy was performed by use of (99m)Tc-DTPA in 6 of the iguanas and by use of (99m)Tc-DMSA in all 10 iguanas. After the injection of (99m)Tc-DMSA, scans were performed for each iguana at intervals during a 20-hour period. Renal biopsies were performed in all 10 iguanas after the final scintigraphic evaluation. In iguanas, the use of (99m)Tc-DTPA for renal scintigraphy was nondiagnostic because of serum protein binding and poor renal uptake of the isotope; mean +/- SD (99m)Tc-DTPA bound to serum proteins was 48.9 +/- 9.9%. Renal uptake of (99m)Tc-DMSA produced distinct visualization of both kidneys. Renal uptake and soft tissue clearance of (99m)Tc-DMSA increased over the 20-hour imaging period; mean +/- SD renal uptake of (99m)Tc-DMSA was 11.31 +/- 3.06% at 20 hours. In each of the 10 iguanas, ultrasonographic and histologic examinations of biopsy specimens from both kidneys revealed no abnormalities. Results indicate that the kidneys of iguanas can be evaluated scintigraphically by use of (99m)Tc-DMSA; this technique may be potentially useful for the diagnosis of renal failure in iguanas.

Gammagrafía renal en niños con primera infección febril del tracto urinario Renal scintigraphy in children with first febrile urinary tract infection

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María Caridad Duarte Pérez

2012-12-01

the first febrile urinary tract infection, and to relate them to the studied variables. Methods: two hundred eleven children diagnosed as first febrile urinary tract infection patients were studied and performed Tc-DMSA renal scintigraphy in the acute phase of infection. The results were correlated to the duration and intensity of the fever before the diagnosis, to the acute phase reactants (hemogram, erythrosedimentation and reactive-C protein and to the results of imaging studies (renal ultrasound and mictional uretrocystography. Results: females prevailed and 82.4 % of patients were under one year-old. In the study group, 54 % presented with scintigraphic alterations and the hypocapture pattern of the radiopharmaceutical was the predominant finding in 70 % of patients. There was significant association between the duration and intensity of the fever, and the renal alterations. Regarding the lab parameters, leukocytosis above 15 000, accelerated erythrosedimentation and raised reactive-C protein were statistically significant and related to the renal alterations, whereas the radiological findings observed in renal ultrasound and mictional urethrocystography were statistically correlated to the renal lesion detected in the scintigraphy. Conclusions: high percentage of patients suffered the spread of infection over the renal parenchyma; additionally the studied clinical, lab and imaging variables indicated renal injure.

Renal transplant scintigraphy (Part 1)

International Nuclear Information System (INIS)

Chew, Ghee

2005-01-01

Renal transplantation is the most effective mode of renal replacement therapy for correction of renal failure. Renal donors can either be: a. a deceased person - the kidneys being removed when brain death or absence of cerebral cortical function / perfusion is confirmed - the cadaveric kidney is packed in ice and nutrient solution and transplanted within 24 hours of removal ('cold ischemia') ob. a living donor - the donor may or may not be related to the recipient. Due to the limited length of the renal vessels and ureter of the donor kidney, it is implanted close to the bladder of the recipient. The donor vessels are anastomosed to the iliac artery and vein of the recipient. Transplant variants: a. 2 kidneys maybe transplanted because: - an old donor with less kidney reserve from atrophy due to age or disease (e.g. hypertension) - an infant donor when both kidneys are removed en bloc, b. Donor kidneys with more than 1 artery, vein or ureter. c. Donor horse shoe kidney d. Combined renal and pancreas transplant for type I diabetics -a short segment of duodenum transplanted with the pancreas maybe implanted into the bladder. Copyright (2005) The Australian and New Zealand Society of Nuclear Medicine

Quantitation in planar renal scintigraphy: which μ value should be used?

International Nuclear Information System (INIS)

Hindie, E.; Jeanguillaume, C.; Galle, P.; Prigent, A.

1999-01-01

The attenuation coefficient value μ used by different authors for quantitation in planar renal scintigraphy varies greatly, from the theoretical value of 0.153 cm -1 (appropriate for scatter-free data) down to 0.099 cm -1 (empirical value assumed to compensate for both scatter and attenuation). For a 6-cm-deep kidney, such variations introduce up to 30% differences in absolute measurement of kidney activity. Using technetium-99m phantom studies, we determined the μ values that would yield accurate kidney activity quantitation for different energy windows corresponding to different amounts of scatter, and when using different image analysis approaches similar to those used in renal quantitation. With the 20% energy window, it was found that the μ value was strongly dependent on the size of the region of interest (ROI) and on whether background subtraction was performed: the μ value thus varied from 0.119 cm -1 (loose ROI, no background subtraction) to 0.150 cm -1 (kidney ROI and background subtraction). When using data from an energy window that could be considered scatter-free, the μ value became almost independent of the image analysis scheme. It is concluded that: (1) when performing background subtraction, which implicitly reduces the effect of scatter, the μ value to be used for accurate quantitation is close to the theoretical μ value; (2) if the acquired data were initially corrected for scatter, the appropriate μ value would then be the theoretical μ value, whatever the image analysis scheme. (orig.)

Al18F-NODA-butyric acid: Biological evaluation of a new PET renal radiotracer

International Nuclear Information System (INIS)

Lipowska, Malgorzata; Klenc, Jeffrey; Shetty, Dinesh; Nye, Jonathon A.; Shim, Hyunsuk; Taylor, Andrew T.

2014-01-01

Introduction: Renal scintigraphy is an important imaging modality for the diagnosis and management of a variety of renal diseases including obstruction and renovascular hypertension as well as the evaluation of absolute and relative kidney function. The goal of this work was to evaluate Al 18 F-NODA-butyric acid (Al 18 F-1) as a potential PET tracer to image the kidneys and monitor renal function by comparing its pharmacokinetic properties with those of 131 I-o-iodohippurate ( 131 I-OIH), the radioactive standard for the measurement of effective renal plasma flow. Methods: Al 18 F-1 was prepared in aqueous conditions using a one-pot Al 18 F-radiofluorination method and its radiochemical purity was determined by HPLC. Biodistribution studies, using 131 I-OIH as an internal control, were performed in normal rats and in rats with renal pedicle ligation. In vitro stability and metabolism of Al 18 F-1 were analyzed by HPLC. Dynamic microPET/CT studies were conducted in normal rats. Results: Al 18 F-1 showed excellent stability in vitro and in vivo. Biodistribution studies in normal rats and in rats with simulated renal failure confirmed that Al 18 F-1 was exclusively cleared through the renal–urinary pathway and that the hepatic/gastrointestinal activity was less for Al 18 F-1 than for 131 I-OIH both at 10 and 60 min. Dynamic PET showed a rapid transit of Al 18 F-1 through the kidneys into the bladder. Conclusion: These results suggest that the easily labeled Al 18 F-based compounds provide a highly promising approach for the development of a PET renal radiotracer that combines superior imaging qualities with a reliable measure of effective renal plasma flow

Is Ureter Visualization Possible on Tc-99m DMSA Scintigraphy with Vesicoureteral Reflux Patients?

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Hasan Atilgan

2014-12-01

Full Text Available Aim: Ureter or pelvicalyceal system is not be vizualized with 99mTechnetium- dimercaptosuccinic acid (99mTc-DMSA which is accumulated by renal cortex normally. In this study the cases whose ureters are visible were reviewed with 99mTc-DMSA scintigraphy. Material and Method: 18 patients (5 females, 13 males with median age 3.5 years (min 2 months-max 18 years were included in this study. Twenty ureters and/or pelvis of 18 patients were visible in 99mTc-DMSA scintigraphy. In two patients%u2019s both ureters were visible. Vesicoureteral reflux (VUR grade, 99mTc-DMSA uptake, renal size, status of pelvicalyceal system, urea, creatinine levels were evaluated in all patients. Results: Three of the visible ureters were actually due to pelvicaliectasis. These pelvicaliectasic patients were excluded from the study. In the evaluation of the remaining 17 ureters of patients, congenital megaureter was present in three patients. Grade 3 VUR was detected in three patients, grade 4 was in three patients. VUR is seen as grade five in eight kidneys of seven patients because one of these patients has bilateral vizualized ureter. Discussion: In patients with congenital megaureter and VUR, ureters can be visible with 99mTc-DMSA scintigraphy and further imaging modalities are recommended for these patients.

Value of imaging studies after a first febrile urinary tract infection in young children: data from Italian renal infection study 1.

Science.gov (United States)

Montini, Giovanni; Zucchetta, Pietro; Tomasi, Lisanna; Talenti, Enrico; Rigamonti, Waifro; Picco, Giorgio; Ballan, Alberto; Zucchini, Andrea; Serra, Laura; Canella, Vanna; Gheno, Marta; Venturoli, Andrea; Ranieri, Marco; Caddia, Valeria; Carasi, Carla; Dall'amico, Roberto; Hewitt, Ian

2009-02-01

We examined the diagnostic accuracy of routine imaging studies (ultrasonography and micturating cystography) for predicting long-term parenchymal renal damage after a first febrile urinary tract infection. This study addressed the secondary objective of a prospective trial evaluating different antibiotic regimens for the treatment of acute pyelonephritis. Data for 300 children urinary tracts were mostly normal. The acute technetium-99m-dimercaptosuccinic acid scans showed pyelonephritis in 54% of cases. Renal scarring developed in 15% of cases. The ultrasonographic and cystographic findings were poor predictors of long-term damage, showing minor sonographic abnormalities for 12 and reflux for 23 of the 45 children who subsequently developed scarring. The benefit of performing ultrasonography and scintigraphy in the acute phase or cystourethrography is minimal. Our findings support (1) technetium-99m-dimercaptosuccinic acid scintigraphy 6 months after infection to detect scarring that may be related to long-term hypertension, proteinuria, and renal function impairment (although the degree of scarring was generally minor and did not impair renal function) and (2) continued surveillance to identify recurrent urinary tract infections that may warrant further investigation.

Clinical nuclear medicine applications in Turkey and specific renal studies

International Nuclear Information System (INIS)

Erbas, B.

2004-01-01

Full text: Nuclear cardiology, nuclear oncology, pediatric nuclear medicine and nuclear endocrinology are the main application areas of clinical nuclear medicine in Turkey. Not only imaging studies, but also therapeutic application of radiopharmaceuticals is also performed at many institutes, such as hyperthyroidism treatment with radioiodine, thyroid cancer ablation and metastases treatment with radioiodine, radio synovectomy, metastatic pain therapy, and recently radioimmunotherapy of lymphomas. Almost all radionuclides and radiopharmaceuticals are obtained commercially from European countries, except 18-FDG which is obtained from two cyclotrons in Turkey. More than 30.000 renal procedures are performed at the University hospitals in a year. Pediatric age groups is approximately % 55 of patients. 99mTc-DTPA (%44), 99mTc-DMSA (%37), 99mTc-MAG3 (%17) and 99mTc-EC (%2) are the most commonly used radiopharmaceuticals for renal imaging. More than 6.000 vials of several pharmaceuticals are used for renal cortical scintigraphy (%35), dynamic renal imaging (%34), renal scintigraphy with diuretic (%27) and captopril scintigraphy (%4). Most common indication for renal cortical scintigraphy is detection of cortical scarring (%53). In addition, using single plasma sample method or gamma-camera method renal clearance measurements with 99mTc-MAG3 99mTc-DTPA have been used at some institutions

Clinical nuclear medicine applications in Turkey and specific renal studies

International Nuclear Information System (INIS)

Erbas, B.

2004-01-01

Nuclear cardiology, nuclear oncology, pediatric nuclear medicine and nuclear endocrinology are the main application areas of clinical nuclear medicine in Turkey. Not only imaging studies, but also therapeutic application of radiopharmaceuticals is also performed at many institutes, such as hyperthyroidism treatment with radioiodine, thyroid cancer ablation and metastases treatment with radioiodine, radio synovectomy, metastatic pain therapy, and recently radioimmunotherapy of lymphomas. Almost all radionuclides and radiopharmaceuticals are obtained commercially from European countries, except 18-FDG which is obtained from two cyclotrons in Turkey. More than 30.000 renal procedures are performed at the University hospitals in a year. Pediatric age groups is approximately % 55 of patients. 99m Tc-DTPA (%44), 99m Tc-DMSA (%37), 99m Tc-MAG3 (%17) and 99m Tc-EC (%2) are the most commonly used radiopharmaceuticals for renal imaging. More than 6.000 vials of several pharmaceuticals are used for renal cortical scintigraphy (%35), dynamic renal imaging (%34), renal scintigraphy with diuretic (%27) and captopril scintigraphy (%4). Most common indication for renal cortical scintigraphy is detection of cortical scarring (%53). In addition, using single plasma sample method or gamma-camera method renal clearance measurements with 99m Tc-MAG3 99m Tc-DTPA have been used at some institutions. (author)

Importance of DMSA scintigraphy in children with the first urinary infection

International Nuclear Information System (INIS)

Petrovski, Z.P.

2002-01-01

The purpose of the study was to evaluate the role of Tc-99m DMSA scintigraphy in children with onset of symptoms of urinary tract infection (UTI). Diagnosis of UTI was confirmed with clinical and biological data and urinary culture.We observed 36 children(29 female and 4 male) without known previous UTI, aged between 1-8 years with average age of 3,7 yrs. DMSA images were obtained within 10 days of diagnosis. Focal cortical defects suggestive of renal scarring with reduction of DMSA uptake were found in 11(30,5%)patients, unilateral in 9 and bilateral in 2 children. Changes of DMSA scan were classified in three groups (A and B-with focal changes of different intensity, C-global contraction of kidney or shrinken kidney). Among the 14 children with clinical symptoms for acute pyelonephritis (APN),8(57%) pts showed abnormal DMSA scintigraphy findings, while 3(13,6%) pts of the 22 children considered as UTI also revealed pathology in DMSA scintigraphy. After treatment 6 months later, 11 abnormal scintigrams were repeated, from which 45,4%(5/11) did completely normalized, 27,3%(3/11) showed partial recovery and 27,3% (3/11) revealed constantly renal lesions in DMSA scan. As a conclusion, the first UTI in childhood is a well recognised cause of chronic renal scarring and renal failure in a small percentage of children. Tc-99m DMSA scintigraphy should be a routine examination in the first UTI with and without clinical findings of APN

Renal dynamic scintigraphy with captropil in systemic arterial hypertension diagnosis

International Nuclear Information System (INIS)

Cervo, Marco Antonio Cadorna; Amarante Junior, Jose Luiz de Medeiros; Souza, Ricardo Alberto Manhaes; Evangelista, Maria Gardenia

1995-01-01

Forty one patients, 15 male and 16 female presenting systemic arterial hypertension were submitted to Basal RDC and after being simulated by Captopril; the radiotracer used was 99 mTc-DTPA (dietileno triamino pentacetic acid-99 Tc-technetium). From the 41 patients studied, 13 had the GFR (Glomerular filtration rate) Captopril when compared to Basal RDC radioactive, 11 of them were confirmed as having vascular renal disease by Renal Artiography and two of them were false (one case renal litiase and the other chronic pyelonephritis). Two more false negative cases have occurred in the RDC and three patients refused to be submitted to a Renal Arteriography. In the cases which the Total Glomerular Filtration Rate was reduced, there was an agreement of 89,5% between the RDC and the Renal Arteriography. No alterations have been observed in the Renal Arteriography on the remaining 23 patients and in the RDC after Captopril there was normal increase in the Glomerular Filtration Rate when compared to the Basal RDC. The method has showed sensitivity of 84% and specificity of 92%. We can conclude that the RDC with Captopril test is not an invasive method, it has good sensitivity and specificity and it can be indicated as a beginning test to select patients when you intend to detect vascular renal disease; nevertheless the RDC will never be used as a final test of vascular lesion. (author)

Qualitative and quantitative evaluation of renal parenchymal damage by 99mTc-DMSA planar and SPECT scintigraphy

International Nuclear Information System (INIS)

Itoh, Kazuo; Yamashita, Tetsufumi; Tsukamoto, Eriko; Nonomura, Katsuya; Furudate, Masayori; Koyanagi, Tomohiko

1995-01-01

The initial 99m Tc-DMSA studies carried out over a four year period in 229 patients with various heterogenic causes of lower urinary tract abnormalities were reviewed. Anatomical damage to the renal parenchyma was graded by means of planar and SPECT studies into a six group classification proposed by Monsour et al.: grade 0 (normal), I (equivocal), II (single defect), III (more than 2 defects), IV (contracted or small) and V (no visualization). Parenchymal uptake of 99m Tc-DMSA was quantitated from planar images at 2 hours postinjection by a computer assisted gamma camera method. SPECT studies could enhance the pick-up rate for parenchymal uptake defects by a factor of 1.5 in comparison with planar imaging. The incidence of anatomical damage to the renal parenchyma increased with a high radiological grade for VUR, and renal uptake per injection dose of 99m Tc-DMSA by the individual kidney significantly decreased in grades III and IV of the anatomical classification. These data revealed that 99m Tc-DMSA planar is still useful for evaluating gross structural damage and for quantitative evaluation of the kidney with computer assistance. SPECT scintigraphy is more effective in disclosing anatomical damage to the renal parenchyma than planar, although it needs further discussion as to whether SPECT may increase sensitivity with minimal or no adverse affect on specificity. (author)

Predictive factors of renal scarring in children with acute urinary tract infection

International Nuclear Information System (INIS)

Baik, Jun Hyun; Park, Young Ha; Hwang, Sung Su; Jeon, Jung Su; Kim, Sung Hoon; Lee, Seong Yong; Chung, Soo Kyo

2003-01-01

The purpose of this study was to evaluate the usefulness of 99m Tc DMSA scintigraphy on the diagnosis of a renal scar in children with urinary tract infections. Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. 99m Tc DMSA scintigraphy and voiding cystoureterography were performed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper of lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars in follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial

Isotopic scintigraphy in kidney grafting

International Nuclear Information System (INIS)

Renfro, Richard.

1976-01-01

Isotopic explorations of kidney transplants were performed on sixty-six patients. Three scintigraphic techniques were used: labelled ferrous ascorbate scintigraphy, sequential 99m technetium DTPA scintigraphy and the 131 I hippuran nephrogram. The aim of this study is to analyse the results obtained under different pathological circumstances affecting the transplant, to discuss the advantages of the techniques and to propose a working procedure. The most reliable and accurate technique is the 131 I hippuran nephrogram combined with sequential 99mTc DTPA, by which renal vascularisation may be judged labelled ferrous ascorbate on the other hand is too insensitive. Although the information supplied is mostly contained in the scintigraphic images, the nephrographic curves and the blood radioactivity decay time and rad V/rad R ratio measurements are very helpful in the early diagnosis and differential diagnosis of complications affecting the transplant. The proper use of isotopic scintigraphy in kidney grafting should provide optimum conditions for better survival of the transplant at minimum risk to the patient [fr

Plain radiography, renography, and [sup 99m]Tc-DMSA renal scintigraphy before and after extracorporeal shock wave lithotripsy for urolithiasis

Energy Technology Data Exchange (ETDEWEB)

Munck, O.; Gerquari, I.; Moeller, J.T.; Jensen, L.I.; Thomsen, H.S. (Dept. of Clinical Physiology, Dept. of Nuclear Medicine, Dept. of Diagnostic Radiology, Herlev Hospital, Copenhagen Univ. (Denmark))

1992-11-01

Eighteen patients were evaluated before and 5 weeks after the first treatment with extracorporeal shock wave lithotripsy (ESWL) using abdominal plain radiography, [sup 131]I-hippuran probe renography, and [sup 99m]Tc-dimercaptosuccinic acid scintigraphy. In 6 patients no urolithiasis was present on the post ESWL plain radiograph, in 7 the size had decreased, and in 5 the stone mass was unchanged. The renograms were within normal range in the 6 patients who were cured by ESWL, whereas this was the case for only 4 of the 12 who still had renal calculi. In 2 patients pelvic stones had descended into the ureter after ESWL, and the renograms indicated obstruction. Another 3 patients had ureteral stones, whereas in the remaining 7 patients only pelvic stones were found on the plain radiographs. In no patient did the scintigrams reveal scars. It is concluded that abdominal plain radiography of the urinary tract and probe renography are complementary and sufficient in the monitoring of patients with urolithiasis post ESWL. (orig.).

Role of scintigraphy in urinary tract infection

International Nuclear Information System (INIS)

Conway, J.J.

1988-01-01

There is controversy regarding the role of radiological imaging for urinary tract infection (UTI). The gold standard has been the intravenous pyelogram (IVP). Yet, the IVP has a very limited value with only about 25% of children with pyelonephritis demonstrating abnormalities. Ultrasound (US) has recently been advocated as a replacement for the poorly sensitive and poorly specific IVP. However, comparative studies between US and IVP indicate only an equivalent sensitivity and specificity. Cortical scintigraphy with Technetium-99m glucoheptonate (99mTc GH) or 99mTc dimercaptosuccinic acid (99mTc DMSA) has also been advocated as a means of differentiating parenchymal (pyelonephritis) from nonparenchymal (lower UTI) involvement in UTI. The clinical presentation may be misleading especially in the infant and child in whom an elevated temperature, flank pain, shaking chills, or an elevated sedimentation rate are often lacking. The clinician attempts to localize the site of infection for it has a direct bearing upon the therapy. A collecting system infection can often be eradicated with a single oral dose of an appropriate antibiotic, whereas renal parenchymal involvement requires IV therapy for an extended interval. Cortical scintigraphy can localize the site of infection with a high degree of accuracy. Recent studies report a sensitivity of 86% and specificity of 81% of pyelonephritis. This is in contrast to the IVP with a sensitivity of only 24% and US with a sensitivity of only 42%. The scintigraphic appearance of parenchymal infection of the kidney is a spectrum of minimal to gross defects reflecting the degree of histologic involvement that spans from a mild infection to frank abscess. Cortical scintigraphy can be used to monitor the evolution of scarring following infection. Cortical scintigraphy with 99mTc DMSA or 99mTc GH is the method of choice for the initial evaluation of UTI. 37 references

Prognostic factors in neonatal acute renal failure

International Nuclear Information System (INIS)

Chevalier, R.L.; Campbell, F.; Brenbridge, A.N.

1984-01-01

Sixteen infants, 2 to 35 days of age, had acute renal failure, a diagnosis based on serum creatinine concentrations greater than 1.5 mg/dL for at least 24 hours. Eight infants were oliguric (urine flow less than 1.0 mL/kg/h) whereas the remainder were nonoliguric. To determine clinical parameters useful in prognosis, urine flow rate, duration of anuria, peak serum creatinine, urea (BUN) concentration, and nuclide uptake by scintigraphy were correlated with recovery. Nine infants had acute renal failure secondary to perinatal asphyxia, three had acute renal failure as a result of congenital cardiovascular disease, and four had major renal anomalies. Four oliguric patients died: three of renal failure and one of heart failure. All nonoliguric infants survived with mean follow-up serum creatinine concentration of 0.8 +/- 0.5 (SD) mg/dL whereas that of oliguric survivors was 0.6 +/- 0.3 mg/dL. Peak serum creatinine concentration did not differ between those patients who were dying and those recovering. All infants who were dying remained anuric at least four days and revealed no renal uptake of nuclide. Eleven survivors were anuric three days or less, and renal perfusion was detectable by scintigraphy in each case. However, the remaining survivor (with bilateral renal vein thrombosis) recovered after 15 days of anuria despite nonvisualization of kidneys by scintigraphy. In neonates with ischemic acute renal failure, lack of oliguria and the presence of identifiable renal uptake of nuclide suggest a favorable prognosis

Prognostic factors in neonatal acute renal failure

Energy Technology Data Exchange (ETDEWEB)

Chevalier, R.L.; Campbell, F.; Brenbridge, A.N.

1984-08-01

Sixteen infants, 2 to 35 days of age, had acute renal failure, a diagnosis based on serum creatinine concentrations greater than 1.5 mg/dL for at least 24 hours. Eight infants were oliguric (urine flow less than 1.0 mL/kg/h) whereas the remainder were nonoliguric. To determine clinical parameters useful in prognosis, urine flow rate, duration of anuria, peak serum creatinine, urea (BUN) concentration, and nuclide uptake by scintigraphy were correlated with recovery. Nine infants had acute renal failure secondary to perinatal asphyxia, three had acute renal failure as a result of congenital cardiovascular disease, and four had major renal anomalies. Four oliguric patients died: three of renal failure and one of heart failure. All nonoliguric infants survived with mean follow-up serum creatinine concentration of 0.8 +/- 0.5 (SD) mg/dL whereas that of oliguric survivors was 0.6 +/- 0.3 mg/dL. Peak serum creatinine concentration did not differ between those patients who were dying and those recovering. All infants who were dying remained anuric at least four days and revealed no renal uptake of nuclide. Eleven survivors were anuric three days or less, and renal perfusion was detectable by scintigraphy in each case. However, the remaining survivor (with bilateral renal vein thrombosis) recovered after 15 days of anuria despite nonvisualization of kidneys by scintigraphy. In neonates with ischemic acute renal failure, lack of oliguria and the presence of identifiable renal uptake of nuclide suggest a favorable prognosis.

Tc-99m mercaptoacetylglycine to evaluate renal damage after ESWL

International Nuclear Information System (INIS)

Schaub, T.; Witsch, U.; El Damanhoury, H.; Naegele-Woehrle, B.; Hahn, K.

1990-01-01

This paper evaluates renal damage after extracorporeal shock wave lithotripsy (ESWL) with a new Tc-99m renal imaging compound. Tc-99m mercaptoacetylglycine-3 (MAG3) sequential scintigraphy was performed on 113 patients. A gamma camera was used, and the studies were done within 2 days before and after ESWL for renal stones. Relative renal function and clearance were calculated. Seventy (62%) of the 113 patients had abnormal findings after ESWL that were not present before the treatment. In 56 patients (50%) intra- or perirenal lesions were seen on sequential scintigraphy. Forty-six patients (41%) had a decrease of the relative renal function of at least 3% without an increase of total renal function

A clinical study on localized renal damage from percutaneous nephroureterolithotomy

International Nuclear Information System (INIS)

Chiba, Yutaka; Orikasa, Seiichi

1988-01-01

To study the localized renal damage from percutaneous nephroureterolithotomy (PNL), 3 divided DMSA renal scintigraphy in 41 renal units and dynamic CT in 17 renal units were performed. 1) Localized renal damages corresponding to the nephrostomy tract estimated by 3 divided DMSA renal scintigraphy were almost recovered by 6 months after PNL in most cases. But in 17 of the 41 renal units (41 %), the postoperative renal scintigram showed low uptake or cold area at the nephrostomy tract. 2) In several cases which showed cold area in postoperative renal scintigram, dynamic CT showed linear or diffuse low density area with sclerotic cortical deformity at the posterior wall of the kidney. These results indicate that an anatomically proper site of the puncture and a smaller nephrostomy size are mandatory to minimize localized renal damage from PNL. (author)

Acetic acid sclerotheraphy of renal cysts

International Nuclear Information System (INIS)

Hong, Hoon Pyo; Oh, Joo Hyeong; Yoon, Yup; Kong, Keun Young; Kim, Eui Jong; Goo, Jang Sung

1998-01-01

Sclerotherapy for renal cysts was performed, using 50% acetic acid as new sclerosing agent. We report the methods and results of this procedure. Fifteen patients underwent sclerotherapy for renal cyst, using 50% acetic acid. Because four patients were lost to follow-up, only 11 of the 15 were included in this study. The renal cysts, including one infected case, were diagnosed by ultrasonograpy (n=3D10) ormagnetic resonance imaging (n=3D1). The patient group consisted of four men and seven women(mean age, 59 years; range, 23-77). At first, the cyst was completely aspirated, and 25 volume% of aspirated volume was replaced with 50% sterile acetic acid through the drainage catheter. During the follwing 20 minutes, the patient changed position, and the acetic acid was then removed from the cyst. Finally, the drainage catheter was removed, after cleaning the cyst with saline. After treatment of infection by antibiotics and catheter drainage for 7 days, sclerotherapy in the infected case followed the same procedure. In order to observe changes in the size of renal cysts and recurrence, all patients were followed up by ultrasound between 2 and 8 months. We defined response to therapy as follows:complete regression as under 5 volume%, partial regression as 5-50 volume% and no response as more than 50 volume% of initial cyst volume. No clinically significant complication occured during the procedures or follow-up periods. All cysts regressed completely during follow-up of 8 months. Complete regression occurred as follows: two cysts at 2 months, seven cysts at 4 months, two cysts at 6 months. Two cysts showed residues at the last follow-up, at 4 and 6 months, respectively. The volume of residual cysts decreased to under 5 volume% of initial volume, however. Completely regressed cysts did not recurr during follow-up. Acetic acid sclerotherapy for renal cysts showed good results, regardless of the dilution of sclerosing agent with residual cyst fluid, and no significant

123I-β-methyl-iodophenyl-pentadecanoic acid myocardial scintigraphy in diabetic patients without overt ischemic heart disease

International Nuclear Information System (INIS)

Shinmura, Ken; Tani, Masato; Suganuma, Yukako; Hasegawa, Hiroshi; Kawamura, Masatoshi; Nakamura, Yoshiro; Hashimoto, Jun; Kubo, Atsushi

1995-01-01

We evaluated 123 I-β-methyl-iodophenyl-pentadecanoic acid (BMIPP) myocardial scintigraphy in 15 diabetes mellitus patients without overt coronary heart disease. Patients with overt coronary heart disease were excluded by careful history taking, resting electrocardiography, treadmill exercise testing echocardiography and resting 201 Tl scintigraphy. Patients with remarkably impaired left ventricular (LV) systolic function (%FS 2 , FBS: 178 vs 114 mg/dl, HbA1c: 7.6 vs 6.2%, IRI: 18.5 vs 9.5 μU/ml, LVEDD: 52 vs 44 mm). 123 I-metaiodobenzyl-guanidine (MIBG) scintigraphy in the 5 patients with abnormal BMIPP uptake showed more severe defects than in the 10 patients with normal BMIPP imaging. BMIPP scintigraphy demonstrated a significant correlation between H/M and L/M by BMIPP (r=0.74). Correlation between H/M by BMIPP scintigraphy and clinical parameters (BMI, systolic blood pressure, FBS, HbA1c, IRI) were found, suggesting that diabetes mellitus patients without over coronary heart disease show abnormal BMIPP imaging when their general glucose utility and 123 I-MIBG uptake are severely impaired (progression of insulin resistance and sympathetic nerve involvement). BMIPP scintigraphy may be useful in investigating the pathogenesis and subclinical abnormality of diabetic heart. (J.P.N.)

Dynamic bone scintigraphy findings in renal osteopathy

International Nuclear Information System (INIS)

Sotornik, I.; Pivonka, J.; Povysil, C.; Lanska, V.; Kocandrle, V.; Taborsky, P.; Zichova, M.; Universita Karlova, Prague; Ustredni Vojenska Nemocnice, Prague

1994-01-01

A study was undertaken to assess types of renal osteopathy by a dynamic modification of osteoscintigraphy. 53 patients underwent dialysis for 27-75 months and 19-52 years old were divided, according to histological bone pictures, into 4 groups: I) 11 patients with hyperparathyroidism, II) 12 patients with osteomalacia, III) 11 patients with mixed renal osteopathy, IV) 11 patients after parathyroidectomy, and 13 controls. Investigations: the rate of 99mTc-Sn-HEDP accumulation in the skeleton and the skeletal/background radioactivity index monitored both for 60 min. (parameters K and P), serum levels of C-PTH, bone isoenzyme of alkaline phosphatase (bALP), acid phosphatase (ACP), free hydroxyproline (S-Hypro). Results: 1. compared to controls: elevations of K and all biochemical parameters, P in groups I and III (p<0.01-<0.001) were found. 2. Group I was characterized by the highest values of all parameters compared with groups II and IV (p<0.01). 3. Linear relationships were found between K and bALP, ACP, S-Hypro (p<0.01) in groups I, II, III. 4. PTE in osteopathy was present in 2/3 of cases in group II showing the lowest values of all parameters. (author) 3 tabs., 4 figs., 25 refs

Apport de la scintigraphie renale dans l'exploration d'un syndrome ...

African Journals Online (AJOL)

Les aspects étiopathogéniques et la place de l'imagerie médicale notamment de la scintigraphie aussi bien dans la prise en charge diagnostique que thérapeutique sont discutées à la lumière de la littérature. Mots clés : Syndrome de jonction pyélo-uréterale, ectopie rénale, Scintigraphie rénale, pays en développement.

Imaging in acute renal infection in children

International Nuclear Information System (INIS)

Sty, J.R.; Wells, R.G.; Starshak, R.J.; Schroeder, B.A.

1987-01-01

Infection is the most common disease of the urinary tract in children, and various imaging techniques have been used to verify its presence and location. On retrospective analysis, 50 consecutive children with documented upper urinary tract infection had abnormal findings on renal cortical scintigraphy with 99mTc-glucoheptonate. The infection involved the renal poles only in 38 and the poles plus other renal cortical areas in eight. Four had abnormalities that spared the poles. Renal sonograms were abnormal in 32 of 50 children. Excretory urograms were abnormal in six of 23 children in whom they were obtained. Vesicoureteral reflux was found in 34 of 40 children in whom voiding cystourethrography was performed. These data show the high sensitivity of renal cortical scintigraphy with 99mTc-glucoheptonate in documenting upper urinary tract infection. The location of the abnormalities detected suggests that renal infections spread via an ascending mode and implies that intrarenal reflux is a major contributing factor

Osteomalacia-inducing renal clear cell carcinoma uncovered by 99mTc-Hydrazinonicotinyl-Tyr3-octreotide (99mTc-HYNIC-TOC) scintigraphy.

Science.gov (United States)

Jin, Xiaona; Jing, Hongli; Li, Fang; Zhuang, Hongming

2013-11-01

Most osteomalacia-causing tumors are small, benign mesenchymal neoplasms, which are commonly located in the extremities or craniofacial regions. An 18-year-old male patient with suspicion of tumor-induced osteomalacia underwent (99m)Tc-HYNIC-TOC scintigraphy to search potential culprit tumor. The images showed a large activity in the region of the left kidney. The lesion was resected and a clear cell renal cell carcinoma was found. One year after the left nephrectomy, the patient was tumor-free without symptoms of osteomalacia.

Interference of mobile phones and digitally enhanced cordless telecommunications mobile phones in renal scintigraphy.

Science.gov (United States)

Stegmayr, Armin; Fessl, Benjamin; Hörtnagl, Richard; Marcadella, Michael; Perkhofer, Susanne

2013-08-01

The aim of the study was to assess the potential negative impact of cellular phones and digitally enhanced cordless telecommunication (DECT) devices on the quality of static and dynamic scintigraphy to avoid repeated testing in infant and teenage patients to protect them from unnecessary radiation exposure. The assessment was conducted by performing phantom measurements under real conditions. A functional renal-phantom acting as a pair of kidneys in dynamic scans was created. Data were collected using the setup of cellular phones and DECT phones placed in different positions in relation to a camera head to test the potential interference of cellular phones and DECT phones with the cameras. Cellular phones reproducibly interfered with the oldest type of gamma camera, which, because of its single-head specification, is the device most often used for renal examinations. Curves indicating the renal function were considerably disrupted; cellular phones as well as DECT phones showed a disturbance concerning static acquisition. Variable electromagnetic tolerance in different types of γ-cameras could be identified. Moreover, a straightforward, low-cost method of testing the susceptibility of equipment to interference caused by cellular phones and DECT phones was generated. Even though some departments use newer models of γ-cameras, which are less susceptible to electromagnetic interference, we recommend testing examination rooms to avoid any interference caused by cellular phones. The potential electromagnetic interference should be taken into account when the purchase of new sensitive medical equipment is being considered, not least because the technology of mobile communication is developing fast, which also means that different standards of wave bands will be issued in the future.

Proposal on new formulas for renal depth in the technetium-99m-mercaptoacetyltriglycine (MAG3) scintigraphy

International Nuclear Information System (INIS)

Uchiyama, Katsuhiro; Kuniyasu, Yoshio; Niio, Yasuo

1997-01-01

Recently, camera-based techniques to measure effective renal plasma flow (ERPF) have become more popular than single plasma sample techniques because camera-based measurements avoid the necessity of delayed plasma samples and in vitro techniques. The measurements of ERPF are used to estimate the clearance of technetium-99m-mercaptoacetyltriglycine (MAG3). However, camera-based techniques are dependent on an accurate estimate of renal depth to correct for soft-tissue attenuation. Then, new formulas for renal depth correction of technetium-99m-MAG3 clearance in place of Toennesen's, M. Ito's, K. Itoh's, and Taylor's methods were tried to establish in this paper. Eleven hundred and seventy patients without any renal disease were objected. The data from measurement of renal depth using X-ray CT in supine position were analyzed statistically. The depths of right kidney (Dr) and left kidney (Dl) were 7.33±1.27 and 7.07±1.27 cm. The correlation coefficients between Dr and height (H), body weight (W), body Surface area (BSA: W 0.425 xH 0.725 x0.007184 m 2 ), age, and abdominal thickness (Ta) were 0.275, 0.709, 0.615, 0.087, and 0.743. The correlation coefficients between Dl and H, W, BSA, age, and Ta were 0.269, 0.732, 0.629, 0.029, and 0.812. Ta had best correlation with both Dr and Dl. The calculation formulas for Dr and Dl using Ta were as follows; Dr=0.32xTa+0.87 cm, and Dl=0.36xTa-0.08 cm. On the other hand, the multiplex calculation formulas of Dr or Dl with H, W, and Ta were as follows; Dr=0.18Ta+8.54x(W/H)+0.75 (r=0.768), and Dl=0.26Ta+5.90x(W/H)-0.16 (r=0.823). The new regression equations provide superior estimates of renal depth compared to conventional equations. Application of these new formulas into camera-based protocols to determine renal clearances may lead to more accurate measurements of ERPF using technetium-99m-MAG3 scintigraphy. (author)

Bilateral renal masses in a 10-year-old girl with renal failure and urinary tract infection: the importance of functional imaging

Energy Technology Data Exchange (ETDEWEB)

Urbania, Thomas H. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, 505 Parnassus Ave., Box 0628, San Francisco, CA (United States); Kammen, Bamidele F.; Nancarrow, Paul A. [Children' s Hospital and Research Center Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Morrell, Rose Ellen [Children' s Hospital and Research Center Oakland, Department of Nephrology, Oakland, CA (United States)

2009-02-15

Renal sonography is a routine step in the evaluation of new onset renal failure. When renal masses are discovered in this setting, functional imaging may be critical. We report a case of bilateral renal masses in a girl with urinary tract infection and renal insufficiency found to have vesicoureteral reflux. Renal scintigraphy revealed these masses to be the only remaining functional renal tissue, preventing potentially harmful resection. (orig.)

Bilateral renal masses in a 10-year-old girl with renal failure and urinary tract infection: the importance of functional imaging

International Nuclear Information System (INIS)

Urbania, Thomas H.; Kammen, Bamidele F.; Nancarrow, Paul A.; Morrell, Rose Ellen

2009-01-01

Renal sonography is a routine step in the evaluation of new onset renal failure. When renal masses are discovered in this setting, functional imaging may be critical. We report a case of bilateral renal masses in a girl with urinary tract infection and renal insufficiency found to have vesicoureteral reflux. Renal scintigraphy revealed these masses to be the only remaining functional renal tissue, preventing potentially harmful resection. (orig.)

Effect of a keto acid-amino acid supplement on the metabolism and renal elimination of branched-chain amino acids in patients with chronic renal insufficiency on a low protein diet.

Science.gov (United States)

Teplan, V; Schück, O; Horácková, M; Skibová, J; Holecek, M

2000-10-27

The aim of our study was to evaluate the effect of a low-protein diet supplemented with keto acids-amino acids on renal function and urinary excretion of branched-chain amino acids (BCAA) in patients with chronic renal insufficiency (CRI). In a prospective investigation 28 patients with CRI (16 male, 12 female, aged 28-66 yrs, CCr 18.6 +/- 10.2 ml/min) on a low-protein diet (0.6 g of protein /kg BW/day and energy intake 140 kJ/kg BW/day) for a period of one month were included. Subsequently, this low protein diet was supplemented with keto acids-amino acids at a dose of 0.1 g/kg BW/day orally for a period of 3 months. Examinations performed at baseline and at the end of the follow-up period revealed significant increase in the serum levels of BCAA leucine (p Keto acid-amino acid administration had no effect on renal function and on the clearance of inulin, para-aminohippuric acid. Endogenous creatinine and urea clearance remained unaltered. A significant correlation between fractional excretion of sodium and leucine (p diet the supplementation of keto acids-amino acids does not affect renal hemodynamics, but is associated--despite increases in plasma concentrations--with a reduction of renal amino acid and protein excretion suggesting induction of alterations in the tubular transport mechanisms.

Dynamic myocardial scintigraphy with 123I-labelled free fatty acids

International Nuclear Information System (INIS)

Wall, E.E. van der.

1981-01-01

In this thesis, long-chain radioiodinated free fatty acids ( 123 I-FFA), 16-iodo- 123 I-cis-Δ 9 -hexadecenoic acid ( 123 I-HA) and 17-iodo- 123 I-heptade-canoic acid ( 123 I-Hsup(o)A), were employed for myocardial scintigraphy in patients with coronary artery disease. The results indicate that clearance of 123 I-FFA from the myocardium is dependent on the nature of ischemic injury. Clearance is delayed if the injury is reversible and accelerated in case of irreversible ischemia. Mechanisms responsible for divergent behaviour of FFA in patients with acute myocardial infarction versus patients with angina pectoris are purely speculative. This differential clearance from normally perfused, transiently ischemic and infarcted myocardium has practical application. The test provides a means to assess the nature of ischemic injury rapidly. These findings may have major consequences for logical management of patients presenting with chest pain and suspected coronary artery disease. (Auth.)

Renal volume assessed by magnetic resonance imaging volumetry correlates with renal function in living kidney donors pre- and postdonation: a retrospective cohort study.

Science.gov (United States)

Lange, Daniel; Helck, Andreas; Rominger, Axel; Crispin, Alexander; Meiser, Bruno; Werner, Jens; Fischereder, Michael; Stangl, Manfred; Habicht, Antje

2018-07-01

Renal function of potential living kidney donors is routinely assessed with scintigraphy. Kidney anatomy is evaluated by imaging techniques such as magnetic resonance imaging (MRI). We evaluated if a MRI-based renal volumetry is a good predictor of kidney function pre- and postdonation. We retrospectively analyzed the renal volume (RV) in a MRI of 100 living kidney donors. RV was correlated with the tubular excretion rate (TER) of MAG3-scintigraphy, a measured creatinine clearance (CrCl), and the estimated glomerular filtration rate (eGFR) by Cockcroft-Gault (CG), CKD-EPI, and modification of diet in renal disease (MDRD) formula pre- and postdonation during a follow-up of 3 years. RV correlated significantly with the TER (total: r = 0.6735, P volumetry might be an alternative technique for the evaluation of split renal function and prediction of renal function postdonation in living kidney donors. © 2018 Steunstichting ESOT.

Renal scintigraphy following angiotensin-converting enzyme inhibition in the diagnosis of renovascular hypertension (captopril scintigraphy)

International Nuclear Information System (INIS)

Sfakianakis, G.N.; Sfakianakis, E.; Bourgoignie, J.

1988-01-01

There is definitely a niche for an accurate test for the diagnosis of RVH; more important, there is a need for a predictive test to help select patients suitable for revascularization procedures as opposed to medical treatment. All current tests have less than optimal results. Captopril scintigraphy warrants evaluation. It is important, however, to approach the test with a full understanding of its theoretical potentials on the basis of current clinical experience. Several options, techniques, and combinations are possible, given the availability of more than one radiopharmaceutical. The purpose of this chapter is to: (a) briefly review RVH and its pathophysiology, with emphasis on the need to establish the diagnosis, lateralize the abnormality, and decide about the mode of treatment; (b) review the current knowledge about converting-enzyme inhibitors; (c) analyze the handling of the different radiopharmaceuticals by the RVH-related kidney with and without pharmacologic intervention; and (d) compare and critically examine proposed protocols for captopril scintigraphy

Comparative evaluation of intragastric bile acids and hepatobiliary scintigraphy in the diagnosis of duodenogastric reflux.

Science.gov (United States)

Chen, Teng-Fei; Yadav, Praveen K; Wu, Rui-Jin; Yu, Wei-Hua; Liu, Chang-Qin; Lin, Hui; Liu, Zhan-Ju

2013-01-01

To assess the diagnostic value of a combination of intragastric bile acids and hepatobiliary scintigraphy in the detection of duodenogastric reflux (DGR). The study contained 99 patients with DGR and 70 healthy volunteers who made up the control group. The diagnosis was based on the combination of several objective arguments: a long history of gastric symptoms (i.e., nausea, epigastric pain, and/or bilious vomiting) poorly responsive to medical treatment, gastroesophageal reflux symptoms unresponsive to proton-pump inhibitors, gastritis on upper gastrointestinal (GI) endoscopy and/or at histology, presence of a bilious gastric lake at > 1 upper GI endoscopy, pathologic 24-h intragastric bile monitoring with the Bilitec device. Gastric juice was aspirated in the GI endoscopy and total bile acid (TBA), total bilirubin (TBIL) and direct bilirubin (DBIL) were tested in the clinical laboratory. Continuous data of gastric juice were compared between each group using the independent-samples Mann-Whitney U-test and their relationship was analysed by Spearman's rank correlation test and Fisher's linear discriminant analysis. Histopathology of DGR patients and 23 patients with chronic atrophic gastritis was compared by clinical pathologists. Using the Independent-samples Mann-Whitney U-test, DGR index (DGRi) was calculated in 28 patients of DGR group and 19 persons of control group who were subjected to hepatobiliary scintigraphy. Receiver operating characteristic curve was made to determine the sensitivity and specificity of these two methods in the diagnosis of DGR. The group of patients with DGR showed a statistically higher prevalence of epigastric pain in comparison with control group. There was no significant difference between the histology of gastric mucosa with atrophic gastritis and duodenogastric reflux. The bile acid levels of DGR patients were significantly higher than the control values (Z: TBA: -8.916, DBIL: -3.914, TBIL: -6.197, all P Reflux: Y = 0.012TBA + 0

Glomerular filtration rate measured by 51Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

International Nuclear Information System (INIS)

Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit

2010-01-01

Introduction: renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid ( 51 Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51 Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. Methods: this prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis ( 51 Cr-EDTA) and 99m Tc-DMSA scintigraphy were performed before and after captopril administration in all patients. Results: the mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m 2 in the group with renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m 2 in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/kg/1.73m 2 , p=0.001) and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m 2 , p=0.68). Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA) did not show

Renal imaging in paediatrics

International Nuclear Information System (INIS)

Porn, U.; Hahn, K.; Fischer, S.

2003-01-01

The most frequent renal diseases in paediatrics include urinary tract infections, hydronephrosis, kidney anomalies and reflux. The main reason for performing DMSA scintigraphy in paediatrics is the detection of cortical abnormalities related to urinary tract infection. Because the amount of tracer retained in the tubular cells is associated with the distribution of functioning renal parenchyma in the kidney, it is possible, to evaluate the split renal function. In comparison to ultrasound and intravenous urography the sensitivity in the detection of acute as well as chronic inflammatory changes is very high, however less specific. An indication for a renography in neonates and children is beside an estimation of the total renal function and the calculation of the split renal function, the assessment of renal drainage in patients with unclear dilatation of the collecting system in ultrasound. The analysis of the time activity curve provides, especially for follow-up studies, a reproducible method to assess the urinary outflow. The diuretic scintigraphy allows the detection of urinary obstruction. Subsequently it is possible to image the micturition phase to detect vesico-ureteric reflux (indirect MCU) after drainage of tracer from the renal pelvis. An reflux in the ureters or the pelvicalyceal system is visible on the scintigraphic images and can be confirmed by time activity curves. A more invasive technique is the direct isotope cystography with bladder catheterization. The present paper should give an overview about the role of nuclear medicine in paediatric urology. (orig.) [de

Clinical application of calculated split renal volume using computed tomography-based renal volumetry after partial nephrectomy: Correlation with technetium-99m dimercaptosuccinic acid renal scan data.

Science.gov (United States)

Lee, Chan Ho; Park, Young Joo; Ku, Ja Yoon; Ha, Hong Koo

2017-06-01

To evaluate the clinical application of computed tomography-based measurement of renal cortical volume and split renal volume as a single tool to assess the anatomy and renal function in patients with renal tumors before and after partial nephrectomy, and to compare the findings with technetium-99m dimercaptosuccinic acid renal scan. The data of 51 patients with a unilateral renal tumor managed by partial nephrectomy were retrospectively analyzed. The renal cortical volume of tumor-bearing and contralateral kidneys was measured using ImageJ software. Split estimated glomerular filtration rate and split renal volume calculated using this renal cortical volume were compared with the split renal function measured with technetium-99m dimercaptosuccinic acid renal scan. A strong correlation between split renal function and split renal volume of the tumor-bearing kidney was observed before and after surgery (r = 0.89, P volumetry had a strong correlation with the split renal function measured using technetium-99m dimercaptosuccinic acid renal scan. Computed tomography-based split renal volume measurement before and after partial nephrectomy can be used as a single modality for anatomical and functional assessment of the tumor-bearing kidney. © 2017 The Japanese Urological Association.

Cortical scintigraphy in the evaluation of renal defects in children with vesico-ureteral reflux - optimization of the procedure and study interpretation

International Nuclear Information System (INIS)

Gadzicki, M.; Bienkiewicz, M.; Mlodkowska, E.; Kusmierek, J.; Knapska, M.; Kowalewska-Pietrzak, M.

2004-01-01

The objective of this study was to analyse the performance of several variants of kidney scintigraphy in children from the standpoint of: scar detection, an assessment of the rating of the pathology and an investigation of interobserver variability involved in the diagnostic procedure. The analysis is based on results of a planar kidney scintigraphy and of a tomographic (SPECT) procedure. The latter was performed in two variants: 1) in which slices were obtained with axis of reconstruction identical with longitudinal axis of the body (SPECT I) and 2) in which axes were fitted to the long axis of each kidney separately (SPECT II). The rating of the diagnosed pathology was made using two scales, according to Goldraich and Howard. Evaluation of the images involved on the one hand, 150 individual kidneys and 75 patients on the other. The assessment was made by three independent observers, differing in experience in nuclear medicine and employed in three independent departments. In the statistical analysis, as a measure of observer agreement, a proportion of agreeing readings (%) was accepted; in addition, the kappa index of agreement was calculated. Better agreement among three observers was attained when planar images were read in contrast to SPECT (I and II) results.The reading of SPECT II images yielded a higher frequency of diagnosed pathology (scars) in kidneys and is characterized by better overall agreement in detection by individual observers than a similar evaluation of SPECT I images. The Goldraich scale secures better interobserver agreement of renal scar detection than is seen when the Howard scale was applied to acquire the rating. The conclusion may be drawn that kidney scintigraphy is a method still burdened with a substantial subjectivism. Planar scintigraphy should be treated as a basic option for imaging post-inflammatory changes in kidneys. (author)

Prognostic value of 99mTc-MAG3 renal scintigraphy for the one-year outcome after kidney transplantation

International Nuclear Information System (INIS)

Guignard, R.; Rossi, M.; Mariano-Goulart, D.; Barbotte, E.

2009-01-01

Because of the increasing use of marginal grafts, it remains a significant difference in terms of transplants half-life between living donor or cadaver donor. The main objective of this study was to assess the prognostic value of various isotopic parameters available on the same day than surgery for the one-year outcome after kidney transplantation. A retrospective study of 100 patients, who received a renal allograft at the University Hospital of Montpellier between 1999 and 2006, and who performed 99m Tc-MAG 3 renal scintigraphy within 72 h after transplantation, was performed. Measurement of various isotopic parameters was performed for angiographic and tubular phases, over three different regions of interest. According to judgment criteria, namely the success or not of transplantation after the first year, previously obtained results were statistically compared. The results of our study confirmed the importance of vascular parameters, especially the Kirchner index, with a good correlation with renal function one year after transplantation. As expected by the physiological models, a well-perfused graft had the most chances of short-term survival. Kirchner index has a negative predictive value of more than 90% for the one-year success after transplantation (V.P.P. = 75%). Parameters assessing more specifically nephronic functional reserve (such as tubular function slope or uptake on perfusion peaks report) are independent risk factors for the failure during the first three months. (authors)

Double-phase parathyroid 99Tcm-MIBI scintigraphy in secondary hyperparathyroidism

International Nuclear Information System (INIS)

Liu Wei; Xu Zhaoqiang; Hu Jianmin; Chang Guojun; Yao Weixuan; Li Yongjun; Chen Jianwei

1999-01-01

Objective: To evaluate the diagnostic value of double-phase parathyroid 99 Tc m -MIBI scintigraphy in secondary hyperparathyroidism (SHP) following chronic renal failure. Methods: 99 Tc m -MIBI parathyroid scintigraphy was performed on 20 SHP patients. All images were analyzed with parathyroid/thyroid ratio (PT/T) and parathyroid index (PTI). 3 patients underwent parathyroidectomy and ectopic autografting. Results: 8 patients were 99 Tc m -MIBI-positive. 9 parathyroid glands removed from 3 patients were histopathologically diagnosed as parathyroid hyperplasia. 8 of the 9 were scintigraphy positive with the sensitivity of 88.9%, the localization of the parathyroids with scanning before operation was accurate. It was found that there were 3 types of MIBI washout in hyperplastic parathyroids. Conclusions: 99 Tc m -MIBI scintigraphy is valuable in localization of parathyroids in SHP, especially of hyperfunctioning glands. Special attention should be paid to the fact that there are different types of MIBI washout in hyperplastic glands, otherwise some abnormal glands might be missed

Development of renal simulators for use in nuclear medicine

International Nuclear Information System (INIS)

Dullius, Marcos Alexandre

2014-01-01

Quality control programs in nuclear medicine include verifying the efficiency of all equipment used for diagnosis and therapy, including scintillation cameras. To that end, we have developed and evaluated the performance of four phantom kidneys - two static anthropomorphic, one semi-dynamic, and one dynamic - to acquire static and dynamic renal scintigraphic images. The static anthropomorphic phantoms were used to characterize and evaluate the response of the processing system for different concentrations of radionuclides through static renal scintigraphy images ( 99m Tc-DMSA), obtained with posterior, right posterior oblique, left posterior oblique, and anterior incidences. The static phantoms were made in two ways; one was made of acrylic from a mold of a pair of human kidneys preserved in formalin, and the second was built with acrylonitrile butadiene styrene (ABS), in a 3D printer using the Slicer program, based on a computed tomography (CT) of the thorax, using the Slicer program. The semi-dynamic and dynamic phantoms were constructed to characterize and evaluate images of dynamic renal scintigraphy. In the semi-dynamic phantom, the injection of radiotracer was performed manually, whereas in the dynamic phantom, the radiotracer was automatically injected through an injector system. With the semi-dynamic phantom, it was possible to analyze the formation of a renogram with normal renal scintigraphic appearance using an imaging system. The simulations obtained from the dynamic phantom simulator enabled studies of normal renal scintigraphy and four other forms of renograms. The static anthropomorphic phantom kidneys proved to be efficient for use in evaluations of varying concentrations of radionuclides. The dynamic phantom kidney was useful for analysis of scintigraphic images and obtaining different pathways for elimination of the radioisotope, allowing for analysis of different renograms. Therefore, the new kidney phantoms would be useful for quality control of

Glomerular filtration rate measured by {sup 51}Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

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Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit, E-mail: annaalice100@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

2010-07-01

Introduction: renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid ({sup 51}Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using {sup 51}Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. Methods: this prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis ({sup 51}Cr-EDTA) and {sup 99m}Tc-DMSA scintigraphy were performed before and after captopril administration in all patients. Results: the mean baseline glomerular filtration rate was 48.6+-21.8 ml/kg/1.73 m{sup 2} in the group with renal artery stenosis, which was significantly lower than the GFR of 65.1+-28.7 ml/kg/1.73m{sup 2} in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6+-14.8 ml/kg/1.73m{sup 2}, p=0.001) and an insignificant change in the group without RAS (to 62.2+-23.6 ml/kg/1.73m{sup 2}, p=0.68). Scintigraphy with technetium-99m dimercapto

99mtechnetium-dimercapto-succinic acid renal scanning and excretory urography in diagnosis of renal scars in children

International Nuclear Information System (INIS)

McLorie, G.A.; Aliabadi, H.; Churchill, B.M.; Ash, J.M.; Gilday, D.L.

1989-01-01

We compared the ability of excretory urography (without tomography) and 99mtechnetium-dimercapto-succinic acid renal scanning to detect renal scars in 32 children with primary vesicoureteral reflux. These children did not have hydronephrosis, renal failure or urinary tract obstruction. In all cases both studies were conducted within a 10-month period. The findings from both modalities were in agreement for 51 of the 64 renal units evaluated (80%). Evaluation of the excretory urogram indicated 6 cases of diffuse and 2 of focal scarring that were not detected by evaluation of the renal scan. The sensitivity of excretory urography to detect renal scars was 84% and the specificity was 83%. The 99mtechnetium-dimercapto-succinic acid renal scan showed 5 cases of focal renal scarring not detected by excretory urography. The sensitivity of the renal scan to detect renal scars was 77% and the specificity was 75%. We conclude that neither study alone could effectively replace the other for the detection of renal scars, and recommend that both be included in the initial evaluation and followup of patients with renal scars

Scintigraphy, pH measurement and radiography in the evaluation of gastroesophageal reflux

International Nuclear Information System (INIS)

Kaul, B.; Petersen, H.; Grette, K.; Erichsen, H.; Myrvold, H.E.

1985-01-01

Scintigraphy as a diagnostic tool has been explored in 69 patients with gastroesophageal reflux (GER) symptoms and endoscopic esophagitis. In all subjects the presence of reflux was also evaluated by radiography and intraesophageal pH measurements (standard acid reflux test). The overall sensitivity of scintigraphy (85.5%) was significantly higher than those of radiography (27.5%) and pH measurements (69.5%). Scintigraphy was performed with normal saline and with acidified orange juice as the transport medium for the isotope 99mTc. The yield of positive scintigrams was higher (22.3 to 61.1%, depending on the grade of endoscopic esophagitis) with the latter variant. Moreover, demonstration of spontaneous reflux was greatly facilitated by the acid scintigraphy. This was particularly obvious in the grade I esophagitis, in which the freqency of spontaneous reflux with saline method was 3.4% and with acid medium 34/3%. Reflux (induced or spontaneous) was seen in 22 normal control subjects with the saline method, and in 1 subject only with the acid method. On the basis of these findings it is concluded that scintigraphy, especially the acid variant of the technique, is a valuable diagnostic procedure in GER disease

Scintigraphy, pH measurement and radiography in the evaluation of gastroesophageal reflux

Energy Technology Data Exchange (ETDEWEB)

Kaul, B.; Petersen, H.; Grette, K.; Erichsen, H.; Myrvold, H.E.

1985-01-01

Scintigraphy as a diagnostic tool has been explored in 69 patients with gastroesophageal reflux (GER) symptoms and endoscopic esophagitis. In all subjects the presence of reflux was also evaluated by radiography and intraesophageal pH measurements (standard acid reflux test). The overall sensitivity of scintigraphy (85.5%) was significantly higher than those of radiography (27.5%) and pH measurements (69.5%). Scintigraphy was performed with normal saline and with acidified orange juice as the transport medium for the isotope 99mTc. The yield of positive scintigrams was higher (22.3 to 61.1%, depending on the grade of endoscopic esophagitis) with the latter variant. Moreover, demonstration of spontaneous reflux was greatly facilitated by the acid scintigraphy. This was particularly obvious in the grade I esophagitis, in which the freqency of spontaneous reflux with saline method was 3.4% and with acid medium 34/3%. Reflux (induced or spontaneous) was seen in 22 normal control subjects with the saline method, and in 1 subject only with the acid method. On the basis of these findings it is concluded that scintigraphy, especially the acid variant of the technique, is a valuable diagnostic procedure in GER disease.

Extra-osseous uterine pathophysiology demonstrated on skeletal scintigraphy

International Nuclear Information System (INIS)

Mansberg, R.; Lewis, G.

1999-01-01

Full text: Skeletal scintigraphy is a sensitive procedure for evaluating disease and trauma involving the skeleton. Extra-skeletal pathophysiology is also often demonstrated. This may include uptake by tumours, soft tissue calcification and infection as well as renal pathology. Skeletal scintigraphy is often performed to evaluate hip and back pain and extra-osseous uterine pathophysiology can be demonstrated in both the early and late phases of the study as in the following cases. Three women underwent skeletal scintigraphy for the investigation of low back pain in two patients and post-partum hip pain in one. A large vascular uterus with deviation of the bladder was demonstrated in the post-partum patient. Increased pelvic vascularity and bladder deviation in the second patient was shown by ultrasound to correspond to a left-sided fibroid with associated adenomyosis. In the third case, right-sided pelvic vascularity and left bladder deviation were shown on ultrasound to be due to an anteverted, anteflexed uterus tilted to the right. These cases illustrate the importance of documenting extra-osseous findings on skeletal scintigraphy and the benefits of correlation with anatomical imaging

Renal effects of amino acids and dopamine in renal transplant recipients treated with or without cyclosporin A

DEFF Research Database (Denmark)

Hansen, J M; Olsen, Niels Vidiendal; Leyssac, P P

1996-01-01

1. The nephrotoxic effects of cyclosporin A may diminish the ability of the transplanted kidney to increase the glomerular filtration rate and effective renal plasma flow during infusion of dopamine or amino acids. 2. The present study included 16 renal transplant recipients transplanted for more...... and of dopamine in renal transplant recipients with a good graft function.......-creatinine, 89 +/- 6 mumol/l). The renal response to infusion of dopamine and of amino acids was investigated on two separate days. All clearance measurements were carried out at nadir cyclosporin A blood levels. 3. Effective renal plasma flow increased significantly in the non-cyclosporin A group...

Diagnostic Value of Technetium-99m-Dimercaptosuccinic Acid Scintigraphy in Prediction of Vesicoureteral Reflux in Children with First-time Febrile Urinary Tract Infection

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Fatemeh Ataei

2017-11-01

Full Text Available Background: Imaging modalities such as voiding cystourethrography (VCUG, direct radionuclide cystography (DRNC, and renal cortical scintigraphy (RCS with technetium-99m dimercaptosuccinic acid (Tc-99mDMSA, are helpful in detecting possible abnormalities of urinary tract such as vesicoureteral reflux (VUR. However, there are confounding data regarding the preference of these modalities. In the present study, we aimed to assess the role of Tc-99mDMSA scan in prediction of possible VUR and the subsequent need for VCUG or DRNC. Materials and Methods: Three hundred fifty seven children under 14 years old with first-time febrile urinary tract infection (UTI who were admitted between April 2004 and February 2017 were enrolled. Data regarding to VCUG or DRNC in order to evaluate the presence of possible VUR were recorded. Finally, accuracy of Tc-99mDMSA scans in prediction of VUR were assessed. Results: Analyses showed a sensitivity and specificity of 95.65% and 14.72%, respectively for Tc-99mDMSA scan in detection of VUR. Patients with mild renal involvement in Tc-99mDMSA scans had a 3.5-fold greater risk of having VUR than those with a normal scans (odds ratio=3.5; 95% confidence interval [CI]: 1.4-8.58; p=0.007. In addition, the risk of VUR is up to 7.0-fold greater in children with moderate renal involvement (odds ratio=7.0; 95% CI: 2.6-13.2; p

Tc-99m Hydroxymethylene Diphosphonate (HMDP) Renal Uptake as a Surrogate Marker of Postoperative Impairment of the Glomerular Filtration Rate in Renal Tumor Patients Following Nephron-Sparing Surgery.

Science.gov (United States)

Choi, Hongyoon; Lee, Won Woo; So, Young; Ha, Seunggyun; Byun, Seok-Soo; Kim, Sang Eun

2014-12-01

We investigated Tc-99m hydroxymethylene diphosphonate (HMDP) scintigraphy findings in renal tumor patients from the perspective of postoperative renal dysfunction following nephron-sparing surgery (NSS). Forty-three renal tumor patients (M:F = 28:15, age 53.9 ± 12.5 years) who had undergone Tc-99m HMDP scintigraphy after NSS were enrolled. The patients were divided into HMDP(+) or HMDP(-) groups by visual assessment, and the asymmetric index (ASI) was calculated using a region-of-interest analysis. In 16 patients, the total and split glomerular filtration rate (GFR) was assessed using Tc-99m diethylenetriaminepentaacetic acid (DTPA) scintigraphy at baseline and at 3 and 6 months post-NSS. High Tc-99m HMDP uptake was observed in the operated kidneys, but this did not persist later than 7 days post-NSS. Split GFR of the operated kidneys at baseline (58.5 ± 9.3 ml/min) was significantly reduced at 6 months post-NSS (40.1 ± 5.9 ml/min, p Tc-99m HMDP. Declines in both total GFR (p = 0.010 and p = 0.002 for 3 and 6 months, respectively) and split GFR of the operated kidneys (p Tc-99m HMDP in the operated kidneys. The ASI was negatively correlated with %change in the split GFR of these operated kidneys at 6 months post-NSS (rho =-0.578, p = 0.0304). Tc-99m HMDP uptake within 1 week following NSS is a surrogate marker of GFR impairment over 6 months post-NSS.

Parathyroid localizlation by 201Tl-99mTc subtraction scintigraphy

International Nuclear Information System (INIS)

Rademaker, P.; Meijer, S.; Piers, D.A.

1990-01-01

Subtraction scintigraphy with 201 Tl and 99m Tc for parathyroid localization was performed preoperatively in 13 patients with chronic renal failure and secondary hyperparathyroidism. Twenty of the 37 examined pathological glands were predicted correctly (sensitivity 54%). In 3 patients with recurrent hyperparathyroidism after surgery all pathological glands found at second operation had been detected correctly by subtraction scintigraphy. We conclude that this localization method has a limited value when used prior to first neck exploration in secondary hyperparathyroidism. In persistent hyperparathyroidism after surgery it may play a useful role in localizing missed and ectopic glands. (author)

Studies on bone scintigraphy in renal osteodystrophy

Energy Technology Data Exchange (ETDEWEB)

Tsuchimochi, Makoto (Nippon Dental Univ., Niigata)

1983-12-01

Bone scintigraphy was superior over roentgenography for detection of abnormal bone findings in chronic dialysis patients. According to the type of scintigraphic findings, an increase in the hot area in the cranium or the mandibule seemed to express fibrous osteitis due to secondary hyperparathyroidism. Multiple coin-shaped hot areas in ribs were thought to indicate advanced osteomalacia or osteomalacia in patients with aluminum poisoning. The 4 hr-B/St ratio of the cranium was thought to serve as a quantitative indicator of the status of fibrous osteitis due to secondary hyperparathyroidism to show the progress and therapeutic course of the disease.

Renal acid excretion in the domestic fowl.

Science.gov (United States)

Long, S; Skadhauge, E

1983-05-01

1. In order to assess the role of uricotelism in net renal acid excretion, blood and ureteral urine samples were collected from five hens fed a commercial poultry feed (Diet A) and five hens fed a protein-rich, Na-poor feed (Diet B). All samples were analysed for pH, PCO2, ammonium, phosphate, uric acid and urates (UA + U) and inulin. 2. On Diet A, average pH in venous blood was 7.42, while urinary pH (pHu) ranged from 4.74 to 7.25. At average pHu (6.10), uric acid accounted for 52% of total acid excreted, H2PO4 for 20% and NH4 for 28%. Net acid excretion in ureteral urine was 345 muequiv h-1 kg body weight-1, or 5-10 times that observed in ureotelic vertebrates (amphibians and mammals). 3. The relative contributions of these urinary buffers to net renal acid excretion changed with pHu. Significant negative correlations exist between pHu and both total phosphate and ammonium excretion rates (P less than 0.001). Excretion rates of (UA + U) showed a positive correlation (P less than 0.05) with pHu. 4. Feeding on Diet B revealed the homeostatic power of the avian kidney. Blood pH and PCO2 were not changed relative to values in hens fed the control diet while striking increases in excretion rates of all urinary buffers (except HCO3) were observed. Average pHu fell to 5.12, and the average net renal acid excretion rate doubled.

Renal transport and metabolism of nicotinic acid

International Nuclear Information System (INIS)

Schuette, S.; Rose, R.C.

1986-01-01

Renal metabolism and brush-border transport of nicotinic acid were studied in renal cortical slices and brush-border membrane vesicles exposed to a physiological concentration of vitamin (2.2-3.5 microM). Vesicle transport of [ 3 H]nicotinic acid was found to be Na+ dependent and concentrative. The presence of a Na+ gradient resulted in a fivefold increase in the rate of nicotinic acid uptake over that observed with mannitol and caused a transient nicotinic acid accumulation two- to fourfold above the equilibrium value. The effects of membrane potential, pH, and elimination of Na+-H+ exchange were also studied. Cortical slices and isolated tubules exposed to 2.2 microM [ 14 C]nicotinic acid took up vitamin and rapidly metabolized most of it to intermediates in the Preiss-Handler pathway for NAD biosynthesis; little free nicotinic acid was detectable intracellularly. The replacement of Na+ with Li+ in the bathing medium reduced total accumulation of 14 C label primarily as a result of reduced nicotinic acid uptake. Cortical tissue concentrated free nicotinic acid only when the involved metabolic pathways were saturated by levels of nicotinic acid far in excess of what occurs in vivo

The usefulness of cardiofocal collimator in static renal imaging

International Nuclear Information System (INIS)

Evren, I.; Durak, H.; Degirmenci, B.; Derebek, E.; Oezbilek, E.; Capa, G.

2001-01-01

Static renal imaging is best performed using pinhole collimator. But this technique takes too much time and generally parallel hole collimators are preferred for static renal imaging in nuclear medicine departments. The purpose of this study was to investigate the usefulness of the cardio-focal collimator used for myocardial perfusion imaging in static renal scintigraphy

Clinical Application of 99mTc-DISIDA Scintigraphy with Nonvisualization of Biliary Excretion

International Nuclear Information System (INIS)

Moon, Tae Yong; Kim, Dong Soo; Kim, Yong Ki

1987-01-01

Authors analysed biochemical studies and scintigraphic findings of obstructive jaundice and nonobstructive jaundice in 44 cases of 99m Tc-DISIDA scintigraphy with nonvisualization of biliary excretion till 120 min or 240 min after injection of 99m Tc-DISIDA. Causative diseases of 99m Tc-DISIDA scintigraphy with nonvisualization of biliary excretion were in order to choledocholithiasis (25%), hepatitis (25%), cholangiocarcinoma (14%), cholangitis (14%) and pancreas head tumor (11%). In obstructive jaundice, statistically significant findings were elevated alkaline phosphatase above 300 IU/L on biochemical study and single lobe enlargement of the liver, irregular radioisotope uptake of the liver and concave indentation of the gall bladder fossa of the liver on scintigraphy. In nonobstructive jaundice, statistically significant findings were persistent renal excretion of 99m Tc-DISIDA and more increased uptake density of the heart than the liver on scintigraphy.

Clinical significance of bone scintigraphy and computerized tomography (CT scan) in the evaluation of renal osteodystrophy in haemodialysed and non-haemodialysed patients

International Nuclear Information System (INIS)

Yatsuboshi, Motohiko

1978-01-01

For the evaluation of renal osteodystophy in both haemodialysed and non-haemodialysed patients, bone scintigraphy and computerized tomography (CT) scan were performed. Twenty-six patients with chronic renal failure were objectives of the study. For the control study of CT scan, patients with brain tumor without renal disease were selected. Bone scan was performed approximately 3 hours after sup(99m) Tc-EHDP (ethane-1-hydroxy-1, 1-diphosphonate) administration. The numericals which were printed out from CT scanner were analyzed in the area of frontal bone. The number of positive group was 9 and that of negative was 17. Positive group in non-haemodialysed patients showed lower serum calcium level and creatinine clearance and higher serum levels of inorganic phosphate and BUN compared with those of negative group. Positive scan group showed longer duration of dialysis and higher serum levels of parathyroid hormone and alkaline phosphatase than those of negative group. Frequency of abnormal findings detected by bone scan was higher than that elicited by roentgenographic examination. CT number of positive scan group was lower than that of negative group or control group. CT number in patients with subperiosteal resorption of phalanx and abnormal findings of calvarium was lower than that of patients without such roentgenographic abnormalities. These findings indicate that bone scan is useful in detecting bone changes of secondary hyperparathyroidism in chronic renal failure. CT scan could also help to estimate the decrease of bone density of calvarium in chronic renal failure. (author)

Concentration of In-111-oxine-labeled autologous leukocytes in noninfected and nonrejecting renal allografts: concise communication

International Nuclear Information System (INIS)

Collier, B.D.; Isitman, A.T.; Kaufman, H.M.; Rao, S.A.; Knobel, J.; Hellman, R.S.; Zielonka, J.S.; Pelc, L.

1984-01-01

Autologous leukocytes labeled with In-111 oxine (ILL) concentrated in the renal allografts of eight patients for whom transplant rejection, infection, or acute tubular necrosis (ATN) could be excluded. All patients had good-to-adequate renal function at the time of ILL scintigraphy, and none developed rejection or renal transplant failure during a 1-mo follow-up period. It is concluded that normally functioning renal allografts without evidence of rejection, infection, or ATN often will concentrate ILL. When a baseline study is not available for comparison, this phenomenon limits the value of ILL scintigraphy as a diagnostic test for transplant rejection or infection

First experiences from Copenhagen with paediatric single photon emission computed tomography/computed tomography

DEFF Research Database (Denmark)

Andersen, Julie Bjerglund; Mortensen, Jann; Bech, Birthe Højlund

2011-01-01

bone scintigraphy combined with In-labelled leukocyte study (osteomyelitis), three I-meta-iodobenzylguanidine scintigraphies (neuroblastoma), three In-octreotide scintigraphies (two carcinoid tumours, one Langerhans cell histiocytosis) and one Tc-dimercaptosuccinic acid scintigraphy (suspected renal...

Mechanisms controlling renal hemodynamics and electrolyte excretion during amino acids

International Nuclear Information System (INIS)

Woods, L.L.; Mizelle, H.L.; Montani, J.P.; Hall, J.E.

1986-01-01

Our purpose was to investigate the mechanisms by which increased plasma amino acids elevate renal blood flow (RBF) and glomerular filtration rate (GFR). Since transport of amino acids and Na + is linked in the proximal tubule, the authors hypothesized that increased amino acids might stimulate proximal tubular Na + reabsorption (PR/sub Na/) and thus increase RBF and GFR by a macula densa feedback mechanism. A solution of four amino acids (Ala, Ser, Gly, Pro) was infused intravenously into anesthetized dogs with normal kidneys (NK) and with kidneys in which the tubuloglomerular feedback mechanism was blunted by lowering renal artery pressure (LPK) or blocked by making the kidneys nonfiltering (NFK). In NK, RBF and GFR increased by 35 +/- 4% and 30 +/- 7% after 90 min of amino acid infusion, while PR/sub Na/ (estimated from lithium clearance) and O 2 consumption increased by 31 +/- 5% and 29 +/- 5% and distal Na + delivery remained relatively constant. Autoregulation of RBF and GFR in response to step deceases in renal artery pressure was impaired during amino acids in NK. The hemodynamic responses to amino acids were abolished in LPK and NFK. Infusion of the nonmetabolized α-aminoisobutyric acid into NK produced changes in renal hemodynamics that were similar to the responses observed with the four metabolizable amino acids. These data are consistent with the hypothesis that elevation of plasma amino acids increases RBF and GFR by a mechanism that requires an intact macula densa feedback. Metabolism of the amino acids does not appear to be necessary for these changes to occur

Mechanisms controlling renal hemodynamics and electrolyte excretion during amino acids

Energy Technology Data Exchange (ETDEWEB)

Woods, L.L.; Mizelle, H.L.; Montani, J.P.; Hall, J.E.

1986-08-01

Our purpose was to investigate the mechanisms by which increased plasma amino acids elevate renal blood flow (RBF) and glomerular filtration rate (GFR). Since transport of amino acids and Na is linked in the proximal tubule, the authors hypothesized that increased amino acids might stimulate proximal tubular Na reabsorption (PR/sub Na/) and thus increase RBF and GFR by a macula densa feedback mechanism. A solution of four amino acids (Ala, Ser, Gly, Pro) was infused intravenously into anesthetized dogs with normal kidneys (NK) and with kidneys in which the tubuloglomerular feedback mechanism was blunted by lowering renal artery pressure (LPK) or blocked by making the kidneys nonfiltering (NFK). In NK, RBF and GFR increased by 35 +/- 4% and 30 +/- 7% after 90 min of amino acid infusion, while PR/sub Na/ (estimated from lithium clearance) and O2 consumption increased by 31 +/- 5% and 29 +/- 5% and distal Na delivery remained relatively constant. Autoregulation of RBF and GFR in response to step deceases in renal artery pressure was impaired during amino acids in NK. The hemodynamic responses to amino acids were abolished in LPK and NFK. Infusion of the nonmetabolized -aminoisobutyric acid into NK produced changes in renal hemodynamics that were similar to the responses observed with the four metabolizable amino acids. These data are consistent with the hypothesis that elevation of plasma amino acids increases RBF and GFR by a mechanism that requires an intact macula densa feedback. Metabolism of the amino acids does not appear to be necessary for these changes to occur.

Renal response to acute acid loading--an organ physiological approach

DEFF Research Database (Denmark)

Osther, P J; Engel, K; Kildeberg, P

2004-01-01

, as the extracellular acid-base status would be expected to be the key physiological trigger for renal NAE. The object of this study was to investigate the renal response to acute non-carbonic acid loading using a quantitative organ physiological approach. MATERIAL AND METHODS: Five-h NH4Cl loading studies were...

A review of equine renal imaging techniques

International Nuclear Information System (INIS)

Matthews, H.K.; Toal, R.L.

1996-01-01

Radiography has a limited role in the evaluation of the kidneys in foals and adult horses. Ultrasonography is the current method of choice for structural evaluation of the kidneys in horses as it provides additional information to standard serum chemistry and urinalysis evaluation. A variety of structural abnormalities have been identified in diseased equine kidneys with the use of ultrasound. Ultrasound guided renal biopsy is the preferred method for performing renal biopsy in the horse. The use of Duplex Doppler ultrasound may allow for the characterization of regional hemodynamics of the equine kidney, but is currently an untapped method for evaluation of equine renal hemodynamics. Radionuclide methods including scintigraphy and quantitative renal function measurement can be used to provide further information about equine renal function. Scintigraphy can provide structural and possibly functional information. Quantitative methods using radiopharmaceuticals can provide precise measurement of glomerular filtration rate and effective renal blood flow. This method is especially helpful in identifying acute renal failure and in guiding response to treatment. All equine renal imaging techniques should be a supplement to the physical examination and standard laboratory tests. Additional diagnostic aids such as urinary tract endoscopy should also be considered in horses with hematuria, hydroureter, and suspected calculi. Taken together, all these modalities provide a thorough evaluation of the equine renal system and provide a basis for the clinician to select treatment options and provide prognostic information to the owner

Gastroesophageal reflux: the acid test, scintigraphy or the pH probe

International Nuclear Information System (INIS)

Seibert, J.J.; Byrne, W.J.; Euler, A.R.; Latture, T.; Leach, M.; Campbell, M.

1983-01-01

The best established technique for diagnosing gastroesophageal reflux in children is the 24 hr esophageal pH probe test. No simultaneous comparison of this technique with radionuclide scans has been reported. Therefore, simultaneous 1 hr pH monitoring and gastroesophageal scintigraphy were performed in 49 infants and children with suspected gastroesophageal reflux. Forty-seven of these patients also were later monitored by the 24 hr pH probe test. Upper gastrointestinal series were performed on all patients. All patients with a positive 1 hr pH monitoring also had positive simultaneous scintigraphy. All patients with positive scintigraphy and pH probe monitoring also had a positive upper gastrointestinal series for reflux. The sensitivity of gastroesophageal scintigraphy, when compared to the 24 hr probe as a standard, was 79%; its specificity was 93%. The sensitivity of the upper gastrointestinal series was 86%, when compared to the 24 hr pH probe test. However, its specificity was only 21%

Prevalence of acute pyelonephritis and incidence of renal scarring in children under the age of two with urinary tract infection evaluated by {sup 99m}Tc-DMSA renal scintigraphy: the experience of a university hospital

Energy Technology Data Exchange (ETDEWEB)

Berdichevski, Eduardo Herz; Vilas, Eduardo Rosito de, E-mail: duduberdi@hotmail.com [Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Hospital Sao Lucas. Service of Medicine; Mattos, Silvia Gelpi; Bezerra, Sofia; Baldisserotto, Matteo [Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Faculdade de Medicina

2013-01-15

Objective: To calculate the frequencies of acute pyelonephritis and renal scarring in patients under the age of two, with first episode of urinary tract infection in a Brazilian university hospital, comparing with data reported in the international literature. Materials and Methods: Scintigraphic reports of children less than two years old submitted to {sup 99m}Tc-DMSA renal scintigraphy in a university hospital in Rio Grande do Sul between 2006 and 2009 were reviewed to investigate acute pyelonephritis/renal scarring. Additionally, the presence of vesicoureteral reflux, early use of antibiotics, and comorbidities were investigated on electronic records. The sample size calculation was based on a systematic review study and obtained a minimum of 147 patients. Patients whose electronic records were not available were excluded. Results: One hundred and fifty-seven children met the inclusion criteria; among them 48 had acute pyelonephritis and 8 of these had renal scars. Neither age nor sex presented any significant association with acute pyelonephritis (p = 0.405 and p = 0.124, respectively). No statistical significance was observed in the association between vesicoureteral reflux and acute pyelonephritis (p = 1.0) and other comorbidities (p = 0.470), and in relation to early use of antibiotics with acute pyelonephritis (p = 0.130) and renal scarring (p = 0.720). Conclusion: The frequencies found in the present study for acute pyelonephritis/renal scarring are in agreement with the results reported by most studies in the literature. (author)

Semi-quantitative evaluation of gallium-67 scintigraphy in lupus nephritis

International Nuclear Information System (INIS)

Lin Wanyu; Hsieh Jihfang; Tsai Shihchuan; Lan Joungliang; Cheng Kaiyuan; Wang Shyhjen

2000-01-01

Within nuclear medicine there is a trend towards quantitative analysis. Gallium renal scan has been reported to be useful in monitoring the disease activity of lupus nephritis. However, only visual interpretation using a four-grade scale has been performed in previous studies, and this method is not sensitive enough for follow-up. In this study, we developed a semi-quantitative method for gallium renal scintigraphy to find a potential parameter for the evaluation of lupus nephritis. Forty-eight patients with lupus nephritis underwent renal biopsy to determine World Health Organization classification, activity index (AI) and chronicity index (CI). A delayed 48-h gallium scan was also performed and interpreted by visual and semi-quantitative methods. For semi-quantitative analysis of the gallium uptake in both kidneys, regions of interest (ROIs) were drawn over both kidneys, the right forearm and the adjacent spine. The uptake ratios between these ROIs were calculated and expressed as the ''kidney/spine ratio (K/S ratio)'' or the ''kidney/arm ratio (K/A ratio)''. Spearman's rank correlation test and Mann-Whitney U test were used for statistical analysis. Our data showed a good correlation between the semi-quantitative gallium scan and the results of visual interpretation. K/S ratios showed a better correlation with AI than did K/A ratios. Furthermore, the left K/S ratio displayed a better correlation with AI than did the right K/S ratio. In contrast, CI did not correlate well with the results of semi-quantitative gallium scan. In conclusion, semi-quantitative gallium renal scan is easy to perform and shows a good correlation with the results of visual interpretation and renal biopsy. The left K/S ratio from semi-quantitative renal gallium scintigraphy displays the best correlation with AI and is a useful parameter in evaluating the disease activity in lupus nephritis. (orig.)

Risk factors for renal scarring in children with primary vesicoureteral reflux disease

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Sevgi Mir

2013-01-01

Full Text Available To determine the incidence of renal scarring among patients with primary vesicoureteral reflux (VUR and the possible risk factor(s, we studied 90 children (60 girls and 30 boys with VUR followed in the Pediatric Nephrology Unit at the Ege University Hospital from 1998 to 2003. All the patients were assessed for VUR grade by voiding cystoureterography and for presence of renal scarring by (99 m technetium dimercapto-succinic acid scintigraphy. All infants with VUR were given low-dose prophylactic antibiotics and followed-up until resolution of the reflux. Grade of reflux and number of urinary tract infection (UTI episodes (≥3 were found to be statistically significant risk factors for renal scarring (P 0.05. Similarly, there was no statistically significant difference of frequency of renal scarring among the different age groups (P >0.05. We conclude that recurrences of UTI and VUR severity are significant risk factors for renal scarring in children with VUR. Therefore, identification of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars that may result in end-stage renal failure.

Dynamic renal scintigraphic estimation of deceased donor kidneys in a rat model

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Huseyin Aydin Mitil

2017-01-01

Full Text Available At present a large number of the renal transplantations are being performed from the deceased donors. The success of these transplantations depends on the viability of the deceased donor kidneys. The aim of this study was to investigate the reliability of scintigraphic estimation of function of deceased donor kidneys by comparing the histopathologic and scintigraphic findings. Ten rats were included in the study (2–3 months old, 250–300 g, all male. Control scintigraphy was performed to all the rats by injection of 37 MBq Tc-99m DTPA from the tail vein in a dynamic manner. Brain death of the rats was achieved by inflation of a Fogartys catheter in the cranial cavity. Immediately, after brain death confirmation, dynamic renal scintigraphy was performed with the same parameters of control scintigraphy. In the comparison of scintigraphies obtained in the before and just after brain death period, there was impairment of tubular functions, concentration and excretion functions in the postbrain death period. In the immediate postbrain death period, there was a significant elevation in the glomerular filtration rate and time to maximum concentration values. In the histopathological evaluation of the kidney samples in the postbrain death period, there were definitive findings of tubular impairment. Dynamic renal scintigraphy also demonstrated definite impairment of tubular system and tubular functions in the deceased donor kidneys. This could explain the reason of the increased frequency of acute tubular necrosis seen among deceased donor kidneys.

MR velocity mapping measurement of renal artery blood flow in patients with impaired kidney function

DEFF Research Database (Denmark)

Cortsen, M; Petersen, L.J.; Stahlberg, F

1996-01-01

Renal blood flow (RBF) was measured in 9 patients with chronic impaired kidney function using MR velocity mapping and compared to PAH clearance and 99mTc-DTPA scintigraphy. An image plane suitable for flow measurement perpendicular to the renal arteries was chosen from 2-dimensional MR angiography....... MR velocity mapping was performed in both renal arteries using an ECG-triggered gradient echo pulse sequence previously validated in normal volunteers. Effective renal plasma flow was calculated from the clearance rate of PAH during constant infusion and the split of renal function was evaluated...... by 99mTc-DTPA scintigraphy. A reduction of RBF was found, and there was a significant correlation between PAH clearance multiplied by 1/(1-hematocrit) and RBF determined by MR velocity mapping. Furthermore, a significant correlation between the distribution of renal function and the percent distribution...

Mandibular brown tumor revealing primary hyperparathyroidism. Contribution of the 99Tc-MIBI scintigraphy (report of case)

International Nuclear Information System (INIS)

Bahri, H.; Mhiri, A.; Zayed, S.; Letaief, B.; Slim, I.; Kraiem, T.; Ben Slimen, M.F.; Sellem, A.; Hammami, H.; Ladgham, A.

2006-01-01

Thanks to the development of new diagnostic and therapeutic techniques, it has became rare to discover a primary hyperparathyroidism at the stage of renal and/or bony complications. The contribution of the 99m Tc-MIBI scintigraphy has been well described in the detection of the parathyroid adenoma but few publications showed its capacity to detect also brown tumors. We report a case of mandible brown tumor, revealing a primary hyperparathyroidism. 99m Tc-MDP scintigraphy, done in the setting of the bony lesion balance, showed the multifocal character of this tumor. 99m Tc-MIBI scintigraphy pointed out both parathyroid adenoma and brown tumor that fixed the radio tracer. (author)

Scintigraphic detection of 'yo-yo' phenomenon in incomplete ureteric duplication

International Nuclear Information System (INIS)

Chu, Winnie C.W.; Chan, Kam-wing; Metreweli, Constantine

2003-01-01

'Yo-yo' reflux in an incompletely duplicated renal system was demonstrated on 99m Tc-mercaptoacetyltriglycine (MAG3) renal scintigraphy in a 7-year-old girl presenting with low-grade fever and pyelonephritis. Incomplete duplication and a bifid renal pelvis, which may be seen in up to 4% of the North American population, occasionally causes symptoms because of recurrent urinary tract infection or loin pain. 99m Tc-MAG3 renal scintigraphy can demonstrate 'yo-yo' reflux in patients with incomplete renal duplication and should be considered in cases with unexplained loin pain, even if 99m Tc-dimercaptosuccinic acid (DMSA) renal scintigraphy is normal. (orig.)

Studies of renal parenchymal impairments with extracorporeal shock wave lithotripsy (ESWL) by diagnostic imaging methods

Energy Technology Data Exchange (ETDEWEB)

Ohishi, Yukihiko; Machida, Toyohei; Tashiro, Kazuya; Wada, Tetsuro; Mochizuki, Atsushi; Torii, Shinichiro; Yoshigoe, Fukuo; Kawashima, Yoshio; Asano, Koji (Jikei Univ., Tokyo (Japan). School of Medicine)

1989-05-01

Renal parenchymal impairments with extracorporeal shock wave lithotripsy (ESWL) were studied by diagnostic imaging methods. The subjects were 25 patients with renal stones, and EDAP LT-01 (piezoelectric system) was used for the equipment of ESWL. The examination by MRI, X-ray CT and /sup 99m/Tc-DMSA scintigraphy using SPECT were performed before and after ESWL. To the 24 kidneys of 12 adult dogs, shock waves were fired in order to examine the experimental renal parenchymal impairments. After the treatment with ESWL, renal abnormal findings were obtained with MRI in 6 patients out of 11 (54.5%), with X-ray CT in 1 patient out of 12 (8.3%), and with the /sup 99m/Tc-DMSA renal scintigraphy in 4 patients out of 6 (66.7%). In the inspections with X-ray CT and renal scintigraphy conducted in 4 weeks, it was noted that the conditions of patients were recovered to the states before ESWL was performed. Using the therapeutic doses of shock wave for humans, the renal parenchymal impairments in the kidney in dogs were normalized in 7 days. Although it has been considered that the degree of renal parenchymal impairments with ESWL treatment may be influenced by the kind of the equipment, frequency of shock waves and their strength, the extent of impairments were rather mild, and it was presumed that the impairments might be recovered on the images in 3 to 4 weeks at the latest. (author).

Studies of renal parenchymal impairments with extracorporeal shock wave lithotripsy (ESWL) by diagnostic imaging methods

International Nuclear Information System (INIS)

Ohishi, Yukihiko; Machida, Toyohei; Tashiro, Kazuya; Wada, Tetsuro; Mochizuki, Atsushi; Torii, Shinichiro; Yoshigoe, Fukuo; Kawashima, Yoshio; Asano, Koji

1989-01-01

Renal parenchymal impairments with extracorporeal shock wave lithotripsy (ESWL) were studied by diagnostic imaging methods. The subjects were 25 patients with renal stones, and EDAP LT-01 (piezoelectric system) was used for the equipment of ESWL. The examination by MRI, X-ray CT and 99m Tc-DMSA scintigraphy using SPECT were performed before and after ESWL. To the 24 kidneys of 12 adult dogs, shock waves were fired in order to examine the experimental renal parenchymal impairments. After the treatment with ESWL, renal abnormal findings were obtained with MRI in 6 patients out of 11 (54.5%), with X-ray CT in 1 patient out of 12 (8.3%), and with the 99m Tc-DMSA renal scintigraphy in 4 patients out of 6 (66.7%). In the inspections with X-ray CT and renal scintigraphy conducted in 4 weeks, it was noted that the conditions of patients were recovered to the states before ESWL was performed. Using the therapeutic doses of shock wave for humans, the renal parenchymal impairments in the kidney in dogs were normalized in 7 days. Although it has been considered that the degree of renal parenchymal impairments with ESWL treatment may be influenced by the kind of the equipment, frequency of shock waves and their strength, the extent of impairments were rather mild, and it was presumed that the impairments might be recovered on the images in 3 to 4 weeks at the latest. (author)

Rapid estimation of split renal function in kidney donors using software developed for computed tomographic renal volumetry

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Kato, Fumi, E-mail: fumikato@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Kamishima, Tamotsu, E-mail: ktamotamo2@yahoo.co.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Morita, Ken, E-mail: kenordic@carrot.ocn.ne.jp [Department of Urology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Muto, Natalia S., E-mail: nataliamuto@gmail.com [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Okamoto, Syozou, E-mail: shozo@med.hokudai.ac.jp [Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Omatsu, Tokuhiko, E-mail: omatoku@nirs.go.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Oyama, Noriko, E-mail: ZAT04404@nifty.ne.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Terae, Satoshi, E-mail: saterae@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan); Kanegae, Kakuko, E-mail: IZW00143@nifty.ne.jp [Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Nonomura, Katsuya, E-mail: k-nonno@med.hokudai.ac.jp [Department of Urology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638 (Japan); Shirato, Hiroki, E-mail: shirato@med.hokudai.ac.jp [Department of Radiology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638 (Japan)

2011-07-15

Purpose: To evaluate the speed and precision of split renal volume (SRV) measurement, which is the ratio of unilateral renal volume to bilateral renal volume, using a newly developed software for computed tomographic (CT) volumetry and to investigate the usefulness of SRV for the estimation of split renal function (SRF) in kidney donors. Method: Both dynamic CT and renal scintigraphy in 28 adult potential living renal donors were the subjects of this study. We calculated SRV using the newly developed volumetric software built into a PACS viewer (n-SRV), and compared it with SRV calculated using a conventional workstation, ZIOSOFT (z-SRV). The correlation with split renal function (SRF) using {sup 99m}Tc-DMSA scintigraphy was also investigated. Results: The time required for volumetry of bilateral kidneys with the newly developed software (16.7 {+-} 3.9 s) was significantly shorter than that of the workstation (102.6 {+-} 38.9 s, p < 0.0001). The results of n-SRV (49.7 {+-} 4.0%) were highly consistent with those of z-SRV (49.9 {+-} 3.6%), with a mean discrepancy of 0.12 {+-} 0.84%. The SRF also agreed well with the n-SRV, with a mean discrepancy of 0.25 {+-} 1.65%. The dominant side determined by SRF and n-SRV showed agreement in 26 of 28 cases (92.9%). Conclusion: The newly developed software for CT volumetry was more rapid than the conventional workstation volumetry and just as accurate, and was suggested to be useful for the estimation of SRF and thus the dominant side in kidney donors.

Imaging of renal osteodystrophy

Energy Technology Data Exchange (ETDEWEB)

Jevtic, V. E-mail: vladimir.jevtic@mf.uni-lj.si

2003-05-01

Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination.

Imaging of renal osteodystrophy

International Nuclear Information System (INIS)

Jevtic, V.

2003-01-01

Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination

Renal acidification responses to respiratory acid-base disorders.

Science.gov (United States)

Madias, Nicolaos E

2010-01-01

Respiratory acid-base disorders are those abnormalities in acid-base equilibrium that are expressed as primary changes in the arterial carbon dioxide tension (PaCO2). An increase in PaCO2 (hypercapnia) acidifies body fluids and initiates the acid-base disturbance known as respiratory acidosis. By contrast, a decrease in PaCO2 (hypocapnia) alkalinizes body fluids and initiates the acid-base disturbance known as respiratory alkalosis. The impact on systemic acidity of these primary changes in PaCO2 is ameliorated by secondary, directional changes in plasma [HCO3¯] that occur in 2 stages. Acutely, hypercapnia or hypocapnia yields relatively small changes in plasma [HCO3¯] that originate virtually exclusively from titration of the body's nonbicarbonate buffers. During sustained hypercapnia or hypocapnia, much larger changes in plasma [HCO3¯] occur that reflect adjustments in renal acidification mechanisms. Consequently, the deviation of systemic acidity from normal is smaller in the chronic forms of these disorders. Here we provide an overview of the renal acidification responses to respiratory acid-base disorders. We also identify gaps in knowledge that require further research.

Evaluation of total renal function from 99mTc-MAG3 scintigraphy in children

International Nuclear Information System (INIS)

Andersson, L.G.; Bratteby, L.E.; Takalo, R.; Svensson, L.

2002-01-01

Aim: The aim of the present study was to evaluate the usefulness of dynamic scintigraphy in the assessment of total renal function in children. The Patlak slope of 99m Tc-MAG3 renography curves were compared to the plasma clearance values of 51Cr-EDTA. Material and methods: The study sample consisted of 53 boys and 33 girls with various nephrologic disorders, referred for routine clinical reasons. The median age of the subjects was 5.1 years (range 0.3 - 14.1 years). Imaging procedure. In supine position, the patient received a bolus injection of 1 MBq/kg, (minimum 10 MBq) 99m Tc-MAG3 and a posterior dynamic gamma camera registration was performed for 21 min using 1 frame per second during the first minute and thereafter 10 seconds frames. Data analysis. Time-activity curves were generated from manually drawn heart and renal regions of interest. The MAG3 uptake was calculated from the Patlak-Rutland plot of each kidney by linear curve fitting until the beginning of the excretory phase. A sum of the slope values was used as a measure of total renal MAG3 uptake. Cr-EDTA clearance. Glomerular filtration rate (GFR) was measured from the plasma clearance of 51 Cr-EDTA using single injection, multiple-sample technique. After intravenous injection of 51 Cr-EDTA (74 kBq/kg for children up to 7 years, 37 kBq/kg for children older than 7 years), blood samples were drawn at 5, 10, 15, 45, 60, 120 and 180 min for radioactivity measurement. The GFR was calculated according to Broechner-Mortensen and expressed in ml/min. Results: The absolute 51 Cr-EDTA clearance varied from 9 to 143 ml/min. There was a close linear relationship between 51 Cr-EDTA clearance and MAG3 uptake (Fig). The correlation coefficient was 0.90 and the regression equation (y=43.5 x + 664). Conclusions: In the present study, there was a good correlation between plasma clearance of 51 Cr-EDTA and the sum of the Patlak slopes. The regression equation can be utilised to transform the 99m Tc-MAG3 uptake to an

Sequential scintigraphy of the kidneys and joints with 99mTc-pyrophosphate in patients with rheumatic arthritis

International Nuclear Information System (INIS)

Askerov, N.M.; Dzhafarov, G.A.

1990-01-01

The proposed method of sequential scintigraphy of the kidneys and joints in a single administration of 99m Tc-pyrophosphate permits obtaining objective information on function and topography of the kidneys and pyodestructive processes in the joints. Dynamic scintigraphy helps to assess visually renal hemodynamics and the anatomotopographic position of the kidney and to obtain exhaustive information on accumulative-evacuatory function of each kidney individually. Scintigraphy also helps to investigate all the joints and to detect pyoinflammatory changes in them. The proposed method considerably reduces the time of investigation and lessens radiation exposure of patients, permitting repeated investigations to assess and correct the treatment of patients with rheumatic arthritis

Endoplasmic Reticulum Chaperon Tauroursodeoxycholic Acid Attenuates Aldosterone-Infused Renal Injury

Directory of Open Access Journals (Sweden)

Honglei Guo

2016-01-01

Full Text Available Aldosterone (Aldo is critically involved in the development of renal injury via the production of reactive oxygen species and inflammation. Endoplasmic reticulum (ER stress is also evoked in Aldo-induced renal injury. In the present study, we investigated the role of ER stress in inflammation-mediated renal injury in Aldo-infused mice. C57BL/6J mice were randomized to receive treatment for 4 weeks as follows: vehicle infusion, Aldo infusion, vehicle infusion plus tauroursodeoxycholic acid (TUDCA, and Aldo infusion plus TUDCA. The effect of TUDCA on the Aldo-infused inflammatory response and renal injury was investigated using periodic acid-Schiff staining, real-time PCR, Western blot, and ELISA. We demonstrate that Aldo leads to impaired renal function and inhibition of ER stress via TUDCA attenuates renal fibrosis. This was indicated by decreased collagen I, collagen IV, fibronectin, and TGF-β expression, as well as the downregulation of the expression of Nlrp3 inflammasome markers, Nlrp3, ASC, IL-1β, and IL-18. This paper presents an important role for ER stress on the renal inflammatory response to Aldo. Additionally, the inhibition of ER stress by TUDCA negatively regulates the levels of these inflammatory molecules in the context of Aldo.

{sup 123}I-{beta}-methyl-iodophenyl-pentadecanoic acid myocardial scintigraphy in diabetic patients without overt ischemic heart disease

Energy Technology Data Exchange (ETDEWEB)

Shinmura, Ken; Tani, Masato; Suganuma, Yukako; Hasegawa, Hiroshi; Kawamura, Masatoshi; Nakamura, Yoshiro; Hashimoto, Jun; Kubo, Atsushi [Keio Univ., Tokyo (Japan). School of Medicine

1995-07-01

We evaluated {sup 123}I-{beta}-methyl-iodophenyl-pentadecanoic acid (BMIPP) myocardial scintigraphy in 15 diabetes mellitus patients without overt coronary heart disease. Patients with overt coronary heart disease were excluded by careful history taking, resting electrocardiography, treadmill exercise testing echocardiography and resting {sup 201}Tl scintigraphy. Patients with remarkably impaired left ventricular (LV) systolic function (%FS<30%) were also excluded. BMIPP uptake scores as the ratio of heart/mediastinum (H/M) and liver/mediastinum (L/M) at 20 minutes after injection were analyzed and compared with clinical profile, serum parameters, and LV parameters obtained from echocardiography. Five of the 15 patients showed abnormal BMIPP images; two patients showed a decreased uptake in the inferior segments, while three showed a diffuse decrease in BMIPP uptake. Body mass index (BMI), fasting blood sugar (FBS), HbA1c, IRI, and LV end-diastolic diameter (LVEDD) were higher in these five patients with abnormal BMIPP findings (abnormal BMIPP group vs normal BMIPP group, BMI: 29 vs 23 kg/m{sup 2}, FBS: 178 vs 114 mg/dl, HbA1c: 7.6 vs 6.2%, IRI: 18.5 vs 9.5 {mu}U/ml, LVEDD: 52 vs 44 mm). {sup 123}I-metaiodobenzyl-guanidine (MIBG) scintigraphy in the 5 patients with abnormal BMIPP uptake showed more severe defects than in the 10 patients with normal BMIPP imaging. BMIPP scintigraphy demonstrated a significant correlation between H/M and L/M by BMIPP (r=0.74). Correlation between H/M by BMIPP scintigraphy and clinical parameters (BMI, systolic blood pressure, FBS, HbA1c, IRI) were found, suggesting that diabetes mellitus patients without over coronary heart disease show abnormal BMIPP imaging when their general glucose utility and {sup 123}I-MIBG uptake are severely impaired (progression of insulin resistance and sympathetic nerve involvement). BMIPP scintigraphy may be useful in investigating the pathogenesis and subclinical abnormality of diabetic heart. (J.P.N.).

Synthesis, bioevaluation and gamma scintigraphy of 99mTc-N-2-(furylmethyl iminodiacetic acid) complex as a new renal radiopharmaceutical

International Nuclear Information System (INIS)

Sanad, M.H.; Talaat, H.M.; Ibrahim, A.A.

2018-01-01

A ligand of N-2-(furylmethyl iminodiacetic acid) (FMIDA) has been easily labeled by a tetradentate chelating agent of [ 99m Tc]. Factors like a stannous chloride solution as a reducing agent (100 μg), substrate amount (100 μg), pH (7), in vitro stability (8 h) and temperature (37 °C) have been systematically studied to optimize high radiochemical yield (98.0%). The radiochemical conversion was calculated on thin-layer chromatography, paper electrophoresis, and high performance liquid chromatography. Biodistribution study showed that this complex was removed from the kidneys and bladder path way during 1 h post injection. Therefore, [ 99m Tc]FMIDA may be used as renal function radiotracer. (author)

Semi-quantitative evaluation of gallium-67 scintigraphy in lupus nephritis

Energy Technology Data Exchange (ETDEWEB)

Lin Wanyu [Dept. of Nuclear Medicine, Taichung Veterans General Hospital, Taichung (Taiwan); Dept. of Radiological Technology, Chung-Tai College of Medical Technology, Taichung (Taiwan); Hsieh Jihfang [Section of Nuclear Medicine, Chi-Mei Foundation Hospital, Yunk Kang City, Tainan (Taiwan); Tsai Shihchuan [Dept. of Nuclear Medicine, Show Chwan Memorial Hospital, Changhua (Taiwan); Lan Joungliang [Dept. of Internal Medicine, Taichung Veterans General Hospital, Taichung (Taiwan); Cheng Kaiyuan [Dept. of Radiological Technology, Chung-Tai College of Medical Technology, Taichung (Taiwan); Wang Shyhjen [Dept. of Nuclear Medicine, Taichung Veterans General Hospital, Taichung (Taiwan)

2000-11-01

Within nuclear medicine there is a trend towards quantitative analysis. Gallium renal scan has been reported to be useful in monitoring the disease activity of lupus nephritis. However, only visual interpretation using a four-grade scale has been performed in previous studies, and this method is not sensitive enough for follow-up. In this study, we developed a semi-quantitative method for gallium renal scintigraphy to find a potential parameter for the evaluation of lupus nephritis. Forty-eight patients with lupus nephritis underwent renal biopsy to determine World Health Organization classification, activity index (AI) and chronicity index (CI). A delayed 48-h gallium scan was also performed and interpreted by visual and semi-quantitative methods. For semi-quantitative analysis of the gallium uptake in both kidneys, regions of interest (ROIs) were drawn over both kidneys, the right forearm and the adjacent spine. The uptake ratios between these ROIs were calculated and expressed as the ''kidney/spine ratio (K/S ratio)'' or the ''kidney/arm ratio (K/A ratio)''. Spearman's rank correlation test and Mann-Whitney U test were used for statistical analysis. Our data showed a good correlation between the semi-quantitative gallium scan and the results of visual interpretation. K/S ratios showed a better correlation with AI than did K/A ratios. Furthermore, the left K/S ratio displayed a better correlation with AI than did the right K/S ratio. In contrast, CI did not correlate well with the results of semi-quantitative gallium scan. In conclusion, semi-quantitative gallium renal scan is easy to perform and shows a good correlation with the results of visual interpretation and renal biopsy. The left K/S ratio from semi-quantitative renal gallium scintigraphy displays the best correlation with AI and is a useful parameter in evaluating the disease activity in lupus nephritis. (orig.)

Overall renal and tubular function during infusion of amino acids in normal man

DEFF Research Database (Denmark)

Olsen, Niels Vidiendal; Hansen, J M; Ladefoged, S D

1990-01-01

sodium concentration] increased by 40% (P less than 0.001). Plasma renin concentration did not change significantly. 4. The results suggest that amino acids increase GFR by a primary effect on renal haemodynamics or, less likely, by reducing the signal to the tubuloglomerular feedback mechanism......1. Amino acids have been used to test renal reserve filtration capacity. Previous studies suggest that amino acids increase glomerular filtration rate (GFR) by reducing distal tubular flow and tubuloglomerular feedback activity. 2. Glomerular function and the renal tubular handling of sodium during...... infusion of amino acids was studied in 12 normal volunteers. 3. Clearance of sodium (CNa) was unchanged. Effective renal plasma flow increased slightly, but significantly, by 9% (P less than 0.05). GFR was increased by 13% (P less than 0.001). Clearance of lithium (CLi) (used as an index of proximal...

Rapid estimation of split renal function in kidney donors using software developed for computed tomographic renal volumetry

International Nuclear Information System (INIS)

Kato, Fumi; Kamishima, Tamotsu; Morita, Ken; Muto, Natalia S.; Okamoto, Syozou; Omatsu, Tokuhiko; Oyama, Noriko; Terae, Satoshi; Kanegae, Kakuko; Nonomura, Katsuya; Shirato, Hiroki

2011-01-01

Purpose: To evaluate the speed and precision of split renal volume (SRV) measurement, which is the ratio of unilateral renal volume to bilateral renal volume, using a newly developed software for computed tomographic (CT) volumetry and to investigate the usefulness of SRV for the estimation of split renal function (SRF) in kidney donors. Method: Both dynamic CT and renal scintigraphy in 28 adult potential living renal donors were the subjects of this study. We calculated SRV using the newly developed volumetric software built into a PACS viewer (n-SRV), and compared it with SRV calculated using a conventional workstation, ZIOSOFT (z-SRV). The correlation with split renal function (SRF) using 99m Tc-DMSA scintigraphy was also investigated. Results: The time required for volumetry of bilateral kidneys with the newly developed software (16.7 ± 3.9 s) was significantly shorter than that of the workstation (102.6 ± 38.9 s, p < 0.0001). The results of n-SRV (49.7 ± 4.0%) were highly consistent with those of z-SRV (49.9 ± 3.6%), with a mean discrepancy of 0.12 ± 0.84%. The SRF also agreed well with the n-SRV, with a mean discrepancy of 0.25 ± 1.65%. The dominant side determined by SRF and n-SRV showed agreement in 26 of 28 cases (92.9%). Conclusion: The newly developed software for CT volumetry was more rapid than the conventional workstation volumetry and just as accurate, and was suggested to be useful for the estimation of SRF and thus the dominant side in kidney donors.

Atherosclerotic ischemic renal disease. Diagnosis and prevalence in an hypertensive and/or uremic elderly population

Directory of Open Access Journals (Sweden)

Rossi Michele

2003-02-01

Full Text Available Abstract Background Atherosclerotic ischemic renal disease is a frequent cause of end-stage renal failure leading to dialysis among the elderly; Its prevalence is inferred from autopsy or retrospective arteriographic studies. This study has been conducted on 269 subjects over 50 with hypertension and/or CRF, unrelated to other known causes of renal disease. Methods All 269 patients were studied either by color-flow duplex sonography (n = 238 or by renal scintigraphy (n = 224, and 199 of the 269 patients were evaluated using both of these techniques. 40 patients, found to have renal artery stenosis (RAS, were subjected to 3D-contrast enhancement Magnetic Resonance Angiography (MRA and/or Selective Angiography (SA. An additional 23 cases, negative both to scintigraphy and to ultrasound study, underwent renal angiography (MRA and/or SA. Results Color-duplex sonography, carried out in 238 patients, revealed 49 cases of RAS. MR or SA was carried out in 35 of these 49 patients, and confirmed the diagnosis in 33. Color-duplex sonography showed a PPV value of 94.3% and NPV of 87.0% while renal scintigraphy, carried out in 224 patients, had a PPV of 72.2% and a NPV of 29.4%. Patients with RAS showed a higher degree of renal insufficiency compared to non stenotic patients while there were no differences in proteinuria. RAS, based on color-duplex sonography studies, was present in 11% of patients in the age group 50–59, 18% in the 60–69 and 23% at age 70 and above. Conclusions A relatively large percentage of the elderly population with renal insufficiency and/or hypertension is affected by RAS and is at risk of developing end-stage renal failure. Color-duplex ultrasonography is a valid routine method of investigation of population at risk for renal artery stenosis.

Late evaluation of the relationship between morphological and functional renal changes and hypertension after non-operative treatment of high-grade renal injuries

Directory of Open Access Journals (Sweden)

Pereira Júnior Gerson

2012-08-01

Full Text Available Abstract Objective To evaluate the anatomical and functional renal alterations and the association with post-traumatic arterial hypertension. Methods The studied population included patients who sustained high grades renal injury (grades III to V successfully non-operative management after staging by computed tomography over a 16-year period. Beyond the review of medical records, these patients were invited to the following protocol: clinical and laboratory evaluation, abdominal computed tomography, magnetic resonance angiography, DMSA renal scintigraphy, and ambulatory blood pressure monitoring. The hypertensive patients also were submitted to dynamic renal scintigraphy (99mTc EC, using captopril stimulation to verify renal vascular etiology. Results Of the 31 patients, there were thirteen grade III, sixteen grade IV (nine lacerations, and seven vascular lesions, and two grade V injuries. All the patients were asymptomatic and an average follow up post-injury of 6.4 years. None had abnormal BUN or seric creatinine. The percentage of renal volume reduction correlates with the severity as defined by OIS. There was no evidence of renal artery stenosis in Magnetic Resonance angiography (MRA. DMSA scanning demonstrated a decline in percentage of total renal function corresponding to injury severity (42.2 ± 5.5% for grade III, 35.3 ± 12.8% for grade IV, 13.5 ± 19.1 for grade V. Six patients (19.4% had severe compromised function ( Conclusions Late results of renal function after conservative treatment of high grades renal injuries are favorable, except for patients with grades IV with vascular injuries and grade V renal injuries. Moreover, arterial hypertension does not correlate with the grade of renal injury or reduction of renal function.

Prevalence of renal uric acid stones in the adult.

Science.gov (United States)

Trinchieri, Alberto; Montanari, Emanuele

2017-12-01

The aim of this study was to estimate uric acid renal stone prevalence rates of adults in different countries of the world. PubMed was searched for papers dealing with "urinary calculi and prevalence or composition" for the period from January 1996 to June 2016. Alternative searches were made to collect further information on specific topics. The prevalence rate of uric acid stones was computed by the general renal stone prevalence rate and the frequency of uric acid stones in each country. After the initial search, 2180 papers were extracted. Out of them, 79 papers were selected after the reading of the titles and of the abstracts. For ten countries, papers relating to both the renal stone prevalence in the general population and the frequency of uric stones were available. Additional search produced 13 papers that completed information on 11 more countries in 5 continents. Estimated prevalence rate of uric acid stones was >0.75% in Thailand, Pakistan, Saudi Arabia, Iran, South Africa (white population), United States and Australia; ranged 0.50-0.75% in Turkey, Israel, Italy, India (Southern), Spain, Taiwan, Germany, Brazil; and uric acid stone formation. A hot and dry climate increases fluid losses reducing urinary volume and urinary pH. A diet rich in meat protein causes low urinary pH and increased uric acid excretion. On the other hand, uric acid stone formation is frequently associated with obesity, metabolic syndrome and diabetes type 2 that are linked to dietary energy excess mainly from carbohydrate and saturated fat and also present with low urine pH values. An epidemic of uric acid stone formation could be if current nutritional trends will be maintained both in developed countries and in developing countries and the areas of greater climatic risk for the formation of uric acid stones will enlarge as result of the "global warming".

Bone marrow scintigraphy with 111In-chloride

International Nuclear Information System (INIS)

Kan, Masayasu; Miyamae, Tatsuya

1977-01-01

111 In-chloride as a useful bone marrow-scanning agent has been used for various hematological diseases. We also have studied the distribution of indium-111 by scintigraphy in 28 patients with systemic hematopoietic disorders and other: 4 with aplastic anemia, 8 with leucemia, 3 with iron-deficiency anemia, one with pernicious anemia, 2 with myelofibrosis, 3 with multiple myeloma, one with malignant lymphoma, 3 with liver cirrhosis or Banti-syndrome and 3 with seminoma received post operative irradiation. The results of scintigraphy (the image of bone marrow, liver, spleen, kidney and intestine) were compared with bone marrow biopsies, ferrokinetic data and Se.I./TIBC. The bone marrow image was interpreted on a three-point scale: normal distribution of activity (+), abnormal distribution (+-), body back ground level (-). In the cases of iron-deficiency anemia and pernicious anemia with hyperplastic erythroid marrow, regardless of its severe anemia, the scintigrams showed clearly delineated bone marrow images and normal organ distribution of indium. On the other hand, the scan images revealed severe suppressions of bone marrow activity and markedly increased renal activity in some cases of aplastic anemia, acute leucemia and malignant lymphoma with hypoplastic and/or tumour-cell infiltrative marrows. Thus, it may be said that the bone marrow uptake of indium-111 correlates well with the degree of erythroid elements, no correlation with nucleated cell counts, and there is a strong tendency to increased renal activity in the cases of markedly decreased erythropoietic cell counts. (auth.)

Roles of renal ammonia metabolism other than in acid-base homeostasis.

Science.gov (United States)

Weiner, I David

2017-06-01

The importance of renal ammonia metabolism in acid-base homeostasis is well known. However, the effects of renal ammonia metabolism other than in acid-base homeostasis are not as widely recognized. First, ammonia differs from almost all other solutes in the urine in that it does not result from arterial delivery. Instead, ammonia is produced by the kidney, and only a portion of the ammonia produced is excreted in the urine, with the remainder returned to the systemic circulation through the renal veins. In normal individuals, systemic ammonia addition is metabolized efficiently by the liver, but in patients with either acute or chronic liver disease, conditions that increase the addition of ammonia of renal origin to the systemic circulation can result in precipitation and/or worsening of hyperammonemia. Second, ammonia appears to serve as an intrarenal paracrine signaling molecule. Hypokalemia increases proximal tubule ammonia production and secretion as well as reabsorption in the thick ascending limb of the loop of Henle, thereby increasing delivery to the renal interstitium and the collecting duct. In the collecting duct, ammonia decreases potassium secretion and stimulates potassium reabsorption, thereby decreasing urinary potassium excretion and enabling feedback correction of the initiating hypokalemia. Finally, the stimulation of renal ammonia metabolism by hypokalemia may contribute to the development of metabolic alkalosis, which in turn can stimulate NaCl reabsorption and contribute to the intravascular volume expansion, increased blood pressure and diuretic resistance that can develop with hypokalemia. The evidence supporting these novel non-acid-base roles of renal ammonia metabolism is discussed in this review.

Predictors of renal scar in children with urinary infection and vesicoureteral reflux.

Science.gov (United States)

Soylu, Alper; Demir, Belde Kasap; Türkmen, Mehmet; Bekem, Ozlem; Saygi, Murat; Cakmakçi, Handan; Kavukçu, Salih

2008-12-01

We evaluated the predictors of renal scar in children with urinary tract infections (UTIs) having primary vesicoureteral reflux (VUR). Data of patients who were examined by dimercaptosuccinic acid (DMSA) scintigraphy between 1995 and 2005 were evaluated retrospectively. Gender, age, reflux grade, presence/development of scarring, breakthrough UTIs, and resolution of reflux, were recorded. The relation of gender, age and VUR grade to preformed scarring and the relation of gender, age, VUR grade, presence of preformed scarring, number of breakthrough UTIs and reflux resolution to new scarring were assessed. There were 138 patients [male/female (M/F) 53/85]. Multivariate analysis showed that male gender [odds ratio (OR) 2.5], age > or = 27 months in girls (OR 4.2) and grades IV-V reflux (OR 12.4) were independent indicators of renal scarring. On the other hand, only the presence of previous renal scarring was found to be an independent indicator for the development of new renal scar (OR 13.4). In conclusion, while the most predictive variables for the presence of renal scarring among children presenting with a UTI were male gender, age > or = 27 months in girls, and grades IV-V reflux, the best predictor of new scar formation was presence of previous renal scarring.

Clinical studies of renal morphological changes with aging

International Nuclear Information System (INIS)

Hosokawa, Shin-ichi; Kawamura, Juichi; Tomoyoshi, Tadao; Yoshida, Osamu

1980-01-01

We studied the change of renal shape due to development and aging by using sup(99m)Tc-DMSA renal scintigraphy. In pediatric age group, the angle between renal longitudinal axis and the lumbar vertebrae is small but becomes larger with aging. The renal size grows with aging in the adult age group, and becomes largest. In geriatric age group it decreases with aging. The stability of renal position is marked in the adult age group, but in the pediatric and geriatric age group it seemed unstable. Renal contour is smooth in the pediatric and adult age group but unsmooth in the geriatric. sup(99m)Tc-DMSA renal image shows diffusely homogeneous renal uptake in the pediatric and adult age groups but not homogeneous in the geriatric. (author)

Renal scintigraphy by captopril in hypertension with hypokalemia

International Nuclear Information System (INIS)

Grandet, P.J.

1997-01-01

A study on 30 files of hypertensive patients with an associated hypokalemia was achieved from January 1996 to May 1997. The technique was that of a basic examination effected by MAG 3 (80 MBq), followed by oral intake of 25 to 50 mg of Captopril; one hour after, a new examination was done by MAG 3, with 130 MBq. The classical aspect of isotopic nephro-gram (IN) was not constantly found in case of renal artery stenosis. The reduction of the peak of the level approached might be the only sign, even without any delay of this summit; the lowering of the peak after Captopril of at least 50% should be taken into account. Thus, on the basis of these arguments, we have found 5 stenoses of renal artery. Twenty patients considered as normal have had not arteriography and are relatively well-equilibrated by medical treatment. Among the false negatives, one is explained by a renal insufficiency given an IE of bad quality, while the other is a dysplasia of renal arteries. The 3 false positives presented a discrete difference between the two examinations by MAG 3. Consequently, we considered that the discrete signs should not be retained. The slowing down of transit time, the net lowering of the peak or its delay (classically, 11 min) are good arguments

WE-D-204-07: Development of An ImageJ Plugin for Renal Function Quantification: RenalQuant

Energy Technology Data Exchange (ETDEWEB)

Marques da Silva, A; Narciso, L [PUCRS, Porto Alegre, RS (Brazil)

2015-06-15

Purpose: Commercial workstations usually have their own software to calculate dynamic renal functions. However, usually they have low flexibility and subjectivity on delimiting kidney and background areas. The aim of this paper is to present a public domain software, called RenalQuant, capable to semi-automatically draw regions of interest on dynamic renal scintigraphies, extracting data and generating renal function quantification parameters. Methods: The software was developed in Java and written as an ImageJ-based plugin. The preprocessing and segmentation steps include the user’s selection of one time frame with higher activity in kidney’s region, compared with background, and low activity in the liver. Next, the chosen time frame is smoothed using a Gaussian low pass spatial filter (σ = 3) for noise reduction and better delimitation of kidneys. The maximum entropy thresholding method is used for segmentation. A background area is automatically placed below each kidney, and the user confirms if these regions are correctly segmented and positioned. Quantitative data are extracted and each renogram and relative renal function (RRF) value is calculated and displayed. Results: RenalQuant plugin was validated using retrospective 20 patients’ 99mTc-DTPA exams, and compared with results produced by commercial workstation software, referred as reference. The renograms intraclass correlation coefficients (ICC) were calculated and false-negative and false-positive RRF values were analyzed. The results showed that ICC values between RenalQuant plugin and reference software for both kidneys’ renograms were higher than 0.75, showing excellent reliability. Conclusion: Our results indicated RenalQuant plugin can be trustingly used to generate renograms, using DICOM dynamic renal scintigraphy exams as input. It is user friendly and user’s interaction occurs at a minimum level. Further studies have to investigate how to increase RRF accuracy and explore how to solve

Top-down approach is possible strategy for predicting breakthrough fUTIs and renal scars in infants.

Science.gov (United States)

Kawai, Shina; Kanai, Takahiro; Hyuga, Taiju; Nakamura, Shigeru; Aoyagi, Jun; Ito, Takane; Saito, Takashi; Odaka, Jun; Furukawa, Rieko; Aihara, Toshinori; Nakai, Hideo

2017-07-01

Acute-phase technetium-99 m dimercaptosuccinic acid (DMSA) scintigraphy is recommended for initial imaging in children with febrile urinary tract infection (fUTI). Recently, the importance of identifying patients at risk of recurrent fUTI (r-fUTI) has been emphasized. To clarify the effectiveness of DMSA scintigraphy for predicting r-fUTI in infants, we investigated the relationship between defects on DMSA scintigraphy and r-fUTI. Seventy-nine consecutive infants (male: female, 60:19) with fUTI were enrolled in this study. DMSA scintigraphy was performed in the acute phase, and patients with defect underwent voiding cystourethrography and chronic-phase (6 months later) DMSA scintigraphy. Patients were followed on continuous antibiotic prophylaxis (CAP). Defects on acute-phase DMSA scintigraphy were observed in 32 children (40.5%) of 79. The mean follow-up observation period was 17.0 ± 10.1 months. Four patients had r-fUTI (5%). Two of them had defects on DMSA scintigraphy in both the acute phase and chronic phase, and had bilateral vesicoureteral reflux (VUR) grade IV. Two others had r-fUTI without defects on DMSA and did not have VUR. Twelve patients had defect on chronic-phase DMSA scintigraphy and four of them had no VUR. The top-down approach is a possible method for predicting r-fUTI in infants and does not miss clinically significant VUR. Also, given that the prevalence of r-fUTI was 5% regardless of the presence of defects on acute-phase DMSA, then, in conjunction with genital hygiene and CAP, acute-phase DMSA might be unnecessary if chronic-phase DMSA is performed for all patients to detect renal scar. © 2017 Japan Pediatric Society.

Image diagnosis of parathyroid glands in chronic renal failure

International Nuclear Information System (INIS)

Takagi, H.; Tominaga, Y.; Uchida, K.; Yamada, N.; Morimoto, T.; Yasue, M.

1983-01-01

Twenty-two out of 31 patients with chronic renal failure and secondary hyperparathyroidism who underwent parathyroidectomy before operation underwent non-invasive image diagnosis of parathyroid glands by computed tomography (CT), scintigraphy with 201 TlCl and /sup 99m/TcO 4+ , and/or ultrasonography. CT visualized 39 of 45 parathyroid glands (86.7%), weighing more than 500 mg. Scintigraphy with a subtraction method using a computer performed the diagnosis in 19 of 27 glands (70.4%). Ultrasonography detected 21 of 27 glands (77.8%). Image diagnosis was also useful in the postoperative follow-up study. The non-invasive image diagnosis of parathyroid glands in patients with chronic renal failure is thus valuable for 1) definite diagnosis of secondary hyperparathyroidism, 2) localization, and 3) diagnosis for effectiveness of conservative treatment

Renal bone disease and extraskeletal calcification during dialysis and after transplantation

International Nuclear Information System (INIS)

Graaf, P. de.

1980-01-01

The author reports 10 studies concerning the diagnosis of renal osteodystrophy and extraskeletal calcification in patients on maintenance hemodialysis as well as some aspects of persistent hyperparathyroidism after renal transplantation. The majority of the studies focus on the value of bone scintigraphy with Tc-99m HEDP in the diagnosis of these disorders. (Auth.)

A case of reversible dilated cardiomyopathy after alpha-interferon therapy in a patient with renal cell carcinoma.

Science.gov (United States)

Kuwata, Akiko; Ohashi, Masuo; Sugiyama, Masaya; Ueda, Ryuzo; Dohi, Yasuaki

2002-12-01

A 47-year-old man with renal cell carcinoma underwent nephrectomy, and postoperative chemotherapy was performed with recombinant alpha-interferon. Five years later, he experienced dyspnea during physical exertion. An echocardiogram revealed dilatation and systolic dysfunction of the left ventricle, and thallium-201 myocardial scintigraphy showed diffuse heterogeneous perfusion. We diagnosed congestive heart failure because of cardiomyopathy induced by alpha-interferon therapy. Withdrawal of interferon therapy and the combination of an angiotensin-converting enzyme inhibitor, diuretics, and digitalis improved left ventricular systolic function. Furthermore, myocardial scintigraphy using [123I] beta-methyl-p-iodophenylpentadecanoic acid (123I-BMIPP) or [123 I]metaiodobenzylguanidine (123I-MIBG) revealed normal perfusion after the improvement of congestive heart failure. This is a rare case of interferon-induced cardiomyopathy that resulted in normal myocardial images in 123I-BMIPP and 123I-MIBG scintigrams after withdrawal of interferon therapy.

Partial Renal Embolization for Pediatric Renovascular Hypertension Secondary to Fibromuscular Dysplasia

International Nuclear Information System (INIS)

Ishijima, Hideyuki; Ishizaka, Hiroshi; Sakurai, Minako; Ito, Kazuto; Endo, Keigo

1997-01-01

We report a 7-year-old boy with renovascular hypertension showing multiple stenoses and microaneurysms of the dorsal branch of the left renal artery caused by fibromuscular dysplasia. Hypertension was successfully treated with transcatheter alcohol and gelatin sponge embolization of the dorsal branch and its distribution. The vertebral branch remained intact. No severe complication was encountered. Loss of renal function by renal scintigraphy was minimal. The patient remains asymptomatic at 1 year

Tc99m- hepatobiliary iminodiacetic acid (HIDA) scintigraphy in clinical practice

International Nuclear Information System (INIS)

Lambie, H.; Cook, A.M.; Scarsbrook, A.F.; Lodge, J.P.A.; Robinson, P.J.; Chowdhury, F.U.

2011-01-01

There have been evolutionary changes in the management of pathological conditions of the hepatobiliary system over recent years, particularly with an increasing emphasis on modern hepatobiliary surgical techniques. Concurrent advances have occurred in imaging technology and availability, leading to a greater use of ultrasound, multidetector computed tomography (CT), and magnetic resonance imaging (MRI) in the primary evaluation of hepatobiliary disease. Radionuclide imaging using technetium 99m (Tc 99m ) hepatobiliary iminodiacetic acid (HIDA) derivatives is an established technique that complements morphological imaging, providing valuable functional information in both pre- and postoperative evaluation of patients with suspected or known hepatobiliary disease. This review discusses the current clinical indications for Tc 99m HIDA scintigraphy using clinical cases to demonstrate how this technique continues to play a valuable diagnostic role in the assessment of the functional integrity of the hepatobiliary system.

Evolution of scintigraphic renal lesions in children after an episode of acute pyelonephritis

International Nuclear Information System (INIS)

Donoso, Gilda; Lagos, Elizabeth; Rosati, Pia; Hevia, Pilar; Cuevas, Karen; Lobo, Gabriel; Perez, Andres; Gutierrez, Daniela

2012-01-01

Background: Abnormal Dimercaptosuccinic acid (DMSA) renal scintigraphy performed six months after an acute pyelonephritis (AP) is generally interpreted as scarring. Aim: To perform a follow up of childhood patients showing scintigraphic renal lesions during the acute phase of pyelonephritis (within 7 days from the beginning of fever). Material and Methods: A scintigraphic control was carried out at 5-7 months and, in case of persistent lesions, an additional late scintigraphy at 10-13 months. All patients were followed clinically for one year and those with a relapse of urinary tract infection were excluded from the study. Results: Eighty five patients with a median age of 8 months were included. Among these, the first scintigraphic control was normal in 59 (69%) and abnormal in 26 patients (31%). In five of these 26 patients (5/26:19%-5/85:6%), a considerable regression of the lesions was obvious on the early control, and normalized completely on the late control. When expressing the results in kidney units, 107 showed lesions during the acute phase of infection; 69% was normal at the early control. Thirty three showed lesions persisting at the early control (31%) and 7 out of these 33 (21%) became normal on the late control (7/107: 7%). In total, 25% of the children included in the study (24% of the kidney units) remained with renal sequelae one year after the initial episode of AP. Conclusions: The persistence of scintigraphic lesions six months after an episode of AP, does not necessarily correspond to permanent scars, since normalization can sometimes be observed on late controls

Iodine-123-labelled serum amyloid P component scintigraphy in amyloidosis

International Nuclear Information System (INIS)

Saile, R.; Deveaux, M.; Marchandise, X.; Duquesnoy, B.

1993-01-01

This study describes the results of scintigraphy with iodine-123-labelled serum amyloid P component (SAP) as a means of establishing the distribution of organ involvement in amyloidosis. The significance of 123 I-SAP scans obtained in 15 patients with biopsy-proven AA or AL amyloidosis is discussed. Biopsy-proven amyloidosis was typically confirmed by scintigraphy, though such confirmation was not obtained in the kidneys in six patients with histological proof of extensive renal amyloid deposition. This lack of uptake may have been due to the accumulation of a major part of the 123 I-SAP in the spleen and/or liver. Twenty-four hour whole-body retention of 123 I-SAP was higher in patients with amyloidosis than in controls. Twenty-four hour tracer accumulation of the radioactivity in the extravascular compartment was notably greater in patients than in controls and appeared to be a good diagnostic criterion. We conclude that 123 I-SAP scintigraphy may be helpful for the evaluation of organ involvement not only in patients with biopsy-proven amyloidosis but also when a biopsy cannot be performed or when a strong suspicion of amyloidosis exists in spite of repeated negative biopsises. (orig.)

Notes on the liver correction applied systematically to all renal scintigrams

International Nuclear Information System (INIS)

Artus, J.C.; Miro, L.; Durand, J.

1976-01-01

A problem still outstanding in renal scintigraphy is analyzed: how to deal with the parasitic tracer uptake by the liver. Some investigators correct systematically for the liver shadow by injecting technetium labelled colloids, for others the data supplied by 197 HgCl 2 scintigraphy alone allow to estimate the kidney uptake. Objective criteria are given as a mean to decide whether a liver scintigram is necessary in order to obtain the kidney uptake rate [fr

Development of renal simulators for use in nuclear medicine; Desenvolvimento de simuladores renais para uso em medicina nuclear

Energy Technology Data Exchange (ETDEWEB)

Dullius, Marcos Alexandre

2014-09-01

Quality control programs in nuclear medicine include verifying the efficiency of all equipment used for diagnosis and therapy, including scintillation cameras. To that end, we have developed and evaluated the performance of four phantom kidneys - two static anthropomorphic, one semi-dynamic, and one dynamic - to acquire static and dynamic renal scintigraphic images. The static anthropomorphic phantoms were used to characterize and evaluate the response of the processing system for different concentrations of radionuclides through static renal scintigraphy images ({sup 99m}Tc-DMSA), obtained with posterior, right posterior oblique, left posterior oblique, and anterior incidences. The static phantoms were made in two ways; one was made of acrylic from a mold of a pair of human kidneys preserved in formalin, and the second was built with acrylonitrile butadiene styrene (ABS), in a 3D printer using the Slicer program, based on a computed tomography (CT) of the thorax, using the Slicer program. The semi-dynamic and dynamic phantoms were constructed to characterize and evaluate images of dynamic renal scintigraphy. In the semi-dynamic phantom, the injection of radiotracer was performed manually, whereas in the dynamic phantom, the radiotracer was automatically injected through an injector system. With the semi-dynamic phantom, it was possible to analyze the formation of a renogram with normal renal scintigraphic appearance using an imaging system. The simulations obtained from the dynamic phantom simulator enabled studies of normal renal scintigraphy and four other forms of renograms. The static anthropomorphic phantom kidneys proved to be efficient for use in evaluations of varying concentrations of radionuclides. The dynamic phantom kidney was useful for analysis of scintigraphic images and obtaining different pathways for elimination of the radioisotope, allowing for analysis of different renograms. Therefore, the new kidney phantoms would be useful for quality

Increased bone radiotracer uptake in renal osteodystrophy

Energy Technology Data Exchange (ETDEWEB)

de Graaf, P.; Schicht, I.M.; de Graeff, J.; te Velde, J.; Kleiverda, K.; Pauwels, E.K.J.

1982-04-01

Bone radiotracer uptake in renal osteodystrophy was investigated in 35 dialysis patients by correlating the results of quantitative bone scintigraphy with those of biochemical and bone morphometric studies. There were highly significant correlations (P < 0.001) between the total skeletal activity and the biochemical (iPTH and alkaline phosphatase), and histologic parameters of hyperparathyroidism. These clinical results strongly suggest that increased bone turnover i.e. hyperparathyroidism, rather than osteomalacia is the major cause of increased skeletal uptake in renal osteodystrophy.

Contributions of scintigraphy and sonography to the diagnosis of traumatic splenic lesions in children

International Nuclear Information System (INIS)

Soucy, J.P.; Danais, S.; Filiatrault, D.; Lamoureux, J.; Lamoureux, F.

1984-01-01

20 children who were sent to the Nuclear Medicine and Sonography services for evaluation of the spleen in the context of a history of abdominal trauma were studied. All but one of the children were treated conservately, the exception having had on emergency renal procedure performed for renal rupture. The working diagnosis, based on the clinical that of splenic trauma in all cases. The result show a sensitivity of 90% (2 false negatives) for scintigraphy, and of 30% (14 false negatives) for sonography for the non-invasive diagnosis of splenic trauma in children [fr

Contributions of scintigraphy and sonography to the diagnosis of traumatic splenic lesions in children

Energy Technology Data Exchange (ETDEWEB)

Soucy, J.P.; Danais, S.; Filiatrault, D.; Lamoureux, J.; Lamoureux, F. (Hopital Sainte-Justine, Montreal (Canada))

1984-01-01

20 children who were sent to the Nuclear Medicine and Sonography services for evaluation of the spleen in the context of a history of abdominal trauma were studied. All but one of the children were treated conservately, the exception having had on emergency renal procedure performed for renal rupture. The working diagnosis, based on the clinical, was that of splenic trauma in all cases. The results show a sensitivity of 90% (2 false negatives) for scintigraphy, and of 30% (14 false negatives) for sonography for the non-invasive diagnosis of splenic trauma in children.

Role of Tc99m-dimercaptosuccinic acid (DMSA) in diagnosis of acute urinary tract infection (UTI) in Sudanese children patients

International Nuclear Information System (INIS)

Abu baker, S. E. E.

2003-01-01

Pediatric nuclear medicine, in order to survive, must be innovative in finding ways of competing with other pediatric imaging studies for better health care. In this study a group of thirty-one patients with urinary tract infection confirmed by clinical investigation, (fever, pain, ....ect), laboratory investigation (RBC and pus cell)and urine culture, were evaluate by nuclear medicine study. The aim of the study was to compare the diagnostic value of cortical scintigraphy using Tc 99m dimercaptosuccinic acid (Tc 99m -DMSA), with two other routine investigations; the intravenous urographic (IVU), and ultrasonography (US), for diagnosis of renal parenchymal abnormality in children. The Tc 99m -DMSA renal scan was utilized as the gold standard test for renal involvement. All patients had Tc 99m -DMSA renal scan, and US, and only 22 patients had contrast IVU. The Tc 99m -DMSA renal scan showed abnormality renal scanning in about 94% of patients, US abnormalities were detected in about 81% of patient, while the IVU detected defects in about 87%. Because the prevalence of upper UTI in children is high, Tc 99m -DMSA renal scan is undoubtedly the available tool for pediatriacicians as a guide in giving appropriate antibiotic therapy and to prevent further renal damage. The study concludes that, the renal cortical scintigraphy with Tc 99m -DMSA has been reported to be a useful children diagnostic study of acute parenchymal renal infections, moreover, is presently the method of choice to detect acute parenchymal infection. (Author)

Evaluation of reflux nephropathy, pyelonephritis and renal dysplasia

Energy Technology Data Exchange (ETDEWEB)

Grattan-Smith, J.D. [Emory University School of Medicine, Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Little, Stephen B. [Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States); Jones, Richard A. [Emory University School of Medicine, Children' s Healthcare of Atlanta, Department of Radiology, Atlanta, GA (United States)

2008-01-15

MR urography has the potential to significantly improve our understanding of the relationship between reflux nephropathy, pyelonephritis, vesicoureteric reflux and renal dysplasia. MR urography utilizes multiple parameters to assess both renal anatomy and function and provides a more complete characterization of acquired and congenital disease. Pyelonephritis and renal scarring can be distinguished by assessing the parenchymal contours and signal intensity. Characteristic imaging features of renal dysplasia include small size, subcortical cysts, disorganized architecture, decreased and patchy contrast enhancement as well as a dysmorphic pelvicalyceal system. Because of its ability to subdivide and categorize this heterogeneous group of disorders, it seems inevitable that MR urography will replace DMSA renal scintigraphy as the gold standard for assessment of pyelonephritis and renal scarring. MR urography will contribute to our understanding of renal dysplasia and its relationship to reflux nephropathy. (orig.)

Evaluation of reflux nephropathy, pyelonephritis and renal dysplasia

International Nuclear Information System (INIS)

Grattan-Smith, J.D.; Little, Stephen B.; Jones, Richard A.

2008-01-01

MR urography has the potential to significantly improve our understanding of the relationship between reflux nephropathy, pyelonephritis, vesicoureteric reflux and renal dysplasia. MR urography utilizes multiple parameters to assess both renal anatomy and function and provides a more complete characterization of acquired and congenital disease. Pyelonephritis and renal scarring can be distinguished by assessing the parenchymal contours and signal intensity. Characteristic imaging features of renal dysplasia include small size, subcortical cysts, disorganized architecture, decreased and patchy contrast enhancement as well as a dysmorphic pelvicalyceal system. Because of its ability to subdivide and categorize this heterogeneous group of disorders, it seems inevitable that MR urography will replace DMSA renal scintigraphy as the gold standard for assessment of pyelonephritis and renal scarring. MR urography will contribute to our understanding of renal dysplasia and its relationship to reflux nephropathy. (orig.)

Effect of potential renal acid load of foods on urinary citrate excretion in calcium renal stone formers.

Science.gov (United States)

Trinchieri, Alberto; Lizzano, Renata; Marchesotti, Federica; Zanetti, Giampaolo

2006-02-01

The aim of this study was to investigate the influence of the potential renal acid load (PRAL) of the diet on the urinary risk factors for renal stone formation. The present series comprises 187 consecutive renal calcium stone patients (114 males, 73 females) who were studied in our stone clinic. Each patient was subjected to an investigation including a 24-h dietary record and 24-h urine sample taken over the same period. Nutrients and calories were calculated by means of food composition tables using a computerized procedure. Daily PRAL was calculated considering the mineral and protein composition of foods, the mean intestinal absorption rate for each nutrient and the metabolism of sulfur-containing amino acids. Sodium, potassium, calcium, magnesium, phosphate, oxalate, urate, citrate, and creatinine levels were measured in the urine. The mean daily PRAL was higher in male than in female patients (24.1+/-24.0 vs 16.1+/-20.1 mEq/day, P=0.000). A significantly (P=0.01) negative correlation (R=-0.18) was found between daily PRAL and daily urinary citrate, but no correlation between PRAL and urinary calcium, oxalate, and urate was shown. Daily urinary calcium (R=0.186, P=0.011) and uric acid (R=0.157, P=0.033) were significantly related to the dietary intake of protein. Daily urinary citrate was significantly related to the intakes of copper (R=0.178, P=0.015), riboflavin (R=0.20, P=0.006), piridoxine (R=0.169, P=0.021) and biotin (R=0.196, P=0.007). The regression analysis by stepwise selection confirmed the significant negative correlation between PRAL and urinary citrate (P=0.002) and the significant positive correlation between riboflavin and urinary citrate (P=0.000). Urinary citrate excretion of renal stone formers (RSFs) is highly dependent from dietary acid load. The computation of the renal acid load is advisable to investigate the role of diet in the pathogenesis of calcium stone disease and it is also a useful tool to evaluate the lithogenic potential of

[Renal scarring in children under 36 months hospitalised for acute pyelonephritis].

Science.gov (United States)

Rodríguez Azor, Begoña; Ramos Fernández, José Miguel; Sánchiz Cárdenas, Sonia; Cordón Martínez, Ana; Carazo Gallego, Begoña; Moreno-Pérez, David; Urda Cardona, Antonio

2017-02-01

Acute pyelonephritis (APN) is one of the most common causes of serious bacterial infection in infants. Renal scarring is the most prevalent long-term complication. To review the incidence of renal scarring within 6 months after an episode of APN in children under 36 months and its relationship with imaging studies, clinical settings, and bacteriology. A retrospective study of previously healthy patients aged one to 36 months, admitted for a first episode of APN, with a minimum follow-up of 6 months. Demographic and clinical variables were collected along with bacteriology, renal and bladder ultrasound scan, voiding cystourethrography, DMSA-scintigraphy, and re-infection events. A total of 125 patients were included in the study, of which 60% were male, the large majority (92%) febrile, and due to E. coli (74.6%). There was a history of prenatal ultrasound scan changes in 15.4%. Ultrasound scan found dilation of the urinary tract in 22.1%. Voiding cystourethrography was performed on 70 patients: 54.3% no abnormalities, 12.8% vesicoureteral reflux (VUR) grade i-iii, and 32.9% iv-v grade VUR. Six patients had iv-v grade VUR with a normal ultrasound scan. Adherence to DMSA-scintigraphy at 6 months was only 61% of that indicated. Renal scarring was found in 44.3% of those in which it was performed (60 cases). Almost half (44%) DMSA-scintigraphy in children aged one to 36 months hospitalised for APN show renal scarring at 6 months, which was found to be associated with the re-infection events and the iv-v grade VUR. There was no relationship between scarring and the bacteriology or the elevations of inflammatory biochemical markers. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Imaging of inflamed carotid artery atherosclerotic plaques with the use of {sup 99m}Tc-HYNIC-IL-2 scintigraphy in end-stage renal disease patients

Energy Technology Data Exchange (ETDEWEB)

Opalinska, Marta; Pach, Dorota; Sowa-Staszczak, Anna; Glowa, Boguslaw; Hubalewska-Dydejczyk, Alicja [Jagiellonian University Medical School, Nuclear Medicine Unit, Department of Endocrinology, Cracow (Poland); Stompor, Tomasz [University of Warmia and Mazury in Olsztyn, Department of Nephrology, Hypertensiology and Internal Medicine, Faculty of Medicine, Olsztyn (Poland); Mikolajczak, Renata; Garnuszek, Piotr; Maurin, Michal; Karczmarczyk, Urszula [National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock (Poland); Fedak, Danuta [Jagiellonian University Medical School, Clinical Biochemistry, Cracow (Poland); Krzanowski, Marcin; Sulowicz, Wladyslaw [Jagiellonian University Medical School, Department of Nephrology, Cracow (Poland); Rakowski, Tomasz [Jagiellonian University Medical School, 2nd Department of Cardiology, Institute of Cardiology, Cracow (Poland)

2012-04-15

Identification of vulnerable plaques remains crucial for better cardiovascular risk assessment. At least 20% of inflammatory cells within unstable (vulnerable) plaques comprise T lymphocytes, which contain receptors for interleukin-2 (IL-2); those receptors can be identified by scintigraphy with radiolabelled IL-2.The aim of this study was to identify the ''inflamed'' (vulnerable) plaques by scintigraphy using IL-2 labelled with {sup 99m}Tc in the selected, high cardiovascular risk group of end-stage renal disease (ESRD) patients. A total of 28 patients (18 men, 10 women, aged 55.2 {+-} 9.6 years, 17 on peritoneal dialysis, 11 on haemodialysis) underwent common carotid artery (CCA) scintigraphy with the use of {sup 99m}Tc-hydrazinonicotinamide (HYNIC)-IL-2. In all cases, ultrasound examination of the CCA was performed and levels of selected proinflammatory factors, atherogenic markers and calcium-phosphate balance parameters were measured. Finally, the target to non-target (T/nT) ratio of IL-2 uptake in atherosclerotic plaques with intima-media thickness (IMT), classic cardiovascular risk factors and concentrations of the measured factors were compared. Increased {sup 99m}Tc-HYNIC-IL-2 uptake in atherosclerotic plaques in 38/41 (91%) cases was detected. The median T/nT ratio of focal {sup 99m}Tc-HYNIC-IL-2 uptake in atherosclerotic plaques was 2.35 (range 1.23-3.63). The mean IMT value on the side of plaques assessed by scintigraphy was 0.79 {+-} 0.18 mm (median 0.8, range 0.5-1.275). Correlations between T/nT ratio and homocysteine (R = 0.22, p = 0.037), apolipoprotein B (apoB) (R = 0.31, p = 0.008), apoB to apoA-I ratio (R = 0.29, p = 0.012) and triglyceride concentration (R = 0.26, p = 0.021) were detected. A lower T/nT ratio in patients with better parameters of nutritional status (haemoglobin, albumin, adiponectin) in comparison with patients with worse nutritional parameters (3.20 {+-} 0.5 vs 2.16 {+-} 0.68, p = 0.025) was revealed as well

Assessment of myocardial fatty acid metabolism in patients with angina pectoris and diabetes mellitus using 123I-BMIPP myocardial scintigraphy

International Nuclear Information System (INIS)

Ito, Kazuki; Tanabe, Takuji; Yuba, Tatsuya; Doue, Tomoki; Adachi, Yoshihiko; Katoh, Shuuji; Sugihara, Hiroki; Azuma, Akihiro; Nakagawa, Masao

2001-01-01

We studied the effect of myocardial ischemia and diabetes mellitus (DM) on the myocardial fatty acid metabolism using 123 I-BMIPP myocardial scintigraphy. We performed 123 I-BMIPP myocardial scintigraphy in 50 patients with myocardial ischemia and without DM (AP), in 30 patients with myocardial ischemia and DM (AP+DM), 12 patients with DM and without myocardial ischemia (DM), and in 10 normal subjects (N). Myocardial uptake rate of 123 I-BMIPP was obtained using the time activity curve. Myocardial washout rate of 123 I-BMIPP was calculated using the polar images of early and delayed SPECT images. Myocardial uptake rate of 123 I-BMIPP (%) were AP: 4.9±0.6, AP+DM: 5.5±0.5, DM 5.7±0.5 and N: 5.0±0.4. 123 I-BMIPP myocardial uptake rate was increased in AP+DM and DM. 123 I-BMIPP myocardial washout rate (%) were AP: 30.2±4.3, AP+DM: 24.5±3.9, DM: 16.1±2.8 and N: 19.4±3.2. 123 I-BMIPP myocardial washout rate was increased in AP and AP+DM. 123 I-BMIPP myocardial washout rate was increased particularly in patients with multi-vessels disease. 123 I-BMIPP myocardial washout rate was decreased in DM. The present study suggested that diabetes mellitus increased myocardial fatty acid uptake and decreased myocardial fatty acid washout, and that myocardial ischemia increased myocardial fatty acid washout. (author)

Serum uric acid levels contribute to new renal damage in systemic lupus erythematosus patients.

Science.gov (United States)

Reátegui-Sokolova, C; Ugarte-Gil, Manuel F; Gamboa-Cárdenas, Rocío V; Zevallos, Francisco; Cucho-Venegas, Jorge M; Alfaro-Lozano, José L; Medina, Mariela; Rodriguez-Bellido, Zoila; Pastor-Asurza, Cesar A; Alarcón, Graciela S; Perich-Campos, Risto A

2017-04-01

This study aims to determine whether uric acid levels contribute to new renal damage in systemic lupus erythematosus (SLE) patients. This prospective study was conducted in consecutive patients seen since 2012. Patients had a baseline visit and follow-up visits every 6 months. Patients with ≥2 visits were included; those with end-stage renal disease (regardless of dialysis or transplantation) were excluded. Renal damage was ascertained using the SLICC/ACR damage index (SDI). Univariable and multivariable Cox-regression models were performed to determine the risk of new renal damage. Uric acid was included as a continuous and dichotomous (per receiving operating characteristic curve) variable. Multivariable models were adjusted for age at diagnosis, disease duration, socioeconomic status, SLEDAI, SDI, serum creatinine, baseline use of prednisone, antimalarials, and immunosuppressive drugs. One hundred and eighty-six patients were evaluated; their mean (SD) age at diagnosis was 36.8 (13.7) years; nearly all patients were mestizo. Disease duration was 7.7 (6.8) years. Follow-up time was 2.3 (1.1) years. The SLEDAI was 5.2 (4.3) and the SDI 0.8 (1.1). Uric acid levels were 4.5 (1.3) mg/dl. During follow-up, 16 (8.6%) patients developed at least one new point in the renal domain of the SDI. In multivariable analyses, uric acid levels (continuous and dichotomous) at baseline predicted the development of new renal damage (HR 3.21 (1.39-7.42), p 0.006; HR 18.28 (2.80-119.48), p 0.002; respectively). Higher uric acid levels contribute to the development of new renal damage in SLE patients independent of other well-known risk factors for such occurrence.

Bone scintigraphy on chronic hemodialyzed patients

International Nuclear Information System (INIS)

Koizumi, Yoshiko

1990-01-01

Patients with renal osteodystrophy (ROD) are classified into four types (secondary hyperparathyroidism: HPT, osteomalasia, ectopic calcification and normal bone scintigram type) according to findings of whole body bone scintigrams. Markedly high accumulations of Tc-99m-MDP are seen in the skull, especially in patients with HPT. For a quantitative evaluation of bone mineral dynamics, factor analysis (FA) was performed on bone scintigraphy in 36 patients with ROD and in 17 controls. Four were examined before and after parathyroidectomy (PTX). In the early phase (20 min) of bone scintigraphy, the bone factor was clearly extracted by FA. Two original parameters were calculated, one is bone radionuclide (RN) uptake count (BUC), the product of the total RN uptake count of the head and the contribution ratio, the other is bone RN uptake count ratio (BUR) derived by the time activity curve (physiological component of bone) of FA. Bone factor shown by FA is significantly different among patients with HPT, osteomalasia and controls. The value of BUC in patients with HPT is high compared to findings in the controls. The results of FA of ROD correlate well with planar images of bone scintigrams and with data on bone minerals, measured by quantitative methods such as single photon absorptiometry, CT attenuation number of the frontal bone, RN activity ratio ([frontal bone]/[brain]), using SPECT of bone scan. In the cases of PTX, the value of BUC was improved compared to preoperative data. FA of bone scintigraphy is a sensitive and useful method for quantitative evaluation of bone mineral dynamics and to assess the therapeutic effects in ROD. (author)

The role of keto acids in the supportive treatment of children with chronic renal failure.

Science.gov (United States)

Mir, Sevgi; Ozkayin, Nese; Akgun, Aysegul

2005-07-01

According to the hyperfiltration theory of renal diseases characterized by a decrease in the number of functional nephrons, increased arterial blood pressure, excessive protein intake in the diet, high levels of calcium (Ca) and phosphorus (P), secondary hyperparathyroidism, hypertriglyceridemia and/or hypercholesterolemia, proteinuria and metabolic acidosis are some factors that impair the prognosis of the disease. The amount of protein in the diet is the most important of these factors. A protein-restricted diet administered to patients with chronic renal failure results in the risk of inadequate amino acid intake. To overcome this problem, the use of dysaminated alpha-keto analogues has been considered to reduce the risk of nitrogenemia resulting from the continuous intake of essential amino acids. Currently, the necessity of essential amino acids even in adult patients with chronic renal failure is controversial; besides, trials on the use of these amino acids in pediatric patients are scarce. The aim of this study is to investigate the efficacy and applicability of conservative therapy with a protein-restricted diet supplemented with keto acids in the management of chronic renal insufficiency or failure.

Standardization of a method to calculate absolute renal uptake of {sup 99m} Tc-DMSA in children; Padronizacao do metodo para calculo da captacao renal absoluta do {sup 99m}Tc-DMSA em criancas

Energy Technology Data Exchange (ETDEWEB)

Ono, Carla Rachel; Sapienza, Marcelo Tatit; Watanabe, Tomoco; Costa, Paulo Luiz Aguirre; Okamoto, Miriam Roseli Yoshie; Garcez, Alexandre Teles; Buchpiguel, Carlos Alberto [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Servico de Medicina Nuclear]. E-mail: crachelo@usp.br; Machado, Beatriz Marcondes; Machado, Marcia Melo Campos [Paulo Univ., SP (Brazil). Faculdade de Medicina. Hospital Universitario; Liberato Junior, Waldyr de Paula

2006-01-15

Objective:To standardize a method and determine normal values for absolute renal uptake of 99m Tc-DMSA in children with normal creatinine clearance. Materials and methods: Twenty-two children (between 7 months and 10 years of age; mean 4.5 years) without clinical evidence of renal disease were studied using 99m Tc-DMSA scintigraphy. Eighteen had normal renal ultrasonography, micturating urethrocystography, creatinine clearance and visual interpretation of the scintigraphy with 99m Tc-DMSA. Four children were excluded, one with incomplete creatinine clearance and three due to reduction in the creatinine clearance. Absolute renal uptake of 99m Tc-DMSA (DMSA-Abs) was expressed as the fraction of the administered dose retained by each kidney six hours after administration of the radiopharmaceutical. Results: DMSA-Abs was 21.8 +- 3.2% for the right kidney and 23.1 +-3.3% for the left kidney. There was no correlation between renal uptake and the age groups studied, although there was a tendency to an increase in the creatinine clearance with age. Conclusion: Normal values of DMSA-Abs can be used as an additional parameter for the initial diagnostic evaluation and during follow-up of renal diseases, mainly when bilateral impairment of renal function is suspected or in a patient with a single functioning kidney (in which renal differential function is of limited value). (author)

Renal Abnormalities Among Egyptian Children With Hemophilia A Using Renal Scintigraphy: Relation to Risk Factors and Disease Severity.

Science.gov (United States)

Hamed, Ahmed Alsaeed; Shalaby, Mennatallah Hatem; El-Kinawy, Nihal Saad; Elamawy, Alaa Adel; Abd El-Ghany, Shereen Mohamed

2017-07-01

Many risk factors may contribute to renal disease in patients with hemophilia A. We aimed to evaluate functional and structural renal abnormalities among a group of Egyptian children with severe and moderate hemophilia A using technetium-99m diethylene triamine pentaacetic acid ( 99m Tc-DTPA) and technetium-99 m dimercaptusuccinic acid ( 99m Tc-DMSA) scan. We also aimed to determine the relation between these abnormalities and different risk factors and disease severity. Forty male patients, 16 with severe and 24 with moderate hemophilia A, were enrolled in this study. Their mean age was 10.2 ± 4.3 years (range, 5-17 years). Full history taking, clinical examination, laboratory, and radionuclide investigations including serum creatinine, blood urea nitrogen (BUN), urine analysis, creatinine clearance, 24-hour urinary protein, 99m Tc-DTPA scan, and 99m Tc-DMSA scan were performed to all enrolled patients. Serum creatinine and BUN were normal in all patients, and corrected creatinine clearance was diminished in 2 patients. However, 99m Tc-DTPA results yielded 19 (47.5%) patients with diminished glomerular filtration rate (GFR). Moreover, it showed that 14 (35%) had obstructive uropathy, 15 (37.5%) had obstructive nephropathy, while 11 (27.5%) patients showed normal scan. One patient had atrophy of 1 kidney on 99m Tc-DMSA scan. Among our cohort, 5 (12.5%) patients were hypertensive. Microscopic hematuria was detected in 14 (35%) patients while 72.5% had proteinuria. We found an association between hematuria and hypertension with diminished GFR. Despite normal kidney functions (serum creatinine and BUN), we found a high rate of diminished GFR and obstructive uropathy and nephropathy as detected by 99m Tc-DTPA scan among children with hemophilia A.

Adrenal scintigraphy

International Nuclear Information System (INIS)

Beierwaltes, W.H.

1979-01-01

The following items are discussed:anatomy and physiology of adrenal glands, clinical indications of scintigraphy, radiobiology and radiochemistry, scintigraphic imaging, adrenocortical hyperfunction, aldosteronism and hypertension associated with low renin level, excess of androgen, adrenocortical hyperfunction and future perspectives of adrenal scintigraphy. (M.A.) [pt

The significance of renoscintigraphy for renal transplantation

International Nuclear Information System (INIS)

Oei Hong Yoe.

1981-01-01

The aim of the study reported here was to evaluate the contribution of renoscintigraphy performed frequently and systematically, for differentiation between the various complications occurring after renal transplantation. Relevant complications of renal transplantation are described, with special attention to the diagnostic methods available at present, and the methods used for radionuclide investigations in renal transplantation are reviewed. The abnormalities seen on the sequential images in ten cases complicated by urine leakage or urinary tract obstruction are described. These are illustrated by the scintigrams and the corresponding radiograms. The results in eight patients whose transplant did not show Hippuran uptake are also described. Transplant failure in five of these eight patients was clearly demonstrated by perfusion scintigraphy. (Auth.)

Reversible diminished renal sup(99m)Tc-DMSA uptake during converting-enzyme inhibition in a patient with renal artery stenosis

Energy Technology Data Exchange (ETDEWEB)

Kremer Hovinga, T K; Beukhof, J R; Donker, A J.M.; Luyk, W H.J. van; Piers, D A

1984-03-01

A patient is described who had accelerated hypertension and unilateral renal artery stenosis, and who developed further deterioration in renal function during treatment with captopril, an angiotension-I (AI) converting-enzyme inhibitor. sup(99m)Tc-DMSA uptake was greatly diminished in the stenotic kidney, although renal blood flow and handling of /sup 131/I hippurate was preserved. Uptake of sup(99m)Tc-DMSA in the affected kidney returned after substitution of captopril by the vasodilator minoxidil, while a comparable degree of blood pressure control was maintained. This, caution must be taken when interpreting results of sup(99m)Tc-DMSA scintigraphy in patients with proven or suspected renal artery stenosis treated with an AI converting-enzyme inhibiting drug. Moreover, our finding points to the importance of glomerular filtration in the renal handling of /sup 99/Tc-DMSA.

Reversible diminished renal sup(99m)Tc-DMSA uptake during converting-enzyme inhibition in a patient with renal artery stenosis

International Nuclear Information System (INIS)

Kremer Hovinga, T.K.; Beukhof, J.R.; Donker, A.J.M.; Luyk, W.H.J. van; Piers, D.A.

1984-01-01

A patient is described who had accelerated hypertension and unilateral renal artery stenosis, and who developed further deterioration in renal function during treatment with captopril, an angiotension-I (AI) converting-enzyme inhibitor. sup(99m)Tc-DMSA uptake was greatly diminished in the stenotic kidney, although renal blood flow and handling of 131 I hippurate was preserved. Uptake of sup(99m)Tc-DMSA in the affected kidney returned after substitution of captopril by the vasodilator minoxidil, while a comparable degree of blood pressure control was maintained. This, caution must be taken when interpreting results of sup(99m)Tc-DMSA scintigraphy in patients with proven or suspected renal artery stenosis treated with an AI converting-enzyme inhibiting drug. Moreover, our finding points to the importance of glomerular filtration in the renal handling of 99 Tc-DMSA. (orig.)

Procalcitonin for the early prediction of renal parenchymal involvement in children with UTI: preliminary results.

Science.gov (United States)

Kotoula, Aggeliki; Gardikis, Stefanos; Tsalkidis, Aggelos; Mantadakis, Elpis; Zissimopoulos, Athanassios; Kambouri, Katerina; Deftereos, Savvas; Tripsianis, Gregorios; Manolas, Konstantinos; Chatzimichael, Athanassios; Vaos, George

2009-01-01

In order to establish the most reliable marker for distinguishing urinary tract infections (UTI) with and without renal parenchymal involvement (RPI), we recorded the clinical features and admission leukocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum procalcitonin (PCT) in 57 children (including 43 girls) aged 2-108 months admitted with a first episode of UTI. RPI was evaluated by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy within 7 days of admission. To establish cut-off points for ESR, CRP, and PCT, we used receiver operating characteristics curves and compared the area under the curve for ESR, CRP, and PCT. Twenty-seven children were diagnosed as having RPI based on positive renal scintigraphy. A body temperature of >38 degrees C, a history of diarrhea, and poor oral intake were more common in patients with RPI. ESR, CRP, and PCT, but not leukocyte count, were significantly higher in patients with RPI (P UTI than ESR and CRP. Using a cut-off value of 0.85 ng/ml, PCT had the best performance, with sensitivity, specificity, and positive and negative predictive values of 89%, 97%, 96%, and 91% respectively. Serum PCT is a better marker than ESR, CRP, and leukocyte count for the early prediction of RPI in children with a first episode of UTI.

Renal cortex taurine content regulates renal adaptive response to altered dietary intake of sulfur amino acids.

OpenAIRE

Chesney, R W; Gusowski, N; Dabbagh, S

1985-01-01

Rats fed a reduced sulfur amino acid diet (LTD) or a high-taurine diet (HTD) demonstrate a renal adaptive response. The LTD results in hypotaurinuria and enhanced brush border membrane vesicle (BBMV) accumulation of taurine. The HTD causes hypertaurinuria and reduced BBMV uptake. This adaptation may relate to changes in plasma or renal cortex taurine concentration. Rats were fed a normal-taurine diet (NTD), LTD, or HTD for 14 d or they underwent: (a) 3% beta-alanine for the last 8 d of each d...

Magnetic resonance Imaging (MRI) and technetium-99m-methoxyisonitrile (MIBI) scintigraphy to evaluate the abnormal parathyroid gland and PEIT efficacy for secondary hyperparathyroidism

International Nuclear Information System (INIS)

Wada, Akihiko; Sugihara, Masaki; Sugimura, Kazuro; Kuroda, Hiroyuki

1999-01-01

Percutaneous ethanol injection therapy (PEIT) of the abnormal parathyroid gland is an effective treatment in patients with chronic renal failure with dialysis that tends to be unresponsive to medication. To evaluate the efficacy of PEIT, we investigated the correlation between serum intact PTH (iPTH), and the findings of MR imaging and 99m Tc-MIBI scintigraphy. PEIT was performed 32 times in 24 patients with secondary hyperparathyroidism. Both MR imaging and MIBI scintigraphy were performed before and after PEIT. The detectability of parathyroid lesions was evaluated by MRI and MIBI scintigraphy with reference to ultrasound (B-mode) findings (as a standard) and the comparison of each treatment was done between imaging changes and serum iPTH levels. In the small parathyroid glands ( 99m Tc-MIBI scintigraphy. The reduction of high signal intensity area after PEIT on T2-weighted MR images is considered an useful therapeutic evaluation guideline than the reduction of MIBI accumulation on scintigraphy. (author)

Bone scintigraphy, plasma ALP, TAP and PAP in patients with prostatic cancer

International Nuclear Information System (INIS)

Imamura, Akihiko; Hoshi, Hiroaki; Jinnouchi, Seishi; Samejima, Masahiko; Watanabe, Katsushi

1988-01-01

This study assessed the ability of bone scintigraphy, alkaline phosphatase (ALP), total acid phosphatase (TAP), and prostatic acid phosphatase (PAP) to diagnose bone metastasis in a series of 62 patients with histologically proven prostatic cancer. Abnormal uptake was seen on the bone scan in 49 patients (79 %). A final diagnosis of bone metastasis was made in 40 patients (65 %). The sensitivity and specificity were 100 % and 59 %, respectively, for bone scintigraphy; 50 % and 96 % for ALP; 65 % and 82 % for TAP; and 73 % and 77 % for PAP. For 40 patients with bone metastasis, all of the ALP, TAP, and PAP were positive in 17 patients (43 %) and negative in 8 patients (20 %). Higher levels of ALP, TAP, and PAP tended to be associated with more extensive bone metastasis. Although serological examination showed lower sensitivity than bone scintigraphy in the diagnosis of bone metastasis, PAP may be most frequently used as a screening procedure of bone metastasis. (Namekawa, K.)

Assessment of hepatic functional reserve for hepatic resection using 99mTc-PMT scintigraphy in comparison with 99mTc-GSA scintigraphy

International Nuclear Information System (INIS)

Sakuma, Atsushi

2000-01-01

99m Tc-diethylenetriamine-pentaacetic acid-galactosyl human serum albumin( 99m Tc-GSA) scintigraphy has been reported as a useful study of hepatic functional reserve recently. We have performed 99m Tc-N-pyridoxyl-5-methyl-tryptophan( 99m Tc-PMT) and 99m Tc-GSA preoperatively for evaluation of hepatic functional reserve and compared the usefulness of those scintigraphy study. Twenty-four patients who were the candidates of hepatic resection underwent 99m Tc-PMT scintigraphy preoperatively. Hepatic blood flow coefficient (K value), the amount of hepatic blood flow (HBF), and the ratio of portal blood flow (PVR) were computed. 99m Tc-GSA scintigraphy was also performed within two weeks of the 99m Tc-PMT scintigraphy, and the ratio of disappearance (HH 15 ) and the hepatic uptake ratio (LHL 15 ) were computed. The relationship between K value, HBF, PVR, HH 15 and LHL 15 was analyzed. Their correlation with other liver function tests was also examined. K value and HBF did not show statistically significant correlations with HH 15 and LHL 15 , PVR correlated statistically significantly HH 15 and LHL 15 . K value correlated with the preoperative values of cholinesterase, Fischer ratio, γ-globulin, ICGR 15 , albumin, and platelet count. There was a statistically significant correlation between LHL 15 and the value of cholinesterase, γ-globulin, platelet count, and Fischer ratio. When the liver resection of subsegmentectomy or more was indicated in 10 patients, nine patients had LHL 15 value less than 0.9 which delineated possibility of poor prognosis. However, judging from K value and HBF, liver resection was considered feasible and it was all successfully performed, resulting in good prognosis. From this study, it is suspected that 99m Tc-GSA scintigraphy reflect the severity of liver fibrosis and the amount of portal blood flows, and 99m Tc-PMT scintigraphy reflect the hepatic blood flow and ability of protein synthesis. It was proved that 99m Tc-PMT scintigraphy is

sup(99m)Tc-MDP scintigraphy for the detection and localization of rhabdomyolysis

International Nuclear Information System (INIS)

Schicha, H.; Rumpf, K.W.; Kaiser, H.; Emrich, D.; Goettingen Univ.

1984-01-01

In 24 patients with biochemically proven rhabdomyolysis 34 scans with sup(99m)Tc-MDP were performed to detect regional as well as generalized myolysis. When performing the scan within 10 days after the maximum of myolysis, scintigraphic detection was possible in 95% of the patients, but after 20 days in none. Regional tracer accumulation in muscles was more frequent (89%) than generalized diffuse accumulation (31%). Predominantly muscles of the thigh, the buttocks and the upper arm were involved. Diffuse tracer accumulation in both kidneys occurred in 75% of patients with significant renal dysfunction. The results show that in addition to regional muscle damage generalized myolysis may be detected by scintigraphy with sup(99m)Tc-MDP. In cases of regional muscle damage scintigraphy proved to be more sensitive than clinical signs. (orig.) [de

sup(99m)Tc-MDP scintigraphy for the detection and localization of rhabdomyolysis

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Schicha, H.; Rumpf, K.W.; Kaiser, H.; Emrich, D.

1984-12-01

In 24 patients with biochemically proven rhabdomyolysis 34 scans with sup(99m)Tc-MDP were performed to detect regional as well as generalized myolysis. When performing the scan within 10 days after the maximum of myolysis, scintigraphic detection was possible in 95% of the patients, but after 20 days in none. Regional tracer accumulation in muscles was more frequent (89%) than generalized diffuse accumulation (31%). Predominantly muscles of the thigh, the buttocks and the upper arm were involved. Diffuse tracer accumulation in both kidneys occurred in 75% of patients with significant renal dysfunction. The results show that in addition to regional muscle damage generalized myolysis may be detected by scintigraphy with sup(99m)Tc-MDP. In cases of regional muscle damage scintigraphy proved to be more sensitive than clinical signs.

[Clinical characteristics and renal uric acid excretion in early-onset gout patients].

Science.gov (United States)

Li, Q H; Liang, J J; Chen, L X; Mo, Y Q; Wei, X N; Zheng, D H; Dai, L

2018-03-01

Objective: To investigate clinical characteristics and renal uric acid excretion in early-onset gout patients. Methods: Consecutive inpatients with primary gout were recruited between 2013 and 2017. The patients with gout onset younger than 30 were defined as early-onset group while the others were enrolled as control group. Clinical characteristics and uric acid (UA) indicators were compared between two groups. Results: Among 202 recruited patients, the early-onset group included 36 patients (17.8%). Compared with control group, the early-onset group presented more patients with obesity [13 patients (36.1%) vs. 22 patients (13.3%), Pgout early onset. Conclusion: The gout patients with early-onset younger than 30 present high serum and glomerular load of uric acid which might be due to obesity and relative under-excretion of renal uric acid.

Adrenal scintigraphy

International Nuclear Information System (INIS)

Veen, E.A. van der.

1978-01-01

The visualization of functioning adrenocortical tissue by scintigraphy became possible with the introduction of radioiodinated cholesterol derivatives. According to the literature, there is evidence that one of these iodinated cholesterols, 6-β-iodomethyl-nor-cholesterol, concentrates in the adrenal cortex to a much greater extent than 131 I-19-odocholesterol. Results comparing both radiopharmaceuticals are described. The authors investigated the possibility of increasing the uptake of iodinated cholesterol using simultaneous ACTH and the 'cholesterol side-chain cleavage enzymeblocker': aminoglutethimide. The results of adrenal scintigraphy performed in 37 patients are described. Finally, the literature on adrenal scintigraphy is reviewed, and results reported in various studies are compared. (Auth.)

Bone marrow scintigraphy vs bone scintigraphy and radiography in multiple myeloma

International Nuclear Information System (INIS)

Feggi, M.; Prandini, N.; Orzincolo, C.; Bagni, B.; Scutellari, P.N.; Spanedda, R.; Gennari, M.; Scapoli, C.L.

1988-01-01

The radiography patterns of the skeleton of 73 patients affected by multiple myeloma (MM) were compared to the correspondent scintigraphic findings. Whole body scans were performed using Tc-diphosphonates 99m (bone scintigraphy). And Tc-microcolloides 99m (bone marrow scintigraphy). The results indicate that: a) radiography is more sensitive and accurate than scintigraphy in detecting typical myeloma-related bone lesions; b) bone scintigraphy is useful in detecting alterations in particular locations-i.e. sternum, ribs, scapulae, etc.-which are difficult to demonstrate by plain X-rays; moreover, the recovery of the fractures can be visualized; c) bone marrow scintigraphy is employed to demonstrate the presence of marrow expasion, of cold/hot spots, and relative marrow uptake, related to phagocytic activity. Since in adult men red marrow is confined to the epiphysis of long bones and to the spine, all the diseases affecting bone marrow cause medullary expansion/reduction, which are both easily detected by specific radiopharmaceuticals. The peripheral expasions is clearly documented especially in distal humeri and femora since marrow uptake is included, in healthy adults, in the axial and proximal appendicular skeleton. In spite of its yielding unique informetion, bone marrow scintigraphy remains an additional technique of bone scan, because of its low diagnoditc accuracy

Renal scintigraphy with captopril for the investigation of arterial hypertension

International Nuclear Information System (INIS)

Nitzsche, E.; Strauss, E.; Moser, E.; Grosser, G.; Sankt Marienkrankenhaus, Frankfurt am Main; Rump, C.; Keller, E.; Meyer, E.

1991-01-01

Renal artery stenosis (RAS) is a rare cause of hypertension. Radiological tests can disclose the morphological changes, but not their functional effect on renal function and perfusion. Normalization of the blood pressure can be achieved by intervention (operation, percutaneous transluminal renal angiography; PTRA), in cases of prolonged RAS-induced hypertension long-term preservation of the organ function is most important. The purpose of this study was the validation of captopril renography as a screening test for hypertension secondary to RAS prior to PTRA. Captopril renography with 99m Tc-MAG 3 has a high sensitivity (94%) and acceptable specificity (88%) for the screening of hypertensive patients. The positive predictive value is 74% and the negative predictive value 98%, compared with the 'gold standard' of angiography. (orig.) [de

Lung scintigraphy

International Nuclear Information System (INIS)

Dalenz, Roberto.

1994-01-01

A review of lung scintigraphy, perfusion scintigraphy with SPECT, lung ventilation SPECT, blood pool SPECT. The procedure of lung perfusion studies, radiopharmaceutical, administration and clinical applications, imaging processing .Results encountered and evaluation criteria after Biello and Pioped. Recommendations and general considerations have been studied about relation of this radiopharmaceutical with other pathologies

Reducing Renal Uptake of {sup 177}Lu Labeled CCK Derivative using Basic Amino Acids

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Lee, Soyoung; Lim, Jaecheong; Joh, Eunha [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2014-05-15

Radiolabeled peptides have been designed to target the relative receptors overespressed in tumor cells, such as integrin αvβ3, gastrin-releasing peptide receptor (GRPR), melanocortin-1 receptor (MC1-R), glucagon-like peptide-a receptor (GLP-1R), and cholecystokinin (CCK) receptor. Most of these peptides are eliminated from the body via the kidney and are partly reabsorbed in the proximal tubular cells. However, the high renal uptake of the radiolabeled peptides may lead to renal toxicity. In this study we investigated various amino acid solutions to reduce the renal uptake of {sup 177}Lu-DOTA-CCK derivative. Renal uptake of {sup 177}Lu-DOTA-CCK derivative is effectively reduced by the administration of positively charged amino acids. The administration of 12 mg of L-lysine was as effective in reducing the renal uptake as 6 mg of lysine and 6 mg of arginine combinations. Further studies will be performed to identify the most potent inhibitor of renal reuptake of radiolabeled peptides and minimize the chance of unwanted side effects.

Standardization of a method to calculate absolute renal uptake of 99m Tc-DMSA in children

International Nuclear Information System (INIS)

Ono, Carla Rachel; Sapienza, Marcelo Tatit; Watanabe, Tomoco; Costa, Paulo Luiz Aguirre; Okamoto, Miriam Roseli Yoshie; Garcez, Alexandre Teles; Buchpiguel, Carlos Alberto; Machado, Beatriz Marcondes; Machado, Marcia Melo Campos; Liberato Junior, Waldyr de Paula

2006-01-01

Objective:To standardize a method and determine normal values for absolute renal uptake of 99m Tc-DMSA in children with normal creatinine clearance. Materials and methods: Twenty-two children (between 7 months and 10 years of age; mean 4.5 years) without clinical evidence of renal disease were studied using 99m Tc-DMSA scintigraphy. Eighteen had normal renal ultrasonography, micturating urethrocystography, creatinine clearance and visual interpretation of the scintigraphy with 99m Tc-DMSA. Four children were excluded, one with incomplete creatinine clearance and three due to reduction in the creatinine clearance. Absolute renal uptake of 99m Tc-DMSA (DMSA-Abs) was expressed as the fraction of the administered dose retained by each kidney six hours after administration of the radiopharmaceutical. Results: DMSA-Abs was 21.8 +- 3.2% for the right kidney and 23.1 +-3.3% for the left kidney. There was no correlation between renal uptake and the age groups studied, although there was a tendency to an increase in the creatinine clearance with age. Conclusion: Normal values of DMSA-Abs can be used as an additional parameter for the initial diagnostic evaluation and during follow-up of renal diseases, mainly when bilateral impairment of renal function is suspected or in a patient with a single functioning kidney (in which renal differential function is of limited value). (author)

Protective effects of Rosmarinic acid against renal ischaemia/reperfusion injury in rats

International Nuclear Information System (INIS)

Ozturk, H.; Ozturk, H.; Terzi, E.H.

2014-01-01

Objective: To investigate the potential protective effects of Rosmarinic acid (RA) on rats exposed to ischaemia/reperfusion renal injury. Methods: The prospective study was conducted at Abant Izzet Baysal University, Turkey, and comprised 21 male Spraque Dawley rats weighing 250-270g each. They were divided into three equal groups. Unilaterally nephrectomised rats were subjected to 60 minutes of left renal ischaemia followed by 60 minutes of reperfusion. Group 1 had shamoperated animals; group 2 had ischaemia/reperfusion untreated animals; and group 3 had ischaemia/reperfusion animals treated with rosmarinic acid. Serum creatinine, blood urea nitrogen, tissue malondialdehyde, glutathione peroxidase, superoxide dismutase and myeloperoxidase (MPO) activities, and light microscopic findings were evaluated. SPSS 17 was used for statistical analysis. Results: Treatment of rats with rosmarinic acid produced a reduction in the serum levels of creatinine and blood urea nitrogen compared to the other groups. However, no statistically significant difference was found. The levels of malondialdehyde and myeloperoxidase were decreased in the renal tissue of group 3, while glutathione peroxidose and superoxide dismutase levels remained unchanged. The injury score decreased in the treatment group rats compared to the untreated group. Rosmarinic acid significantly decreased focal glomerular necrosis, dilatation of Bowman's capsule, degeneration of tubular epithelium, necrosis in tubular epithelium, and tubular dilatation. Conclusions: Rosmarinic acid prevented ischaemia/reperfusion injury in the kidneys by decreasing oxidative stress. (author)

Cicatriz renal: factores de riesgo relacionados con infección urinaria Renal scar: risk factors related to urinary infection

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Lourdes María Pérez Clemente

2007-06-01

Full Text Available La infección urinaria es una de las infecciones bacterianas más frecuente en la niñez, superada solamente por las infecciones respiratorias. En algunos casos, puede causar cicatrices renales que pueden inducir complicaciones futuras, como la hipertensión arterial y enfermedad renal crónica. Los métodos de diagnóstico por imagen en los niños tienen como objetivo identificar a los pacientes en riesgo de desarrollar cicatrices renales o daño renal permanente, o de prevenir la progresión del daño renal preexistente. Se evaluaron retrospectivamente los datos clínicos de 100 niños con diagnóstico de infección urinaria, a los cuales se les realizó gammagrafía renal con ácido dimercaptosuccínico (DMSA. Se correlacionó la presencia de cicatriz renal con la edad, sexo, número de episodios de infección urinaria y presencia de reflujo vesicoureteral. Se demostró que todo niño con infección urinaria, independientemente del sexo, corre el riesgo de desarrollar cicatriz renal, el cual aumenta con la presencia de reflujo vesicoureteral, infecciones recurrentes y en la medida en que aumenta la edad. Por ello sugerimos estudiar, mediante ultrasonido, cistografía y gammagrafía con DMSA marcado con tecnecio 99 (Tc99m-DMSA, a todo niño con infección urinaria, para detectar oportunamente a quienes están en riesgo de desarrollar cicatriz renal o daño renal permanente.Urinary infection is one of the most common bacterial infections in childhood after respiratory infections. In some cases, it can cause renal scars that may lead to future complications like blood hypertension and chronic renal disease. The diagnostic imaging methods for children are aimed at identifying those patients at risk of developing renal scars or a permanent renal damage, and preventing the progression of pre-existing renal damage. Clinical data from 100 children diagnosed with urinary infection, who had been performed a renal DMSA scintigraphy, were retrospectively

Serum uric acid and renal function in patients with type 1 diabetes: a nationwide study in Brazil.

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Pizarro, Marcela Haas; Santos, Deborah Conte; Barros, Bianca Senger Vasconcelos; de Melo, Laura Gomes Nunes; Gomes, Marilia Brito

2018-01-01

Diabetes nephropathy is a microvascular complication associated with high morbidity and mortality in patients with type 1 diabetes, and its pathogenesis is not fully understood. Our aim was to evaluate the association between levels of serum uric acid and renal function assessed by glomerular filtration rate (GFR) and albuminuria in patients with type 1 diabetes. This is a multicenter, cross-sectional, observational study with 1686 patients, conducted between August 2011 and August 2014 in 14 public clinics from ten Brazilian cities. Renal function was estimated by CKD-EPI (adults) and by Schwartz (adolescents). We analyzed 1686 patients, aged 30.1 ± 12.0, with 15.4 ± 9.3 years of duration of diabetes; 55.8% were female and 54.0% were Caucasians. Serum uric acid was related to renal function, with a mean of 4.8 ± 1.4 (in the normal renal function group) vs 5.2 ± 2.0 (GFR ≥ 60 ml/min and albuminuria) vs 6.5 ± 2.6 mg/dl (GFR uric acid and GFR (r = - 0.316, p uric acid. Considering only patients with normal renal function (n = 1170), a decrease of 2.04 ml/min in the GFR for every increase of 1 mg/dl in Serum uric acid was noted using multivariate analysis. Patients with higher levels of serum uric acid have worse renal function, independently of HbA1c or duration of diabetes, which persisted even in patients with normal renal function. Further prospective studies are necessary to establish if patients with higher serum uric acid may have an elevated risk for developing chronic kidney disease.

Radionuclide Peritoneal Scintigraphy in Patients with Ascites and Pleural Effusion

International Nuclear Information System (INIS)

Lee, Jae Tae; Lee, Kyu Bo; Whang, Kee Suk; Kim, Gwang Won; Chung, Byung Chun; Cho, Dong Kyu; Chung, Joon Mo

1990-01-01

Simultaneous presence of ascites and pleural effusion has been documented in patients with cirrhosis of the liver, renal disease, Meigs' syndrome and in patients undergoing peritoneal dialysis. Mechanisms proposed in the formation of pleural effusion in most of the above diseases are lymphatic drainage and diaphragmatic defect. But sometimes, hepatic hydrothoraxes in the absence of clinical ascites and pleural effusion secondary to pulmonary or cardiac disease are noted. It is not always possible to differentiate between pleural effusion caused by transdiaphragmatic migration of ascites and by other causes based solely on biochemical analysis. Authors performed radionuclide scintigraphy after intraperitoneal administration of 99m Tc-labeled colloid in 23 patients with both ascites and pleural effusion in order to discriminate causative mechanisms responsible for pleural effusion. Scintigraphy demonstrated the transdiaphtagmatic flow of fluid from the peritoneum to pleural cavities in 13 patients correctly. In contrast, in 5 patients with pleural effusion secondary to pulmonary, pleural and cardiac diseases, radiotracers fail to traverse the diaphragm and localize in the pleural space. Ascites draining to mediastinal lymph nodes and blocked passage of lymphatic drainage were also clarified, additionally. Conclusively, radionuclide peritoneal scintigraphy is an accurate, rapid and easy diagnostic tool in patients with both ascites and pleural effusion. It enables the causes of pleural effusion to be elucidated, as well as providing valuable information required when determining the appropriate therapy.

Genetic variation underlying renal uric acid excretion in Hispanic children: the Viva La Familia Study.

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Chittoor, Geetha; Haack, Karin; Mehta, Nitesh R; Laston, Sandra; Cole, Shelley A; Comuzzie, Anthony G; Butte, Nancy F; Voruganti, V Saroja

2017-01-17

Reduced renal excretion of uric acid plays a significant role in the development of hyperuricemia and gout in adults. Hyperuricemia has been associated with chronic kidney disease and cardiovascular disease in children and adults. There are limited genome-wide association studies associating genetic polymorphisms with renal urate excretion measures. Therefore, we investigated the genetic factors that influence the excretion of uric acid and related indices in 768 Hispanic children of the Viva La Familia Study. We performed a genome-wide association analysis for 24-h urinary excretion measures such as urinary uric acid/urinary creatinine ratio, uric acid clearance, fractional excretion of uric acid, and glomerular load of uric acid in SOLAR, while accounting for non-independence among family members. All renal urate excretion measures were significantly heritable (p uric acid clearance with a single nucleotide polymorphism (SNP) in zinc finger protein 446 (ZNF446) (rs2033711 (A/G), MAF: 0.30). The minor allele (G) was associated with increased uric acid clearance. Also, we found suggestive associations of uric acid clearance with SNPs in ZNF324, ZNF584, and ZNF132 (in a 72 kb region of 19q13; p <1 × 10 -6 , MAFs: 0.28-0.31). For the first time, we showed the importance of 19q13 region in the regulation of renal urate excretion in Hispanic children. Our findings indicate differences in inherent genetic architecture and shared environmental risk factors between our cohort and other pediatric and adult populations.

Whole body bone scintigraphy in tenofovir-related osteomalacia: a case report

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Di Biagio Antonio

2009-07-01

Full Text Available Abstract Introduction Tenofovir disoproxil fumarate (Viread® is the only nucleotide reverse transcriptase inhibitor currently approved for the treatment of HIV. It is frequently prescribed not only for its efficacy but also for its decreased side effect profile compared with other nucleotide analogs. In addition, it is now increasingly recognized as a cause of acquired Fanconi's syndrome in individuals with HIV. Case presentation We describe a 48-year-old woman infected with HIV, with chronic renal insufficiency, who developed Fanconi's syndrome after inclusion of tenofovir disoproxil fumarate in her antiretroviral therapy. A whole body bone scintigraphy was performed, revealing an abnormal distribution of radiotracer uptake, with characteristic changes compatible with osteomalacia. All symptoms disappeared after tenofovir discontinuation and mineral supplementation. No other explanation for the sudden and complete resolution of the bone disease was found. Conclusion The case highlights the role of whole body bone scintigraphy in the diagnosis of tenofovir-related osteomalacia.

Renal scintigraphy with DMSA 99 mTc and the direct radionuclide cystogram in children with recurrent urinary tract infections

International Nuclear Information System (INIS)

Donoso R, Gilda; Lobo S, Gabriel; Arteaga V, Maria de la Paz; Arnello V, Francisca; Jimenez, Cesar; Perez, Andres

2003-01-01

The aim of this study was to correlate the results of Renal Scintigraphy (RS) and the Direct Radionuclide Cystogram (DRC) in children with recurrent urinary tract infections. Method: we analyse 92 children, 82 % females , with ages ranging from 1 month- 12 years old (mean:4,3 years old). Both techniques were performed conventionally with a gammacamera/ computer system. We determined the concordance or discordance between them, and the positive and negative predictive value (PPV, NPV ) of one method with respect the other. For statistical analysis we use Chi square and MacNemar test. Results: 45 % of the RS were abnormal, and the 27 % of DRC was positive. We found a concordance of the results in both techniques in 70 % (p< 0.001) .For the RS vs DRC the PPV was 46% and the NPV was 88%. For the DRC vs RS the PPV was the 76 % and the NPV was 67%. Conclusions. 1.- : 1.- the normality of RS is a better predictor of normality than DRC. 2.-The abnormality of DRC predicts better the abnormality of RS than the inverse. 3.- The results of both techniques show a significant concordance (author)

Amino Acid Metabolism in Acute Renal Failure: Influence of Intravenous Essential L-Amino Acid Hyperalimentation Therapy

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Abel, Ronald M.; Shih, Vivian E.; Abbott, William M.; Beck, Clyde H.; Fischer, Josef E.

1974-01-01

A solution of 8 essential I-amino acids and hypertonic dextrose was administered to 5 patients in acute postoperative renal failure in a program of hyperalimentation designed to decrease the patient's catabolic state and to accrue certain metabolic benefits. A sixth patient receiving intravenous glucose alone served as a control. The pretreatment plasma concentrations of amino acids in all 6 patients did not differ significantly from normal; following intravenous essential amino acids at a dose of approximately 12.6 gm/24 hours, no significant elevations out of the normal range of these substances occurred. Since urinary excretion rates did not dramatically increase, urinary loss was excluded as a possible cause for the failure of increase of plasma concentrations. The results suggest that the administration of an intravenous solution of 1-amino acids and hypertonic dextrose is associated with rapid clearance from the blood of these substances and, with a failure of increased urinary excretion, indirect evidence of amino acid utilization for protein synthesis has been obtained. Histidine supplementation in patients with acute renal failure is probably unnecessary based on the lack of significant decreases in histidine concentrations in these patients. PMID:4850497

Thallium-201 and technetium-99m pertechnetate subtraction scintigraphy in patients with hyperparathyroidism

International Nuclear Information System (INIS)

Kuwashima, Shigeko; Koizumi, Mitsuru; Goto, Masafumi; Nomura, Toshiharu; Fujioka, Mutsuhisa; Watari, Tsutomu

1992-01-01

A reliable technique for detecting and localizing abnormal parathyroid tissue has been a persistent problem. We evaluated thallium-technetium (Tl/Tc) subtraction scintigraphy in 16 patients with clinical biochemical evidence of hyperparathyroidism prior to other diagnostic methods and surgery. Seven patients had surgery and were confirmed to have parathyroid adenoma or hyperplasia. The other methods included ultrasonography (US) in 6 patients, computed tomography (CT) in 10 patients, magnetic resonance imaging (MRI) in 8 patients, and bone scintigraphy in 7 patients. In patients who had several imaging modalities, the detection rate was significantly better for Tl/Tc subtraction scan than for US, CT or MRI. Bote scintigraphy, though not so sensitive as Tl/Tc subtraction studies, was an important tool for evaluating metabolic bone disorder including hyperparathyroidism and renal osteodystrophy. Thus, Tl/Tc subtraction scan is more useful for diagnosis when hyperparathyroidism is suspected if both Tl/Tc subtraction scan and bone scan are performed. The detectability depended on the mass size, and detection of abnormal glands was greater for adenoma than for hyperplasia. The results suggest that Tl/Tc subtraction scan is a simple, non-invasive and useful tool for locating parathyroid abnormality even when compared with MRI. (author)

Skeleton scintigraphy in trauma

International Nuclear Information System (INIS)

Ansari, M.

2002-01-01

Skeletal trauma is common and presents both an opportunity and a problem in skeletal scintigraphy. The opportunity arises in the ability of skeletal scintigraphy to demonstrate abnormalities early after direct trauma. It is well recognized that the early detection of fractures in some sites cannot be reliably achieved by standard radiography, especially in the femoral neck and scaphoid bone. The problem comes in recognizing the effects of skeletal trauma when using skeletal scintigraphy for another purpose, such as the detection of metastatic disease. iatrogenic trauma to either the skeleton or soft tissues may be manifest scintigraphic ally. For example Craniotomy typically leaves a rim pattern at the surgical margin. Rib Retraction during thoracotomy can elicit periosteal reaction. Areas of the skeletal receiving curative levels of ionizing radiation (typically 4000 rads or greater) characteristically demonstrate decreased uptake within 6 months to 1 year after therapy. The generally high sensitivity of the skeletal scintigraphy seems to make it an ideal survey test in cases of suspected child abuse especially in which radiographs are unrevealing. Because of difficulties in obtaining a history of trauma from a preschool child or even eliciting a satisfactory description of the location and nature of the pain, skeletal scintigraphy provides a simple and reliable investigation in these children. Subtle trauma, such as that from stress fractures is often difficult to visualize on a plain radiograph. Skeletal scintigraphy is frequently positive at the time of clinical presentation. Skeletal scintigraphy is exquisitely sensitive to the remodeling process and typically shows abnormalities 1 to 2 weeks or more before the appearance of radiographic changes in stress fractures. The periosteal reaction can be visualized within hours of the injury. Insufficiency and fatigue fractures such as vertebral compression fracture, which is probably the most common consequence of

Extra-Renal Elimination of Uric Acid via Intestinal Efflux Transporter BCRP/ABCG2

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Hosomi, Atsushi; Nakanishi, Takeo; Fujita, Takuya; Tamai, Ikumi

2012-01-01

Urinary excretion accounts for two-thirds of total elimination of uric acid and the remainder is excreted in feces. However, the mechanism of extra-renal elimination is poorly understood. In the present study, we aimed to clarify the mechanism and the extent of elimination of uric acid through liver and intestine using oxonate-treated rats and Caco-2 cells as a model of human intestinal epithelium. In oxonate-treated rats, significant amounts of externally administered and endogenous uric acid were recovered in the intestinal lumen, while biliary excretion was minimal. Accordingly, direct intestinal secretion was thought to be a substantial contributor to extra-renal elimination of uric acid. Since human efflux transporter BCRP/ABCG2 accepts uric acid as a substrate and genetic polymorphism causing a decrease of BCRP activity is known to be associated with hyperuricemia and gout, the contribution of rBcrp to intestinal secretion was examined. rBcrp was confirmed to transport uric acid in a membrane vesicle study, and intestinal regional differences of expression of rBcrp mRNA were well correlated with uric acid secretory activity into the intestinal lumen. Bcrp1 knockout mice exhibited significantly decreased intestinal secretion and an increased plasma concentration of uric acid. Furthermore, a Bcrp inhibitor, elacridar, caused a decrease of intestinal secretion of uric acid. In Caco-2 cells, uric acid showed a polarized flux from the basolateral to apical side, and this flux was almost abolished in the presence of elacridar. These results demonstrate that BCRP contributes at least in part to the intestinal excretion of uric acid as extra-renal elimination pathway in humans and rats. PMID:22348008

99Tcm-MIBI hepatobiliary scintigraphy in peadiatric patients with severe cholestatic infant hepatitis syndrome

International Nuclear Information System (INIS)

Chen Guibing; Huang Jinxiong; He Xiaojiang; Luo Zuoming; Lu Zhengyuan; Wu Hua

2010-01-01

Objective: Because of the limited of 99 Tc m -diethyl iminodiacetic acid ( 99 Tc m -EHIDA) hepatobiliary scintigraphy in the diagnosis of severe cholestatic infant hepatitis syndrome, trial use 99 Tc m -methoxy isobutyl isonitrile ( 99 Tc m -MIBI) as a new hepatobiliary scintigraphy imaging agent to understand its applied basis and primary evaluate value in diagnosis of severe cholestatic infant hepatitis syndrome. Methods: constructed choledochal atresia animal model and investigated the application basis of 99 Tc m -MIBI hepatobiliary scintigraphy. Twenty-seven children patients of severe cholestatic who finally confirmed infant hepatitis syndrome were underwent firstly 99 Tc m -EHIDIA hepatobiliary scintigraphy. After 24 h delay imaging next day, 99 Tc m -MIBI hepatobiliary scintigraphy was underwent after 1 h. Two imaging agents of value in the diagnosis of severe cholestatic infant hepatitis syndrome were compared. Results: It was proved that 99 Tc m -MIBI was surely excreted by hepatobiliary and had no intestinal autocrine phenomenon in animal test. So 99 Tc m -MIBI can be used to undergo hepatobiliary scintigraphy. The sensitivity of 99 Tc m -MIBI hepatobiliary scintigraphy in the diagnosis of severe cholestatic infant hepatitis syndrome was 100% in our primary clinical study. Its sensitivity was higher than which of 99 Tc m -EHIDA hepatobiliary scintigraphy (66.67%) by far. Conclusion: With regard to those children patients who suspected highly severe cholestatic infant hepatitis syndrome in clinical, the sensitivity of 99 Tc m -MIBI hepatobiliary scintigraphy is obviously superior to conventional 99 Tc m -EHIDA hepatobiliary scintigraphy. (authors)

MAG3 renal scintigraphy: improved ability to make anatomical diagnoses in neonates

International Nuclear Information System (INIS)

Rossleigg, M.A.; Kainer, G.; Rosenberg, A.R.; Farnaworth, R.H.

1995-01-01

Technetium-99m mercaptoacetyltriglycine (MAG3) is the most recently introduced renal radiopharmaceutical in Australia and is established as the agent of choice for use in diuresis renography, particularly in neonates and infants. It provides superior anatomical information compared to previously used agents. Three cases are reported in which MAG3 diuresis renography was performed in neonates, who were found to have hydronephrosis detected antenatally. In two neonates, a previously unrecognized horseshoe kidney was demonstrated and in case 3 there were scan features characteristic of a ureterocele. It is highly unlikely that these abnormalities would have been delineated with 99m Tc dimethyltriamine pentaacetic acid (DTPA) study, as confirmed in case 1, because of the relatively poor uptake of DTPA when compared to MAG3. 6 refs., 3 figs

The effects of valproic acid on renal corpuscle of pregnant rats and ...

African Journals Online (AJOL)

The effects of valproic acid on renal corpuscle of pregnant rats and protective role of folic acid and vitamin E. Ayfer Aktas, Yusuf Nergız, Yusuf Nergız, Murat Akkus, Murat Akkus, Yasemin Nasır, Yasemin Nasır ...

A Modified method for reducing renal injury in zoledronic acid treatment of hypercalcemia and adverse skeletal events

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Jiang Liu

2013-01-01

Full Text Available Aims: In this paper, we have reported a previously undescribed risk factor of deterioration of renal function in zoledronic acid treatment of skeletal metastasis - high serum calcium level. Based on this consideration, a modified method of treatment of hypercalcemia (HCM with zoledronic acid is suggested in this paper. Material and Methods: Bone scan findings of 1090 cancer patients were analyzed, of which 26 had intense renal parenchymal uptake as a result of HCM or bone metastases. Subsequently, a total of 56 bone metastases patients with zoledronic acid treatment were divided into three groups: HCM group who were pre-treated to normal serum calcium level (13 patients, HCM group (19 patients, and normal serum calcium group (24 patients. Results: More patients with intense renal parenchymal uptake were hyperglycemic, statistically significantly (18/26 versus 19/1064, P = 2.1, E-78. No more patients with intense renal parenchymal uptake were associated with bone metastases (14/26 versus 438/1064, P = 0.20. Subsequently, more HCM patients receiving zoledronic acid treatment showed renal injury compared to patients with normal serum calcium level (5/15 versus 2/24, P < 0.05 and HCM patients with pre-treatment to normal serum calcium level (5/15 versus 1/17, P < 0.05. Conclusions: Intense renal parenchymal uptake of bisphosphonates is closely related to HCM rather than to bone metastases in cancer patients. The serum calcium should be measured and reduced to normal level before zoledronic acid is used in managements of adverse skeletal events in order to decrease the risk of renal injury.

Role of calculated glomerular filtration rate using percutaneous nephrostomy creatinine clearance in the era of radionuclide scintigraphy

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Sunil Raghunath Patil

2017-01-01

Conclusions: GFR based on radionuclide scintigraphy may be insufficient for evaluation of residual renal function to determine the management of obstructed kidney with borderline function. For adequate decision-making, other factors including creatinine clearance via PCN should also be considered. Gates method tends to overestimate GFR as compared to calculated creatinine clearance at low GFR levels.

Renal damage detected by DMSA, despite normal renal ultrasound, in children with febrile UTI.

Science.gov (United States)

Bush, N C; Keays, M; Adams, C; Mizener, K; Pritzker, K; Smith, W; Traylor, J; Villanueva, C; Snodgrass, W T

2015-06-01

2011 American Academy of Pediatrics guidelines recommended renal-bladder ultrasound (RBUS) as the only evaluation after febrile urinary tract infection (FUTI) in infants aged 2-24 months. We determined the sensitivity, specificity, and false negative rate of RBUS to identify DMSA-detected renal damage in this age group as well as in older children. Consecutive patients referred to pediatric urology with a history of FUTI underwent DMSA ≥ 3 months after FUTI. Abnormal RBUS was defined as: Society of Fetal Urology hydronephrosis grades I-IV; hydroureter ≥ 7 mm; renal scar defined as focal parenchymal thinning; and/or size discrepancy ≥ 1 cm between kidneys. Abnormal DMSA was presence of any focal uptake defects and/or split renal function 24 months. RBUS had poor sensitivity (34%) and low positive predictive value (47%) to identify patients with renal damage. 99/149 (66%) children with renal damage on DMSA had normal RBUS. After FUTI, 66% of children with reduced renal function and/or renal cortical defects found by DMSA scintigraphy had a normal RBUS. Since abnormal DMSA may correlate with increased risk for VUR, recurrent FUTI and renal damage, our data suggest RBUS alone will fail to detect a significant proportion of patients at risk. The data suggest that imaging after FUTI should include acute RBUS and delayed DMSA, reserving VCUG for patients with abnormal DMSA and/or recurrent FUTI. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Bone scintigraphy in lesions of the skull

International Nuclear Information System (INIS)

Fischer, M.; Wasilewski, A.; Deitmer, T.

1982-01-01

The value of 3-phase-scintigraphy in bone lesions of the skull with a new seeking agent 99mTc-2,3-dicarboxypropane-1,1-diphosphonic acid (DPD) is studied. A high soft tissue-bone-ratio of DPD is emphasized. For this reason DPD is used for bone scintigraphy of the skull, because the mass of soft tissue in relation to bone is high and a higher clearance improves the interpretation of the images of the first two phases. An increased tracer uptake is found for skeletal neoplasms (malignant and benign lesions) and for acute osteomyelitis. By contrast, the chronic inflammatory bone lesions showed normal tracer uptake. This new bone seeking agent allows to localize and differentiate tumorous or acute inflammatory lesions and chronic inflammatory bone lesions of the skull

Uses and limitations of renal scintigraphy in renal transplantation monitoring

International Nuclear Information System (INIS)

Heaf, J.G.; Iversen, J.

2000-01-01

The value of thrice weekly technetium-99m mercaptoacetyltriglycine renography after renal transplantation was investigated in 213 consecutive transplants. A grading system was used: 0 = normal renogram; 1 = normal uptake, reduced excretion; 2 = normal uptake, flat excretion curve; 3 = rising curve; 4 = reduced rate of uptake, rising curve and reduced absolute uptake; 5 = minimal uptake. The initial renogram grade (RG) was primarily a marker of ischaemic damage, being poorer with cadaver donation, long cold ischaemia (>24 h), and high donor and recipient age. High primary RG predicted primary graft non-function, long time to graft function, low discharge Cr EDTA clearance and low 1- and 5-year graft survival. Discharge RG predicted late (>6 months) graft loss. RG was highly correlated (P<0.001) with creatinine and creatinine clearance, and changes in RG were correlated with changes in renal function. A change in RG of 0.5 was non-specific, while a change of 1 or more predicted clinical complications in 95% of cases. The negative predictive value was low (58%). RG change antedated clinical diagnosis in only 38% of cases, and in only 14% of acute rejections did an RG change of 1 or more antedate a rising creatinine. RG did not contribute to the differential diagnosis between acute rejection, acute tubulointerstitial nephropathy and cyclosporine toxicity. In conclusion, an initial renography after transplantation is valuable as it measures ischaemic damage and predicts duration of graft non-function and both short and long-term graft survival. A review of the literature suggests that the indication for serial scintigraphic monitoring for functioning grafts is less certain: the diagnostic specificity is insufficient for it to be the definitive investigation for common diagnostic problems and it does not give sufficient advance warning of impending problems. (orig.)

Evaluation of lung epithelial permeability in the volatile substance abuse using Tc-99m DTPA aerosol scintigraphy

International Nuclear Information System (INIS)

Cayir, D.; Demirel, K.; Korkmaz, M.; Koca, G.

2011-01-01

Chronic inhalant use is associated with significant toxic effects, including neurological, renal, hepatic, and pulmonary damage. However, there is a paucity of reports regarding respiratory complications in inhalant abusers. The aim of this study was to evaluate pulmonary epithelial permeability in the volatile substance abuse (VSA) using technetium-99m-labeled diethylenetriamine pentaacetic acid (Tc-99m DTPA) aerosol scintigraphy. This study included 18 patients with volatile substance abuse and 18 volunteer controls. All of patients and controls were smokers. Tc-99m DTPA aerosol scintigraphy was performed in all cases. Time-activity curves from each lung were generated and clearance half-time (T 1/2 ) of Tc-99m DTPA were calculated. T 1/2 of whole lung was calculated as a mean of the T 1/2 of left and right lung. The T 1/2 values of Tc-99m DTPA clearance in the substance abusers were significantly decreased as compared to the control group with respective mean values of 28.86±8.44, and 62.14±26.12 min (p=0.001). It was seen Tc-99m DTPA clearance from lung was faster as the duration of substance abuse was increased. Tc-99m DTPA pulmonary clearance is markedly accelerated in the volatile substance abuse. This suggests that inhalant abuse of substance may produce abnormalities in pulmonary alveolo-capillary membrane function. (author)

Role of NH3 and NH4+ transporters in renal acid-base transport.

Science.gov (United States)

Weiner, I David; Verlander, Jill W

2011-01-01

Renal ammonia excretion is the predominant component of renal net acid excretion. The majority of ammonia excretion is produced in the kidney and then undergoes regulated transport in a number of renal epithelial segments. Recent findings have substantially altered our understanding of renal ammonia transport. In particular, the classic model of passive, diffusive NH3 movement coupled with NH4+ "trapping" is being replaced by a model in which specific proteins mediate regulated transport of NH3 and NH4+ across plasma membranes. In the proximal tubule, the apical Na+/H+ exchanger, NHE-3, is a major mechanism of preferential NH4+ secretion. In the thick ascending limb of Henle's loop, the apical Na+-K+-2Cl- cotransporter, NKCC2, is a major contributor to ammonia reabsorption and the basolateral Na+/H+ exchanger, NHE-4, appears to be important for basolateral NH4+ exit. The collecting duct is a major site for renal ammonia secretion, involving parallel H+ secretion and NH3 secretion. The Rhesus glycoproteins, Rh B Glycoprotein (Rhbg) and Rh C Glycoprotein (Rhcg), are recently recognized ammonia transporters in the distal tubule and collecting duct. Rhcg is present in both the apical and basolateral plasma membrane, is expressed in parallel with renal ammonia excretion, and mediates a critical role in renal ammonia excretion and collecting duct ammonia transport. Rhbg is expressed specifically in the basolateral plasma membrane, and its role in renal acid-base homeostasis is controversial. In the inner medullary collecting duct (IMCD), basolateral Na+-K+-ATPase enables active basolateral NH4+ uptake. In addition to these proteins, several other proteins also contribute to renal NH3/NH4+ transport. The role and mechanisms of these proteins are discussed in depth in this review.

Assessment of renal function with the Tc-99m-MAG3 clearance

International Nuclear Information System (INIS)

Keske, U.; Corcles, M.; Andreessen, R.; Wilfling, M.; Roll, D.; Gahl, G.; Felix, R.

1990-01-01

This paper evaluates the applicability of the 99m-Tc-mercaptoacetyle-triglycine (MAG3) clearance for the documentation of renal function. Renal clearance was measured with the method of Tauxe in 699 patients during routine renal scintigraphy with 80 MBq of 99mTc-MAG3. Serum creatinine level and MAG3 clearance show an inverse correlation. Patients with an elevated serum creatinine level constantly have a lowered MAG3 clearance and vice versa. For creatinine values lower than 1.8 mg/dL, minor changes in creatinine level are accompanied by large changes in MAG3 clearance. Age (in years) dependence of MAG3 clearance was evaluated in 487 patients who showed no evidence of impaired renal function

Urinary tract infection in small children: the evolution of renal damage over time.

Science.gov (United States)

Swerkersson, Svante; Jodal, Ulf; Sixt, Rune; Stokland, Eira; Hansson, Sverker

2017-10-01

Our objective was to analyze the evolution of kidney damage over time in small children with urinary tract infection (UTI) and factors associated with progression of renal damage. From a cohort of 1003 children UTI, a retrospective analysis of 103 children was done. Children were selected because of renal damage at index 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy at least 3 months after UTI, and a late DMSA scan was performed after at least 2 years. Damage was classified as progression when there was a decline in differential renal function (DRF) by ≥4%, as regression when there was complete or partial resolution of uptake defects. Of 103 children, 20 showed progression, 20 regression, and 63 remained unchanged. There were no differences between groups regarding gender or age. In the progression group, 16/20 (80%) children had vesicoureteral reflux (VUR) grade III-V and 13 (65%) had recurrent UTI. In multivariable regression analysis, both VUR grade III-V and recurrent UTI were associated with progression. In the regression group, 16/20 (80%) had no VUR or grade I-II, and two (10%) had recurrent UTI. Most small children with febrile UTI do not develop renal damage and if they do the majority remain unchanged or regress over time. However, up to one-fifth of children with renal damage diagnosed after UTI are at risk of renal deterioration. These children are characterized by the presence of VUR grades III-V and recurrent febrile UTI and may benefit from follow-up.

Functional-anatomic evaluation of dilated uropathies in children using combined MR-nephrography and MR-urography compared to renal scintigraphy; Funktionell-anatomische Diagnostik dilatierter Uropathien bei Kindern mit kombinierter MR-Nephrographie und MR-Urographie im Vergleich zur renalen Isotopennephrographie

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Reither, M. [Abt. fuer bildgebende Diagnostik am Kinderkrankenhaus Park Schoenfeld, Kassel (Germany); Tuerkay, S. [GE Medical Systems Deutschland GmbH, Solingen (Germany)

2004-02-01

Purpose: to evaluate MR-tomographic assessment of split renal function and degree of obstruction compared to diuretic renal scintigraphy, and pathoanatomic imaging of the urinary tract as all in one exam. Patients and methods: in a prospective study 62 children, aged 1 month to 9.5 years, mean 2.8 years, underwent diuretic renal scintigraphy and dynamic MR-nephrography at the same day except for 7 patients with a time interval of 1 day. In all patients we did T2w (water-technique) MR-urography additionally. Results: comparing spilt renal function we found a very close correlation in 54 out of 62 patients (correlation coefficient = 0.95). Due to technical failures 8 cases couldn't be calculated. Comparing degrees of obstruction there was an agreement in 57 out of 62 patients, 3 studies were gradually over-, 2 underestimated. All but one morphologic diagnoses in advance obtained by ultrasound and completed by other imaging modalities later on were confirmed MR-urographically. Though correctly imaged the functionless upper moiety in a renal duplication with ureterocele was misinterpreted at a first glance. (orig.) [German] Ziel: Es sollte geprueft werden, ob die Berechnung der seitengetrennten Nierenfunktion, die Bestimmung des Obstruktionsgrades und die pathoanatomische Darstellung des Harntraktes im Vergleich zur Diurese-Szintigraphie in einem Untersuchungsgang MR-tomographisch zuverlaessig moeglich ist. Patienten und Methode: In einer prospektiven Studie wurden bei 62 Kindern im Alter von 1 Monat bis 9,5 Jahren, Mittelwert 2,8 Jahre, ein Diurese-Szintigramm und eine dynamische MR-Nephrographie am gleichen Tag durchgefuehrt; lediglich bei 7 Patienten lag 1 Tag zwischen beiden Untersuchungen. Alle Patienten erhielten zusaetzlich eine T2w-MR-Urographie in ''Wasserbild''-Technik. Ergebnisse: Beim Vergleich der seitengetrennten Nierenfunktion fand sich eine sehr enge Korrelation bei 54 von insgesamt 62 Patienten (Korrelationskoeffizient = 0

Liver and spleen scintigraphy

International Nuclear Information System (INIS)

Devries, D.F.

1988-01-01

Since the introduction of liver and spleen scintigraphy in the early 1950s, it has undergone considerable changes, the most notable being technetium 99m sulfur colloid, the gamma camera, and single photon emission computed tomography (SPECT). What is the role f liver-spleen scintigraphy in this high-technology society? This chapter attempts to address this question by looking at the radiopharmaceuticals, the technique, and most importantly, the application of scintigraphy to the diagnosis of focal and diffuse hepatic and splenic disease

Assessment of hepatic functional reserve for hepatic resection using {sup 99m}Tc-PMT scintigraphy in comparison with {sup 99m}Tc-GSA scintigraphy

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Sakuma, Atsushi [Dokkyo Univ. School of Medicine, Mibu, Tochigi (Japan)

2000-03-01

{sup 99m}Tc-diethylenetriamine-pentaacetic acid-galactosyl human serum albumin({sup 99m}Tc-GSA) scintigraphy has been reported as a useful study of hepatic functional reserve recently. We have performed {sup 99m}Tc-N-pyridoxyl-5-methyl-tryptophan({sup 99m}Tc-PMT) and {sup 99m}Tc-GSA preoperatively for evaluation of hepatic functional reserve and compared the usefulness of those scintigraphy study. Twenty-four patients who were the candidates of hepatic resection underwent {sup 99m}Tc-PMT scintigraphy preoperatively. Hepatic blood flow coefficient (K value), the amount of hepatic blood flow (HBF), and the ratio of portal blood flow (PVR) were computed. {sup 99m}Tc-GSA scintigraphy was also performed within two weeks of the {sup 99m}Tc-PMT scintigraphy, and the ratio of disappearance (HH{sub 15}) and the hepatic uptake ratio (LHL{sub 15}) were computed. The relationship between K value, HBF, PVR, HH{sub 15} and LHL{sub 15} was analyzed. Their correlation with other liver function tests was also examined. K value and HBF did not show statistically significant correlations with HH{sub 15} and LHL{sub 15}, PVR correlated statistically significantly HH{sub 15} and LHL{sub 15}. K value correlated with the preoperative values of cholinesterase, Fischer ratio, {gamma}-globulin, ICGR{sub 15}, albumin, and platelet count. There was a statistically significant correlation between LHL{sub 15} and the value of cholinesterase, {gamma}-globulin, platelet count, and Fischer ratio. When the liver resection of subsegmentectomy or more was indicated in 10 patients, nine patients had LHL{sub 15} value less than 0.9 which delineated possibility of poor prognosis. However, judging from K value and HBF, liver resection was considered feasible and it was all successfully performed, resulting in good prognosis. From this study, it is suspected that {sup 99m}Tc-GSA scintigraphy reflect the severity of liver fibrosis and the amount of portal blood flows, and {sup 99m}Tc-PMT scintigraphy

Salivary scintigraphy

International Nuclear Information System (INIS)

Sabri, P.J.

1988-01-01

Salivary gland scintigraphy with technetium 99m ( 99m Tc) in the form pertechnetate ion is a relatively simple procedure, which can provide a unique and sensitive means for investigating salivary gland physiologic function and its derangements. However, salivary scintigraphy is poorly suited for the detection and characterization of masses in and around the salivary glands. Computed tomography (CT) has, therefore, largely supplanted scintigraphy for the evaluation of masses and is the method of choice because it can provide exquisite anatomic detail. Consequently, CT is more sensitive for mass detection and can also provide useful information as to whether a mass has arisen from within or from outside of a salivary gland or whether a mass is circumscribed or invasive. It also can disclose the relationship of the mass to the facial nerve and occasionally can provide histologic characterization of such masses as cysts, lipomas, and masseter muscle hypertrophy

The renal quantitative scintillation camera study for determination of renal function

International Nuclear Information System (INIS)

Thompson, I.M. Jr.; Boineau, F.G.; Evans, B.B.; Schlegel, J.U.

1983-01-01

The renal quantitative scintillation camera study assesses glomerular filtration rate and effective renal plasma flow based upon renal uptake of 99mtechnetium-iron ascorbate and 131iodine-hippuran, respectively. The method was compared to inulin, para-aminohippuric acid and creatinine clearance studies in 7 normal subjects and 9 patients with various degrees of reduced renal function. The reproducibility of the technique was determined in 15 randomly selected pediatric patients. The values of glomerular filtration rate and effective renal plasma flow were not significantly different from those of inulin and para-aminohippuric acid studies. The reproducibility of the technique was comparable to that of inulin and para-aminohippuric acid studies. Patient acceptance of the technique is excellent and the cost is minimal. Renal morphology and excretory dynamics also are demonstrated. The technique is advocated as a clinical measure of renal function

The clinical evaluation of CT and radionuclide examination in renal diseases

International Nuclear Information System (INIS)

Kutani, Wataru; Ishida, Hirofumi; Shirakawa, Shigetoshi; Shintaku, Takao; Funaki, Ryo

1980-01-01

One hundred and twelve cases of renal diseases were studied by computed tomography (CT) using EMI 5005/12. Of them, 60 were examined by both CT and renal scintigraphy, and comparatively evaluated. The CT units were checked before and after the contrast enhancement. Renal scintigrams were obtained by gamma cameras (PHO/GAMMA HP 6406, PHO/GAMMA LFOV) using 99 M Tc-DMSA. CT was especially useful in diagnosing the renal cysts and the hydronephrosis. Cysts in other organs (liver, spleen and pancreas) were simultaneously ascertained in polycystic diseases. CT was not helpful in diagnosing nephritis and diabetic nephropathy. Floating kidney and horse-shoe kidney were difficult to diagnose with CT. The renal scintigram was the reflection of the renal function, and was relatively more useful than CT in diagnosing horse-shoe kidney, floating kidney and nephritis, while it was not useful for non-functioning kidneys. (author)

Impairment of PPARα and the Fatty Acid Oxidation Pathway Aggravates Renal Fibrosis during Aging.

Science.gov (United States)

Chung, Ki Wung; Lee, Eun Kyeong; Lee, Mi Kyung; Oh, Goo Taeg; Yu, Byung Pal; Chung, Hae Young

2018-04-01

Defects in the renal fatty acid oxidation (FAO) pathway have been implicated in the development of renal fibrosis. Although, compared with young kidneys, aged kidneys show significantly increased fibrosis with impaired kidney function, the mechanisms underlying the effects of aging on renal fibrosis have not been investigated. In this study, we investigated peroxisome proliferator-activated receptor α (PPAR α ) and the FAO pathway as regulators of age-associated renal fibrosis. The expression of PPAR α and the FAO pathway-associated proteins significantly decreased with the accumulation of lipids in the renal tubular epithelial region during aging in rats. In particular, decreased PPAR α protein expression associated with increased expression of PPAR α -targeting microRNAs. Among the microRNAs with increased expression during aging, miR-21 efficiently decreased PPAR α expression and impaired FAO when ectopically expressed in renal epithelial cells. In cells pretreated with oleic acid to induce lipid stress, miR-21 treatment further enhanced lipid accumulation. Furthermore, treatment with miR-21 significantly exacerbated the TGF- β -induced fibroblast phenotype of epithelial cells. We verified the physiologic importance of our findings in a calorie restriction model. Calorie restriction rescued the impaired FAO pathway during aging and slowed fibrosis development. Finally, compared with kidneys of aged littermate controls, kidneys of aged PPAR α -/- mice showed exaggerated lipid accumulation, with decreased activity of the FAO pathway and a severe fibrosis phenotype. Our results suggest that impaired renal PPAR α signaling during aging aggravates renal fibrosis development, and targeting PPAR α is useful for preventing age-associated CKD. Copyright © 2018 by the American Society of Nephrology.

99mTc-RBC subtraction scintigraphy

International Nuclear Information System (INIS)

Inagaki, Syoichi; Tonami, Syuichi; Yasui, Masakazu; Kuranishi, Makoto; Sugishita, Kouki; Nakamura, Mamoru

1994-01-01

Sequential abdominal scintigrams with 99m Tc-labelled red blood cells (RBC) were subtracted for observing a site of gastrointestinal bleeding and calculating the bleeding rate. This method is technically very easy and can detect the site of bleeding with the minimum rate, as low as 0.2 ml/min., in a phantom experiment. In 23 cases with final diagnosis of gastrointestinal bleeding, conventional non-subtraction scintigraphy detected only 30% (7/23), but subtraction scintigraphy detected 61% (14/23). It was concluded that subtraction scintigraphy had higher sensitivity than conventional scintigraphy for early diagnosing bleeding. A combination of non-subtraction and subtraction scintigraphy is recommended to detect a site of gastrointestinal bleeding in a clinical setting. (author)

Low-Dose Adefovir-Induced Hypophosphatemic Osteomalacia on Whole-Body Bone Scintigraphy

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Kim, Sung Hoon; Won, Kyoung Sook; Song, Bongil; Jo, Il; Zeon, Seok Kil [Keimyung Univ., Daegu (Korea, Republic of)

2013-12-15

While adefovir dipivoxil (ADV) effectively suppresses the hepatitis B virus, it can cause proximal renal tubular dysfunction leading to phosphate wasting. The safety of low-dose ADV (a dose of 10 mg/day), which does not induce clinically significant nephrotoxicity, is well recognized, but a few cases of hypophosphatemic osteomalacia (HO) caused by low-dose ADV therapy have recently been reported. Although HO induced by low-dose ADV therapy is rare, the presence of bone pain in patients treated with ADV should be monitored. Bone scintigraphy can be performed to confirm the occurrence of osteomalacia and to determine the disease extent. Bone scintigraphic and radiological image findings with a brief review of the literature are presented in this article. We report two cases of HO induced by low-dose ADV therapy that showed multifocal increased radiotracer uptakes in the bilateral bony ribs, spines, pelvic bones and lower extremities on whole-body bone scintigraphy. Bone pain gradually improved after phosphate supplementation and by changing the antiviral agent. Whole-body bone scintigraphy is a highly sensitive imaging tool and can show disease extent at once in the setting of the wide range of the clinical spectrum with nonspecific radiological findings. Furthermore, frequent involvement of the lower extremities, as a result of maximum weight bearing, could be an additional scintigraphic clue for the diagnosis of HO. These cases could be helpful for both clinicians prescribing ADV and nuclear physicians to prevent delayed diagnosis and plan further appropriate treatment.

Low-Dose Adefovir-Induced Hypophosphatemic Osteomalacia on Whole-Body Bone Scintigraphy

International Nuclear Information System (INIS)

Kim, Sung Hoon; Won, Kyoung Sook; Song, Bongil; Jo, Il; Zeon, Seok Kil

2013-01-01

While adefovir dipivoxil (ADV) effectively suppresses the hepatitis B virus, it can cause proximal renal tubular dysfunction leading to phosphate wasting. The safety of low-dose ADV (a dose of 10 mg/day), which does not induce clinically significant nephrotoxicity, is well recognized, but a few cases of hypophosphatemic osteomalacia (HO) caused by low-dose ADV therapy have recently been reported. Although HO induced by low-dose ADV therapy is rare, the presence of bone pain in patients treated with ADV should be monitored. Bone scintigraphy can be performed to confirm the occurrence of osteomalacia and to determine the disease extent. Bone scintigraphic and radiological image findings with a brief review of the literature are presented in this article. We report two cases of HO induced by low-dose ADV therapy that showed multifocal increased radiotracer uptakes in the bilateral bony ribs, spines, pelvic bones and lower extremities on whole-body bone scintigraphy. Bone pain gradually improved after phosphate supplementation and by changing the antiviral agent. Whole-body bone scintigraphy is a highly sensitive imaging tool and can show disease extent at once in the setting of the wide range of the clinical spectrum with nonspecific radiological findings. Furthermore, frequent involvement of the lower extremities, as a result of maximum weight bearing, could be an additional scintigraphic clue for the diagnosis of HO. These cases could be helpful for both clinicians prescribing ADV and nuclear physicians to prevent delayed diagnosis and plan further appropriate treatment

Clinical study of CT-guided sclerotherapy using 50 percent acetic acid in the treatment of renal cyst

International Nuclear Information System (INIS)

Pang Jun; Han Changli; Zhang Zhaofu; Dai Jingru

2007-01-01

Objective: To investigate the efficacy of 50% acetic acid as a renal cyst sclerotherapy agent, and with further comparison to that of absolute alcohol. Methods: Eighty five patients with renal cyst were undergone sclerotherapy through spiral CT guidance including 43 cases with absolute alcohol and the others with 50% acetic acid as selerosing agents. All the cysts were aspirated under CT-guidance, beforehand. The selerosising agents were withdrawn from the cysts after a definite period of retention. Results: The disappearance rates of cyst cavity with absolute alcohol and acetic acid were 55.81% and 71.42%, respectively. Complication occurenee rates with absolute alcohol and acetic acid were 16.28% and 4.76%, respectively. The average retention periods of absolute alcohol and acetic acid in cyst were (20±4) minutes, and (10±2)minutes, respectively. Statistical analysis demonstrated that all the data in two groups were significantly different. Conclusion: Using 50% acetic acid as sclerosising agent in treating renal cyst possesses the better effect and less side effect, providing a tendency to replace the traditional therapy. (authors)

Use of computed tomography assessed kidney length to predict split renal GFR in living kidney donors

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Gaillard, Francois; Fournier, Catherine; Leon, Carine; Legendre, Christophe [Paris Descartes University, AP-HP, Hopital Necker-Enfants Malades, Renal Transplantation Department, Paris (France); Pavlov, Patrik [Linkoeping University, Linkoeping (Sweden); Tissier, Anne-Marie; Correas, Jean-Michel [Paris Descartes University, AP-HP, Hopital Necker-Enfants Malades, Radiology Department, Paris (France); Harache, Benoit; Hignette, Chantal; Weinmann, Pierre [Paris Descartes University, AP-HP, Hopital Europeen Georges Pompidou, Nuclear Medicine Department, Paris (France); Eladari, Dominique [Paris Descartes University, and INSERM, Unit 970, AP-HP, Hopital Europeen Georges Pompidou, Physiology Department, Paris (France); Timsit, Marc-Olivier; Mejean, Arnaud [Paris Descartes University, AP-HP, Hopital Europeen Georges Pompidou, Urology Department, Paris (France); Friedlander, Gerard; Courbebaisse, Marie [Paris Descartes University, and INSERM, Unit 1151, AP-HP, Hopital Europeen Georges Pompidou, Physiology Department, Paris (France); Houillier, Pascal [Paris Descartes University, INSERM, Unit umrs1138, and CNRS Unit erl8228, AP-HP, Hopital Europeen Georges Pompidou, Physiology Department, Paris (France)

2017-02-15

Screening of living kidney donors may require scintigraphy to split glomerular filtration rate (GFR). To determine the usefulness of computed tomography (CT) to split GFR, we compared scintigraphy-split GFR to CT-split GFR. We evaluated CT-split GFR as a screening test to detect scintigraphy-split GFR lower than 40 mL/min/1.73 m{sup 2}/kidney. This was a monocentric retrospective study on 346 potential living donors who had GFR measurement, renal scintigraphy, and CT. We predicted GFR for each kidney by splitting GFR using the following formula: Volume-split GFR for a given kidney = measured GFR*[volume of this kidney/(volume of this kidney + volume of the opposite kidney)]. The same formula was used for length-split GFR. We compared length- and volume-split GFR to scintigraphy-split GFR at donation and with a 4-year follow-up. A better correlation was observed between length-split GFR and scintigraphy-split GFR (r = 0.92) than between volume-split GFR and scintigraphy-split GFR (r = 0.89). A length-split GFR threshold of 45 mL/min/1.73 m{sup 2}/kidney had a sensitivity of 100 % and a specificity of 75 % to detect scintigraphy-split GFR less than 40 mL/min/1.73 m{sup 2}/kidney. Both techniques with their respective thresholds detected living donors with similar eGFR evolution during follow-up. Length-split GFR can be used to detect patients requiring scintigraphy. (orig.)

Use of computed tomography assessed kidney length to predict split renal GFR in living kidney donors

International Nuclear Information System (INIS)

Gaillard, Francois; Fournier, Catherine; Leon, Carine; Legendre, Christophe; Pavlov, Patrik; Tissier, Anne-Marie; Correas, Jean-Michel; Harache, Benoit; Hignette, Chantal; Weinmann, Pierre; Eladari, Dominique; Timsit, Marc-Olivier; Mejean, Arnaud; Friedlander, Gerard; Courbebaisse, Marie; Houillier, Pascal

2017-01-01

Screening of living kidney donors may require scintigraphy to split glomerular filtration rate (GFR). To determine the usefulness of computed tomography (CT) to split GFR, we compared scintigraphy-split GFR to CT-split GFR. We evaluated CT-split GFR as a screening test to detect scintigraphy-split GFR lower than 40 mL/min/1.73 m"2/kidney. This was a monocentric retrospective study on 346 potential living donors who had GFR measurement, renal scintigraphy, and CT. We predicted GFR for each kidney by splitting GFR using the following formula: Volume-split GFR for a given kidney = measured GFR*[volume of this kidney/(volume of this kidney + volume of the opposite kidney)]. The same formula was used for length-split GFR. We compared length- and volume-split GFR to scintigraphy-split GFR at donation and with a 4-year follow-up. A better correlation was observed between length-split GFR and scintigraphy-split GFR (r = 0.92) than between volume-split GFR and scintigraphy-split GFR (r = 0.89). A length-split GFR threshold of 45 mL/min/1.73 m"2/kidney had a sensitivity of 100 % and a specificity of 75 % to detect scintigraphy-split GFR less than 40 mL/min/1.73 m"2/kidney. Both techniques with their respective thresholds detected living donors with similar eGFR evolution during follow-up. Length-split GFR can be used to detect patients requiring scintigraphy. (orig.)

Influence of ursodeoxycholic acid on hepatobiliary scintigraphy with /sup 99m/Tc-N-pyridoxyl-5-methyltryptophan in chronic liver diseases

Energy Technology Data Exchange (ETDEWEB)

Hayakawa, Tomihiro; Katagiri, Kenji; Shiraki, Shigehiro and others

1988-11-01

Hepatobiliary scintigraphy using /sup 99m/Tc-N-pyridoxyl-5-methyltryptophan (PMT) was used to elucidate the effect of ursodeoxycholic acid (UDCA) treatment on chronic liver diseases. After UDCA administration, the peak of the hepatic uptake-excretion curve of /sup 99m/Tc-PMT (peak time) was significantly shortened. Serum ..gamma..-GTP level also improved during UDCA therapy. These results suggest that UDCA enhances uptake especially of anions like /sup 99m/Tc-PMT, and increases their secretion into bile. Consequently, UDCA may be pharmachologically useful for chronic liver diseases.

The influence of ursodeoxycholic acid on hepatobiliary scintigraphy with 99mTc-N-pyridoxyl-5-methyltryptophan in chronic liver diseases

International Nuclear Information System (INIS)

Hayakawa, Tomihiro; Katagiri, Kenji; Shiraki, Shigehiro

1988-01-01

Hepatobiliary scintigraphy using 99m Tc-N-pyridoxyl-5-methyltryptophan (PMT) was used to elucidate the effect of ursodeoxycholic acid (UDCA) treatment on chronic liver diseases. After UDCA administration, the peak of the hepatic uptake-excretion curve of 99m Tc-PMT (peak time) was significantly shortened. Serum γ-GTP level also improved during UDCA therapy. These results suggest that UDCA enhances uptake especially of anions like 99m Tc-PMT, and increases their secretion into bile. Consequently, UDCA may be pharmachologically useful for chronic liver diseases. (author)

Improved interpretation of renal-vein-renin-ratio by simultaneous determination of renal 131I-hippuric-acid-clearance-ratio in patients with renovascular hypertension

International Nuclear Information System (INIS)

Helber, A.; Boenner, G.; Hummerich, W.; Wambach, G.; Meurer, K.A.; Dvorak, K.; Lent, V.; Zehle, A.; Kaufmann, W.; Koeln Univ.; Staedtisches Krankenhaus Koeln-Merheim; Staedtisches Krankenhaus Koeln-Merheim; Koeln Univ.

1979-01-01

In patients with unilateral vascular kidney disease and hypertension, ratio of renal-vein-renin was compared with 131 I-Hippuric-acid clearance and change in blood pressure during Saralasininfusion. The ratio of renal-vein-renin was positively correlated with the ratio in renal plasma flow between the kidneys in all patients studied. The ratio of renins therefore is a result of two factors: The difference in renin secretion and the difference in blood flow in the two kidneys. In patients with angiotensin independent hypertension renin-ratios up to 2.0 were found without relevance to elevated blood pressure. When the difference in renal blood flow between both kidneys was small, even a slight difference in renal vein renin indicated hypertension related to increased renin secretion. (orig./AJ) [de

Adrenal scintigraphy using 131I-Adosterol

International Nuclear Information System (INIS)

Fukunaga, Masao; Dokoh, Shigeharu; Yamamoto, Itsuo; Morita, Rikushi; Torizuka, Kanji

1977-01-01

131 I-Adosterol (6β-iodomethyl-19-norcholest-5(10)-3β-ol) was administered to evaluate adrenal grand in 20 patients including 9 patients with primary aldosteronism, 5 with Cushing's syndrome, one with pheochromocytoma, one with retroperitoneal tumor, 3 with essential hypertension and one with obesity. Standard scintigraphies were performed at 3rd day and again 6th day after administration of 131 I-adosterol (1-1.5 mCi). Suppression scintigraphies were obtained while the patients were taking dexamethasone 2 to 3 mg daily from 3 days prior to injection of the tracer until adrenal imaging. In the cases with essential hypertension and obesity, both adrenal glands were delineated equally by standard scintigraphy, and in one patient, undergone suppression scintigraphy, the uptake of 131 I-adosterol by both glands were completely inhibited by dexamethasone administration. In primary aldosteronism, six of the 9 patients demonstrated the increased radioactivity in one side, and were diagnosed as aldosteronoma. In 3 cases, failed to show the lesions on standard scintigraphy, the lesions could be detected by suppression scintigraphy, and aldosteronomas measuring 1 x 1 x 0.7, 2 x 2 x 1 and 1.7 x 1.5 x 0.8 cm were confirmed by operation. In Cushing's syndrome, standard scintigraphy could easily distinguish between adenoma (one case) and bilateral hyperplasia (4 cases). Adrenal scintigraphy was also a useful method in order to assess the effect of pituitary irradiation therapy in the case of hyperplasia. In pheochromocytoma and retroperitoneal tumor, the side of the lesion was identified by the absence of a functioning gland. Suppression scintigraphy was particularly useful in detecting the localization of the small tumor in primary aldosteronism. (auth.)

Radionuclide assessment of renal function in patients with oncogynecological diseases

International Nuclear Information System (INIS)

Vlakhov, N.; Penkova, D.; Kovachev, A.

1989-01-01

Results of 131 I-hippuran (0.74 MBq) nephrography and 99m Tc DMCA (55.6 MBq) scintigraphy of the kidneys in 204 women from 21 to 75 years of age are analyzed. All patients were examined before and after treatment (surgical, radiation, hormonal). It was found that combined radiotherapy of patients with cervix uteri cancer and surgical treatment of patients with corpus uteri cancer resulted in aggravation of the secretory and excretory renal disorders, as compared to the pre-treatment state. It was not until after the second year of treatment that normal renal function was reestablished. Radionuclide methods furnish the opportunity both for early detection of renal function disorders and for their dynamic control and treatment. 1 tab., 4 refs

Myocardial scintigraphy using iodine-123 15-(p-Iodophenyl)-3-R, S-methylpentadecanoic acid predicts the response to beta-blocker therapy in patients with dilated cardiomyopathy but does not reflect therapeutic effect

Energy Technology Data Exchange (ETDEWEB)

Yoshinaga, Keiichiro; Tahara, Minoru; Torii, Hiroyuki; Akimoto, Masaki [Kagoshima City Medical Association Hopital (Japan); Kihara, Koichi; Tei, Chuwa

2000-05-01

Myocardial fatty acid metabolism is disturbed in patients with idiopathic dilated cardiomyopathy. Myocardial scintigraphy using iodine-123 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP) was used to assess the response to {beta}-blocker therapy in 19 patients with dilated cardiomyopathy. BMIPP myocardial scintigraphy was performed before and 6 months after initiating {beta}-blocker therapy with metoprolol. Cardiac BMIPP uptake was assessed as the total defect score (TDS) and heart-to-mediastinum activity (H/M) ratio. Patients were classified retrospectively as responders with an improvement of at least one functional class (New York Heart Association) or an increase in ejection fraction of {>=}0.10 at 6 months, or as nonresponders meeting neither criterion. Responders had a significantly better pretreatment TDS (p<0.005) and H/M ratio (p<0.0001) than nonresponders. TDS exhibited no significant changes over 6 months in either group (responders: 13.2{+-}3.7 vs 12.5{+-}3.3; nonresponders: 20.8{+-}6.5 vs 20.5{+-}3.0). Responders showed no significant changes in H/M ratio (2.47{+-}0.28 vs 2.43{+-}0.42); paradoxically, nonresponders showed a significant increase from 1.82{+-}0.11 to 2.10{+-}0.19 (p<0.05), suggesting that {beta}-blocker therapy protected the myocardial fatty acid metabolism even in the absence of clinical improvement. BMIPP myocardial scintigraphy provides a prediction of response to {beta}-blocker treatment, but does not reflect the therapeutic effect in responders at 6 months. (author)

/sup 131/I-meta-iodobenzylguanidine scintigraphy of neuroblastomas

International Nuclear Information System (INIS)

Munkner, T.

1986-01-01

Sixteen neuroblastoma patients have been studied by /sup 131/I-meta-iodobenzylguanidine scintigraphy. Three patients were possibly cured, and their scintigraphy results were normal. Thirteen patients had tumors and metastases demonstrated by /sup 131/I-MIBG, two of these patients had a normal vanillylmandelic acid excretion levels. One patient has been treated by /sup 131/I-MIBG, but died. /sup 131/I-MIBG was concentrated in other cells too, e.g., in erythrocytes and platelets. Neuroblastoma is the most common solid malignant disease in children. It has a poor prognosis in patients more than one year old. Early detection and a display of the spread of the tumor is of utmost importance for planning and controlling the treatment. Mass screening for neuroblastoma in infants has been suggested and tried in Japan. Scintigraphy after injection of /sup 131/I-meta-iodobenzylguanidine has been used successfully for locating neuroblastomas. An initial study failed to demonstrate neuroblastoma by means of MIBG in two patients. Since the latter part of 1983, MIBG has been used in a number of European centers for imaging neuroblastomas with very promising results, and a multicenter investigation has been initiated. The Ann Arbor group has recently extended its studies to a group of ten patients and has confirmed the European results

Technetium-99m BIDA biliary scintigraphy in the evaluation of the jaundiced patient

International Nuclear Information System (INIS)

Lee, A.W.; Ram, M.D.; Shih, W.J.; Murphy, K.

1986-01-01

Biliary scintigraphy using 99mTc p-butyl acetanilidiminodiacetic acid (BIDA) was performed as part of the diagnostic evaluation on 96 patients with jaundice (serum bilirubin greater than 2 mg/dl) to assess its value in this group of patients. The results of scintigraphy revealed no obstruction to the flow of the scintigraphic agent into the duodenum in 54 patients, delayed appearance of the agent (normal upper limit 60 min) in the duodenum indicating partial obstruction in 22 patients, and complete obstruction of the duct demonstrated by absence of agent in the duodenum in 20 patients. The findings were correlated with the final diagnosis and the overall results show accuracy of 92.7%, sensitivity of 97.3%, and specificity of 89.8%. Biliary scintigraphy was thus found to be useful in differentiating nonobstructive, partially obstructive, and completely obstructive causes of jaundice

Comparative study of dynamic renal scintigraphy and conventional ultrasonography for the diagnosis of hydronephrosis as a complication of urolithiasis

International Nuclear Information System (INIS)

Hadzhiyska, V.; Petrov, T.; Kostadinova, I.; Krusteva, R.; Marianovski, V.

2010-01-01

Hydronephrosis is the most common complication of the nephrolithiasis which often leads to irreversible and long lasting consequences for the kidney involved. The aim of the study is to compare the results from the Ultrasonography (US) and the Dynamic renal scintigraphy (DRS) in the diagnosis of hydronephrosis as a complication of nephro- and urolithiasis. Forty-six patients (21 male, 26 female), aged between 13 and 85 years, with mainly unilateral proved or suspected hydronephrosis are studied. All of them have history for nephro- or urolithiasis. A DRS with 99mTc-DTPA is done by using 255 MBq dose and 25 min. protocol. Diuretic test is performed in 24 (52 %) of the patients. The results from the US and the DRS are compared for all patients. The results from the comparative study show that the DRS confirm and precise the diagnosis from the US in 72% of the cases, while in the rest of them the findings from the DRS differs from the US diagnosis. In 32 % of the cases where diuretic test was performed an obstructive hydronephrosis is found. The comparative investigation provides evidence that the DRS corrects and precise the diagnosis of hydronephrosis, determined by US in significant percentage of the cases, provides additional information by using functional parameters and should be used as a basic diagnostic method for the last therapeutic decision. (authors)

Scintigraphy of spinal disorders in adolescents

Energy Technology Data Exchange (ETDEWEB)

Mandell, G.A. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States)); Harcke, H.T. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States))

1993-08-01

Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

Scintigraphy of spinal disorders in adolescents

International Nuclear Information System (INIS)

Mandell, G.A.; Harcke, H.T.

1993-01-01

Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

Lung scintigraphy; Centellograma pulmonar

Energy Technology Data Exchange (ETDEWEB)

Dalenz, Roberto

1994-12-31

A review of lung scintigraphy, perfusion scintigraphy with SPECT, lung ventilation SPECT, blood pool SPECT. The procedure of lung perfusion studies, radiopharmaceutical, administration and clinical applications, imaging processing .Results encountered and evaluation criteria after Biello and Pioped. Recommendations and general considerations have been studied about relation of this radiopharmaceutical with other pathologies.

Graft Loss Due to Percutaneous Sclerotherapy of a Lymphocele Using Acetic Acid After Renal Transplantation

International Nuclear Information System (INIS)

Adani, Gian Luigi; Baccarani, Umberto; Bresadola, Vittorio; Lorenzin, Dario; Montanaro, Domenico; Risaliti, Andrea; Terrosu, Giovanni; Sponza, Massimo; Bresadola, Fabrizio

2005-01-01

Development of lymphoceles after renal transplantation is a well-described complication that occurs in up to 40% of recipients. The gold standard approach for the treatment of symptomatic cases is not well defined yet. Management options include simple aspiration, marsupialization by a laparotomy or laparoscopy, and percutaneous sclerotherapy using different chemical agents. Those approaches can be associated, and they depend on type, dimension, and localization of the lymphocele. Percutaneous sclerotherapy is considered to be less invasive than the surgical approach; it can be used safely and effectively, with low morbidity, in huge, rapidly accumulating lymphoceles. Moreover, this approach is highly successful, and the complication rate is acceptable; the major drawback is a recurrence rate close to 20%. We herewith report a renal transplant case in which the patient developed a symptomatic lymphocele that was initially treated by ultrasound-guided percutaneous sclerotherapy with ethanol and thereafter using acetic acid for early recurrence. A few hours after injection of acetic acid in the lymphatic cavity, the patient started to complain of acute pain localized to the renal graft and fever. An ultrasound of the abdomen revealed thrombosis of the renal vein and artery. The patient was immediately taken to the operating room, where the diagnosis of vascular thrombosis was confirmed and the graft was urgently explanted. In conclusion, we strongly suggest avoiding the use of acetic acid as a slerosating agent for the percutaneous treatment of post-renal transplant lymphocele because, based on our experience, it could be complicated by vascular thrombosis of the kidney, ending in graft loss

Nuclear medicine in the management of renal vein thrombosis post renal transplantation - a case study

International Nuclear Information System (INIS)

Waran, L.; Unger, S.

2005-01-01

Renal scintigraphy allows the assessment of both perfusion and function of the transplanted kidney. Treatment of renal dysfunction depends on its cause. Nuclear medicine plays an important role in determining the cause of renal dysfunction, thereby providing appropriate intervention. Renal vein thrombosis (RVT) is a rare occurrence (1-2%) in renal transplants, and constitutes a surgical emergency. Early detection of RVT is critical in order to prevent infarction and subsequent loss of the graft. A 43-year-old woman with end stage renal disease as a result of diabetic nephropathy underwent transplantation of a living-related-donor kidney. The patient underwent a post operative Tc-MAG, scan that demonstrated good perfusion to the graft. Three days post-transplantation, the patient complained of acute pain and swelling. Creatinine increased from 0.13 to 0.16. and urine output decreased. The m Tc-MAG, scan revealed dramatic deterioration, with absent perfusion to the kidney. Immediate allograft exploration was performed in theatre and RVT was revealed, followed by thrombectomy. A follow-up renal scan performed the next day demonstrated a viable kidney with improved but patchy perfusion throughout, indicating patchy cortical infarction as well as acute tubular necrosis. On day 19. the patient again complained of severe pain over the graft, and the 99 mTc-MAG, scan again revealed absent perfusion, this time with residual function. Further surgical exploration confirmed re-thrombosis of the renal vein, and subsequent genetic analysis revealed that the patient had a rare mutation of her clotting Factor V gene, leading to an increased thrombogenic tendency. Following full anticoagulation, the patient was finally discharged on day 58. This case illustrates a rare case of renal allograft infarction secondary to renal vein thrombosis. The ability of nuclear medicine to provide immediate functional information helped confirm the diagnosis, and salvage the kidney

Quantitative renal scintigraphy: anatomo-clinical and biological correlation (concerning 51 mercury 197 renal scintigraphs)

International Nuclear Information System (INIS)

Pinganaud, J.-M.

1976-01-01

To find out whether the renal mercury uptake measurement in urology is a satisfactory way to judge the separate functional value of the kidneys the records of 51 patients were examined. The exploration took place as follows: - injection of 300 μCi 197 HgCl 2 , - measurement of the radioactivity fixed on each kidney, three days later, by means of a gamma camera. Of these 51 uptake measurements only one result appears inconsistent by excess. All the others agree perfectly with comparative observations. On the whole a close correlation is found between the renal mercury uptake measurement and the various clinical, urographic and anatomical data obtained on this group of patients. The method seems to be ideal because reliable, harmless and repeatable. Where dosimetry is concerned an injected dose of 300μCi delivers 9mrad to each kidney, 6mrad to the ovaries. By way of comparison it is interesting to note that an intraveinous urograph with 5 exposures delivers 500mrad to the ovaries. It is considered safe to repeat the examination 3 to 4 times on one patient [fr

The usefulness of early whole body bone scintigraphy in the detection of bone metastasis from prostatic cancer

International Nuclear Information System (INIS)

Otsuka, Nobuaki; Fukunaga, Masao; Furukawa, Yohji; Tanaka, Hiroyoshi

1994-01-01

Early whole body bone scintigraphy was performed on 25 patients with prostatic cancer (15 cases with bone metastases and 10 cases without bone metastasis) to obtain anterior and posterior whole body images five minutes after administration of 99m Tc-hydroxymethylene diphosphonate(HMDP). The results were compared with the findings of routine bone scintigraphy after three hours, and the usefulness of the above method for the diagnosis of bone metastasis from prostatic cancer was evaluated. In cases in which increased activity was found in the upper and lower lumbar vertebrae by routine bone scintigraphy but no abnormality was seen by early whole body bone scintigraphy, senile degenerative bone changes such as spondylosis deformance were observed by bone radiography. In cases with multiple bone metastases, abnormal multiple accumulations were found by both early whole body bone scintigraphy and routine bone scintigraphy. In addition, in cases showing super bone scan, high accumulation in the skeletal system had already been detected by early whole body bone scintigraphy. When the courses before and after treatment in nine cases of multiple bone metastases were passaged from the results of early whole body bone scintigraphy and from changes in tumor markers (prostatic specific antigen, γ-semino protein and prostatic acid phosphatase), increased activity and the appearance of new hot spots as well as an increase in tumor markers were detected by early whole body scintigraphy in three of the four advanced cases, whereas decreased accumulations and a decrease in and normalization of tumor markers were observed in five improved cases. (author)

The usefulness of early whole body bone scintigraphy in the detection of bone metastasis from prostatic cancer

Energy Technology Data Exchange (ETDEWEB)

Otsuka, Nobuaki; Fukunaga, Masao; Furukawa, Yohji; Tanaka, Hiroyoshi [Kawasaki Medical School, Kurashiki, Okayama (Japan)

1994-06-01

Early whole body bone scintigraphy was performed on 25 patients with prostatic cancer (15 cases with bone metastases and 10 cases without bone metastasis) to obtain anterior and posterior whole body images five minutes after administration of [sup 99m]Tc-hydroxymethylene diphosphonate(HMDP). The results were compared with the findings of routine bone scintigraphy after three hours, and the usefulness of the above method for the diagnosis of bone metastasis from prostatic cancer was evaluated. In cases in which increased activity was found in the upper and lower lumbar vertebrae by routine bone scintigraphy but no abnormality was seen by early whole body bone scintigraphy, senile degenerative bone changes such as spondylosis deformance were observed by bone radiography. In cases with multiple bone metastases, abnormal multiple accumulations were found by both early whole body bone scintigraphy and routine bone scintigraphy. In addition, in cases showing super bone scan, high accumulation in the skeletal system had already been detected by early whole body bone scintigraphy. When the courses before and after treatment in nine cases of multiple bone metastases were passaged from the results of early whole body bone scintigraphy and from changes in tumor markers (prostatic specific antigen, [gamma]-semino protein and prostatic acid phosphatase), increased activity and the appearance of new hot spots as well as an increase in tumor markers were detected by early whole body scintigraphy in three of the four advanced cases, whereas decreased accumulations and a decrease in and normalization of tumor markers were observed in five improved cases. (author).

Complicated pregnancies in inherited distal renal tubular acidosis: importance of acid-base balance.

Science.gov (United States)

Seeger, Harald; Salfeld, Peter; Eisel, Rüdiger; Wagner, Carsten A; Mohebbi, Nilufar

2017-06-01

Inherited distal renal tubular acidosis (dRTA) is caused by impaired urinary acid excretion resulting in hyperchloremic metabolic acidosis. Although the glomerular filtration rate (GFR) is usually preserved, and hypertension and overt proteinuria are absent, it has to be considered that patients with dRTA also suffer from chronic kidney disease (CKD) with an increased risk for adverse pregnancy-related outcomes. Typical complications of dRTA include severe hypokalemia leading to cardiac arrhythmias and paralysis, nephrolithiasis and nephrocalcinosis. Several physiologic changes occur in normal pregnancy including alterations in acid-base and electrolyte homeostasis as well as in GFR. However, data on pregnancy in women with inherited dRTA are scarce. We report the course of pregnancy in three women with hereditary dRTA. Complications observed were severe metabolic acidosis, profound hypokalemia aggravated by hyperemesis gravidarum, recurrent urinary tract infection (UTI) and ureteric obstruction leading to renal failure. However, the outcome of all five pregnancies (1 pregnancy each for mothers n. 1 and 2; 3 pregnancies for mother n. 3) was excellent due to timely interventions. Our findings highlight the importance of close nephrologic monitoring of women with inherited dRTA during pregnancy. In addition to routine assessment of creatinine and proteinuria, caregivers should especially focus on acid-base status, plasma potassium and urinary tract infections. Patients should be screened for renal obstruction in the case of typical symptoms, UTI or renal failure. Furthermore, genetic identification of the underlying mutation may (a) support early nephrologic referral during pregnancy and a better management of the affected woman, and (b) help to avoid delayed diagnosis and reduce complications in affected newborns.

Initial effect of enalapril on kidney function in patients with moderate to severe chronic nephropathy

DEFF Research Database (Denmark)

Kamper, A L; Thomsen, H S; Nielsen, S L

1990-01-01

in their renal function. Thirty-one patients were studied, 26 on chronic antihypertensive treatment with drugs other than ACE inhibitors and 5 untreated normotensive. 51Cr-EDTA plasma clearance and renal technetium-99m dimercaptosuccinic acid (99mTc-DMSA) scintigraphy were made before and 24 h after start...

Lacrimal scintigraphy in the diagnosis of epiphora

International Nuclear Information System (INIS)

Hanna, I.T.; MacEwen, C.J.; Kennedy, N.

1992-01-01

The value of lacrimal scintigraphy in the assessment of nasolacrimal duct obstruction was determined by comparing the results with syringing in 67 patients (83 eyes). As expected, of 28 lacrimal drainage systems which were obstructed on syringing, 23 (82%) had abnormalities of tear drainage on scintigraphy. However, in 55 lacrimal drainage systems that were patent on syringing, 19 (35%) were normal, but in 36 (65%) abnormalities not apparent on syringing were detected on scintigraphy. Thus scintigraphy is a very useful technique in the assessment of nasolacrimal duct obstruction particularly in systems patent on syringing. Since the site of obstruction can be determined, lacrimal scintigraphy can facilitate the planning of the appropriate surgery. (author)

Effect of Folic Acid Supplementation on Renal Phenotype and Epigenotype in Early Weanling Intrauterine Growth Retarded Rats

Directory of Open Access Journals (Sweden)

Xiaori He

2015-07-01

Full Text Available Background/Aims: The objective of this study was to examine the responses of p53 promoter methylation involved in kidney structure and function of early weaning intrauterine growth retarded (IUGR rats to dietary folic acid supplementation. Method: Sprague-Dawley rats were fed isocaloric diets containing either 21% protein diet (normal feed or 10% protein diet throughout pregnancy and normal feed during lactation. After weaning, Offspring were then fed onto normal feed and normal feed supplemented with 5 mg folic acid/kg feed for a month, this produced 4 dietary groups (maternal diet/ weanling diet: Con, Folic, IUGR and IUGR+Folic. Renal function, renal structure, p53 promoter methylation and protein expression of offspring rats were measured at postnatal 2 months and 3 months. Results: Glomerular volume, blood urea nitrogen, 24 hours urine protein were significantly elevated in IUGR rats compared with Con rats but were decreased by dietary folic acid supplementation. p53 protein expression in IUGR rats were significantly higher than that in Con rats, and p53 promoter methylation status in IUGR rats was reduced significantly compared with Con rats. However, the changes in p53 gene expression and DNA methylation status of IUGR rats were reversed by dietary folic acid supplementation. Conclusions: Our study showed for the first time that folic acid supplementation during early period of life could reverse the abnormality in renal p53 methylation status and protein expression, glomerular volume and renal function of IUGR rats offspring.

Myocardial scintigraphy with thallium-201

Energy Technology Data Exchange (ETDEWEB)

Lichte, H [Zentralkrankenhaus Gauting (Germany, F.R.). Nuklearmedizinische Abt.

1977-04-01

Myocardial scintigraphy with /sup 201/thallium is a non-invasive method for detection of myocardial infarction and coronary heart disease. Redistribution-analysis as a sequential-scintigraphy of an exercise-scan permits to distinguish between myocardial scars and coronary vessel disease.

Clinical evaluation of 123I-BMIPP myocardial scintigraphy in patients with hypertrophic cardiomyopathy

International Nuclear Information System (INIS)

Ohtsuki, Katsuichi; Sugihara, Hiroki; Umamoto, Ikuo

1992-01-01

123 I-β-methyl-p-iodophenylpentadecanoic acid ( 123 I-BMIPP) myocardial scintigraphy was performed in 13 patients with hypertrophic cardiomyopathy and compared with 201 Tl myocardial scintigraphy performed within 3 months for evaluating the clinical significance of 123 I-BMIPP myocardial scintigraphy. SPECT images were divided into 13 segments and segmental images were visually scored on a 4 (increased tracer uptake) to 0 (severely decreased tracer uptake) scale according to the tracer uptake. In comparison of 123 I-BMIPP early images and 201 Tl perfusion images, mismatches were seen in about 70% of all segments. The number of segments demonstrating lower myocardial uptake of 123 I-BMIPP was larger than that of 201 Tl. In hypertrophic regions, the tracer uptake of 123 I-BMIPP early images was significantly lower than that of 201 Tl images and the lower uptake of 123 I-BMIPP delayed images was more marked. In non-hypertrophic regions, no significant difference was seen between the tracer uptakes of 123 I-BMIPP early images and 201 Tl images but the tracer uptake of 123 I-BMIPP delayed images was significantly lower than that of 201 Tl images. The mismatch between the tracer uptakes of 123 I-BMIPP images and 201 Tl images was thought to be a reflection of disordered myocardial fatty acid metabolism. 'Washout', the difference between the tracer uptakes of 123 I-BMIPP early images and delayed images was also thought to be a reflection of disordered myocardial fatty acid metabolism. These results suggest that 123 I-BMIPP is a promising radiopharmaceutical for evaluating disordered myocardial fatty acid metabolism in patients with HCM. (author)

Amino Acid Medical Foods Provide a High Dietary Acid Load and Increase Urinary Excretion of Renal Net Acid, Calcium, and Magnesium Compared with Glycomacropeptide Medical Foods in Phenylketonuria

Directory of Open Access Journals (Sweden)

Bridget M. Stroup

2017-01-01

Full Text Available Background. Skeletal fragility is a complication of phenylketonuria (PKU. A diet containing amino acids compared with glycomacropeptide reduces bone size and strength in mice. Objective. We tested the hypothesis that amino acid medical foods (AA-MF provide a high dietary acid load, subsequently increasing urinary excretion of renal net acid, calcium, and magnesium, compared to glycomacropeptide medical foods (GMP-MF. Design. In a crossover design, 8 participants with PKU (16–35 y provided food records and 24-hr urine samples after consuming a low-Phe diet in combination with AA-MF and GMP-MF for 1–3 wks. We calculated potential renal acid load (PRAL of AA-MF and GMP-MF and determined bone mineral density (BMD measurements using dual X-ray absorptiometry. Results. AA-MF provided 1.5–2.5-fold higher PRAL and resulted in 3-fold greater renal net acid excretion compared to GMP-MF (p=0.002. Dietary protein, calcium, and magnesium intake were similar. GMP-MF significantly reduced urinary excretion of calcium by 40% (p=0.012 and magnesium by 30% (p=0.029. Two participants had low BMD-for-age and trabecular bone scores, indicating microarchitectural degradation. Urinary calcium with AA-MF negatively correlated with L1–L4 BMD. Conclusion. Compared to GMP-MF, AA-MF increase dietary acid load, subsequently increasing urinary calcium and magnesium excretion, and likely contributing to skeletal fragility in PKU. The trial was registered at clinicaltrials.gov as NCT01428258.

Scintigraphy in equine practice

International Nuclear Information System (INIS)

Fulton, I.C.; Anderson, B.

2002-01-01

The most common use for nuclear medicine in equine practice is bone imaging using technetium 99m as the radionuclide. This article will describe establishment of a facility to perform equine scintigraphy, the peculiarities associated with nuclear medicine and horses and describe a variety of the pathology we identify using scintigraphy. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Technetium-99m diethylenetriaminepentaacetic acid radioaerosol scintigraphy in organophosphate induced pulmonary toxicity: experimental study.

Science.gov (United States)

Yavuz, Yucel; Kaya, Eser; Yurumez, Yusuf; Sahin, Onder; Bas, Orhan; Fidan, Huseyin; Sezer, Murat

2008-09-01

The aim of this experimental study was to investigate pathological signs of lung damages caused by acute organophosphate (OP) poisoning by using Tc-99m DTPA radioaerosol scintigraphy and histopathological investigation. Fourteen rabbits were divided into two equal groups (n = 7). Group 1 (control group) received normal saline (same volume of fenthion, 2 ml/kg) via orogastric tube. Group 2 (OP toxicity group) received 150 mg/kg of fenthion (diluted fenthion, 2 ml/kg) via orogastric tube. Six hours later, Tc-99m-DTPA aerosol inhalation lung scintigraphy was performed in both groups. Then all rabbits were anesthetized with ketamine hydrochloride (35 mg/kg, i.p.) and xysilazine (5 mg/kg, i.p.), and sacrificed by intracardiac blood discharge. The lungs were then removed. There was a significant difference in T1/2 values of Tc-99m DTPA clearance between control group and OP toxicity group (p = 0.04). Intraparenchymal vascular congestion and thrombosis, intraparenchymal hemorrhage, respiratory epithelial proliferation, number of macrophages in the alveolar, and bronchial lumen, alveolar destruction, emphysematous changes, and bronchoalveolar hemorrhage scores were significantly higher in the rabbits exposed to OP compared with the control group (p < 0.05). This study showed that OP toxicity caused a decrease in the alveolar clearance. Tc-99m DTPA radioaerosol inhalation lung scintigraphy was found to be a sensitive determination of acute lung damage in OP poisoning.

Usefulness of gastroesophageal reflux scintigraphy using the knee-chest position for the diagnosis of gastroesophageal reflux disease

International Nuclear Information System (INIS)

Asakura, Yasushi; Imai, Yukinori; Ota, Shinichi; Fujiwara, Kenji; Miyamae, Tatsuya

2005-01-01

The aim of this study is to evaluate the usefulness of gastroesophageal reflux (GER) scintigraphy using the knee-chest (KC) position for the diagnosis of gastroesophageal reflux disease (GERD). The study subjects were 37 patients with GERD and 8 healthy volunteers (control group). Endoscopically observed esophageal mucosal breaks were evaluated with the Los Angeles classification. For GER scintigraphy, the subjects ingested liquid yogurt labeled with 99m Tc-diethylene triamine pentaacetic acid ( 99m Tc-DTPA) and water. Imaging was performed in the supine and KC position, and GER was graded as 1-4 according to the extent of GER assessed by scintigraphy. GER scintigraphy revealed no reflux in the control group (specificity: 100%). In the supine position, gastroesophageal reflux was observed in 49% of the patients with GERD, compared to 76% in the KC position. 21 of 23 (91%) patients with erosive esophagitis were shown to have GER with scintigraphy. GER scintigraphy revealed severe reflux (grade 3 or 4) (83%, 10/12) in the patients who had severe mucosal breaks (the Los Angels classification grade C or D). GER scintigraphy detected grade 1 or 2 reflux in 7 of the 14 patients who were endoscopically negative. There was a correlation between the endoscopically determined severity of mucosa and the reflux grade which was determined with GER scintigraphy. GER scintigraphy can detect gastroesophageal reflux with a high sensitivity in the KC position and might be a useful method in the screening and assessment of the severity of this disease. This method would be useful for the diagnosis of GERD in endoscopically negative patients. (author)

Usefulness of 99mTc(V)-dimercaptosuccinic acid scintigraphy in the assessment of response to external radiation therapy in soft tissue sarcoma in Giant Schnauzer dog

International Nuclear Information System (INIS)

Chaudhari, P. R.; Mathe, D.; Balogh, L.; Andocs, G.; Janoki, G. A.

2005-01-01

A nine-year-old male black Giant Schnauzer dog was referred for the scintigraphic evaluation with a history of malignant fibrosarcoma with a rapidly growing non painful mass on the left shoulder region quite near to the site of an operation performed four months ago. We carried out oncological scintigraphy using pentavalent 99mT echnetium labelled dimercaptosuccinic acid [ 99mT c(V)-DMSA], a tumour localising radiopharmaceutical agent. The study was performed to assess the margins, vascularity of the tumour and response to the cancer therapy. Uniform intense radiopharmaceutical uptake was observed in the lesion indicating its margins, vascularity and malignant nature. The dog was subjected to external radiation therapy to control the growth of the cancer and to bring the tumour mass to an operable size. The dog was followed up with 99mT c(V)-DMSA scintigraphy pre-irradiation and post-irradiation. Immediately after the post-irradiation scintigraphy, the dog was operated on. During the surgery, resection of the tumour margins was performed carefully using a hand held gamma probe to assure that no tumour tissue was left inside. In conclusion, the authors would like to state that 99mT c(V)-DMSA oncoscintigraphy is valuable in the assessment and evaluation of therapy in canine soft tissue cancer. (author)

Correlation of the glomerular filtration rate by the Gates scintigraphy method and by the creatinine purification in urine of 24 hours

International Nuclear Information System (INIS)

Gomez A, E.

2003-01-01

The kidney is an important organ that makes that exist equilibrium inside the organism. In it' s multiple functions, one that interests us to know is the glomerular filtration rate (GFR). To know this, exist laboratory and scintigraphy studies like the scintigraphy with technique of Gates and the creatinine purification in urine of 24 hours. The files of 44 patients were studied, which were clinically candidates to kidney donors healthy (25 women and 19 men) with ages that varied from the 18 years to the 54 years ( 35.1 years), with a weight of 43 kilograms to 94 kilograms (68.95 Kg) and with a corporal surface of 1.29 to 2.08 m 2 (1.70 m 2 ). These patients underwent study protocols with creatinine purification and with renal scintigraphy. The glomerular filtration rate obtained by creatinine purification varied from 51.9 ml/min. to 156 ml/min. and the GFR obtained by scintigraphy varied from 3.6 ml/min. to 155.2 ml/min. Once obtained the gathering of data the test of Student was applied to compare the averages of both distributions and the analysis of lineal regression to determine the coefficients of correlation of the complete group. (Author)

Bone scintigraphy in children

International Nuclear Information System (INIS)

Mann, M.D.

2004-01-01

Full text: Bone scintigraphy is an integral part of the evaluation of bone disease in children. Common indications are suspected infection or inflammation, bone tumours and metastases, trauma and avascular necrosis. In all these disorders the sensitivity of scintigraphy is high. Gallium scintigraphy is often useful in children with clinical signs of infection not responding to treatment but the radiation dose is high. High quality images are essential. They depend on the full participation and co-operation of the child, parents and radiographers, the administration of appropriate analgesics, gentle but firm handling of the child, the injection of the appropriate amount of radiopharmaceutical, good positioning and immobilization, optimised equipment, and the acquisition of a suitable number of counts in an appropriate matrix size. Unless there are specific reasons for not doing so, we routinely perform two phase bone scintigraphy. This usually involves whole body blood pool and delayed images followed by static images of selected areas and, less often, pinhole images or SPECT. The interpretation of bone scan images in children requires knowledge of the age dependent differences in bone metabolism in the developing skeleton and the effect on the appearance of the maturing skeleton. (author)

Role of magnetic resonance urography in pediatric renal fusion anomalies

International Nuclear Information System (INIS)

Chan, Sherwin S.; Ntoulia, Aikaterini; Khrichenko, Dmitry; Back, Susan J.; Darge, Kassa; Tasian, Gregory E.; Dillman, Jonathan R.

2017-01-01

Renal fusion is on a spectrum of congenital abnormalities that occur due to disruption of the migration process of the embryonic kidneys from the pelvis to the retroperitoneal renal fossae. Clinically, renal fusion anomalies are often found incidentally and associated with increased risk for complications, such as urinary tract obstruction, infection and urolithiasis. These anomalies are most commonly imaged using ultrasound for anatomical definition and less frequently using renal scintigraphy to quantify differential renal function and assess urinary tract drainage. Functional magnetic resonance urography (fMRU) is an advanced imaging technique that combines the excellent soft-tissue contrast of conventional magnetic resonance (MR) images with the quantitative assessment based on contrast medium uptake and excretion kinetics to provide information on renal function and drainage. fMRU has been shown to be clinically useful in evaluating a number of urological conditions. A highly sensitive and radiation-free imaging modality, fMRU can provide detailed morphological and functional information that can facilitate conservative and/or surgical management of children with renal fusion anomalies. This paper reviews the embryological basis of the different types of renal fusion anomalies, their imaging appearances at fMRU, complications associated with fusion anomalies, and the important role of fMRU in diagnosing and managing children with these anomalies. (orig.)

Role of magnetic resonance urography in pediatric renal fusion anomalies

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Chan, Sherwin S. [Children' s Mercy Hospital, Department of Radiology, Kansas City, MO (United States); Ntoulia, Aikaterini; Khrichenko, Dmitry [The Children' s Hospital of Philadelphia, Division of Body Imaging, Department of Radiology, Philadelphia, PA (United States); Back, Susan J.; Darge, Kassa [The Children' s Hospital of Philadelphia, Division of Body Imaging, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); Tasian, Gregory E. [University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); The Children' s Hospital of Philadelphia, Division of Urology, Department of Surgery, Philadelphia, PA (United States); Dillman, Jonathan R. [Cincinnati Children' s Hospital Medical Center, Division of Thoracoabdominal Imaging, Department of Radiology, Cincinnati, OH (United States)

2017-12-15

Renal fusion is on a spectrum of congenital abnormalities that occur due to disruption of the migration process of the embryonic kidneys from the pelvis to the retroperitoneal renal fossae. Clinically, renal fusion anomalies are often found incidentally and associated with increased risk for complications, such as urinary tract obstruction, infection and urolithiasis. These anomalies are most commonly imaged using ultrasound for anatomical definition and less frequently using renal scintigraphy to quantify differential renal function and assess urinary tract drainage. Functional magnetic resonance urography (fMRU) is an advanced imaging technique that combines the excellent soft-tissue contrast of conventional magnetic resonance (MR) images with the quantitative assessment based on contrast medium uptake and excretion kinetics to provide information on renal function and drainage. fMRU has been shown to be clinically useful in evaluating a number of urological conditions. A highly sensitive and radiation-free imaging modality, fMRU can provide detailed morphological and functional information that can facilitate conservative and/or surgical management of children with renal fusion anomalies. This paper reviews the embryological basis of the different types of renal fusion anomalies, their imaging appearances at fMRU, complications associated with fusion anomalies, and the important role of fMRU in diagnosing and managing children with these anomalies. (orig.)

Liver scintigraphy

International Nuclear Information System (INIS)

Tateno, Yukio

1996-01-01

Liver scintigraphy can be classified into 3 major categories according to the properties of the radiopharmaceuticals used, i.e., methods using radiopharmaceuticals which are (1) incorporated by hepatocytes, (2) taken up by reticulo endothelial cells, and (3) distributed in the blood pool of the liver. Of these three categories, the liver scintigraphy of the present research falls into category 2. Radiopharmaceuticals which are taken up by endothelial cells include 198 Au colloids and 99m Tc-labelled colloids. Liver scintigraphy takes advantage of the property by which colloidal microparticles are phagocytosed by Kupffer cells, and reflect the distribution of endothelial cells and the intensity of their phagocytic capacity. This examination is indicated in the following situations: (i) when you suspect a localized intrahepatic lesion (tumour, abscess, cyst, etc.), (ii) when you want to follow the course of therapy of a localized lesion, (iii) when you suspect liver cirrhosis, (iv) when you want to know the severity of liver cirrhosis or hepatitis, (v) when there is hepatomegaly and you want to determine the morphology of the liver, (vi) differential diagnosis of upper abdominal masses, and (vii) when there are abnormalities of the right diaphragm and you want to know their relation to the liver

Fanconi's syndrome, interstitial fibrosis and renal failure by aristolochic acid in Chinese herbs.

Science.gov (United States)

Hong, Yin-Tai; Fu, Lin-Shien; Chung, Lin-Huei; Hung, Shien-Chung; Huang, Yi-Ting; Chi, Chin-Shiang

2006-04-01

Aristolochic acid-associated nephropathy (AAN) has been identified as a separate entity of progressive tubulo-interstitial nephropathy. Its characteristic pathological findings, including hypocellular interstitial fibrosis, intimal thickening of interlobular and afferent arterioles with glomeruli sparing or mild sclerosis, have been identified. Many cases of AAN in adults have been reported in Taiwan as well as throughout the world, but it has seldom been described in children. We report on a 10-year-old boy who presented with severe anemia, Fanconi's syndrome, and progressive renal failure. Renal biopsy revealed typical findings of AAN. Aristolochic acids I and II were identified from a Chinese herb mixture ingested by the boy. AAN was diagnosed after other etiologies had been excluded. The case demonstrates the hazards of Chinese herbs with regard to children's health in Taiwan and suggests that more attention should be paid to this issue.

Clinical evaluation of scintigraphy for malignant tumors in children

International Nuclear Information System (INIS)

Ishii, Katsumi; Aso, Koichi; Yamada, Nobuaki; Horiike, Shigeharu; Matsubayashi, Takashi

1982-01-01

X-ray study, Computed tomography, Echography and Scintigraphy are chosen to draw visual images of malignant tumors in children. To obtain higher diagnostic sensitivity, we recommend that 67-Ga-scintigraphy and other different scitigraphy for organs are performed on each child suspected of having malignant tumor. 67-Ga does not have accurate sensitivity for neuroblastoma, but bone scintigraphy with 99m-Tc-labelled phosphate complexes detects neuroblastoma as a positive image. 67-Ga scintigraphy and other different radiopharmaceutical scintigraphy should be used for primary visualization and control of malignant tumor in children. Serial scintigraphy at proper intervals are very effective to detect local recurrence and metastasis of malignant tumors. (author)

Pacing and the non-invasive evaluation of myocardial fatty acid metabolism by means of 17-123I-heptadecanoic acid scintigraphy

International Nuclear Information System (INIS)

Duwel, C.M.B.; Visser, F.C.; Eenige, M.J. van; Roos, J.P.; Roos, J.C.

1988-01-01

The extent of myocardial non-esterified fatty acid (NEFA) oxidation depends among other things on exogeneous NEFA supply and energy demand. In 6 patients with a multi-programmable pacemaker scintigraphy with 17- 123 Iodo-heptadecanoic acid (17- 123 I-HDA) was performed to investigate NEFA metabolism at two levels: at a control level (basal heart rate 69±6) and at increased pace frequency (104±5). In both situations the derived time-activity curves, measured during a period of 75 min, were fitted with a monoexponential plus a constant curve: A(t) = A(0).exp (-t In2/T1/2)+C. The half-time value, the uptake measured as the peak activity and the relative size of the oxidation pool were determined. The median of the half-time value did not change: 24 min (range 19-31) in the control heart rate study and 22 min (19-27) during the increased pace frequency study. The median of the uptake increased significantly from 33 cpm/pixel/2 mCi/100 kg (23-34) to 40 cpm/pixel/2 mCi/100 kg (35-42; p 123 I-HDA. This result suggests that radioiodinated NEFA may be a valuable tool to quantify non-invasively the level of the myocardial NEFA metabolism in the human heart. (orig.) [de

Significance of thymic scintigraphy

International Nuclear Information System (INIS)

Baba, Hiromi; Oshiumi, Yoshihiko; Nakayama, Chikashi; Morita, Kazunori; Koga, Ichinari

1978-01-01

Thymic scintigraphy by 67 Ga-citrate and 75 Se-methionine was done on 6 cases of thymoma, and 5 cases of myasthenia gravis. Scan was positive on 5 of 6 cases of thymoma. All patients with malignant thymoma were positive. Among the 7 cases of myasthenia gravis, scintigrams revealed 2 thymomas and 1 hyperplasia on whom no thymic mass suspected. Thymic scintigraphy is useful examination when dealing with myasthenia gravis. (auth.)

Role of mitochondrial permeability transition in human renal tubular epithelial cell death induced by aristolochic acid

International Nuclear Information System (INIS)

Qi Xinming; Cai Yan; Gong Likun; Liu Linlin; Chen Fangping; Xiao Ying; Wu Xiongfei; Li Yan; Xue Xiang; Ren Jin

2007-01-01

Aristolochic acid (AA), a natural nephrotoxin and carcinogen, can induce a progressive tubulointerstitial nephropathy. However, the mechanism by which AA causes renal injury remains largely unknown. Here we reported that the mitochondrial permeability transition (MPT) plays an important role in the renal injury induced by aristolochic acid I (AAI). We found that in the presence of Ca 2+ , AAI caused mitochondrial swelling, leakage of Ca 2+ , membrane depolarization, and release of cytochrome c in isolated kidney mitochondria. These alterations were suppressed by cyclosporin A (CsA), an agent known to inhibit MPT. Culture of HK-2 cell, a human renal tubular epithelial cell line for 24 h with AAI caused a decrease in cellular ATP, mitochondrial membrane depolarization, cytochrome c release, and increase of caspase 3 activity. These toxic effects of AAI were attenuated by CsA and bongkrekic acid (BA), another specific MPT inhibitor. Furthermore, AAI greatly inhibited the activity of mitochondrial adenine nucleotide translocator (ANT) in isolated mitochondria. We suggested that ANT may mediate, at least in part, the AAI-induced MPT. Taken together, these results suggested that MPT plays a critical role in the pathogenesis of HK-2 cell injury induced by AAI and implied that MPT might contribute to human nephrotoxicity of aristolochic acid

Chronic renal failure due to unilateral renal agenesis and total renal dysplasia (=aplasia)

International Nuclear Information System (INIS)

Kroepelin, T.; Ziupa, J.; Wimmer, B.

1983-01-01

Three adult patients with unilateral renal agenesis/total dysplasia (= aplasia) and with an early chronic renal failure are presented. One patient had renal agenesis without ureter bud and ureteric ostium on one side, and reflux pyelonephritis on the other; one had small compact total renal dysplasia (= aplasia) on one side, while chronic uric acid nephropathy (chronic renal disease as a cause of gout) was diagnosed on the other; the third patient had a total large multicystic dysplasia on one side, and on the other a segmental large multicystic dysplasia. Radiological steps and radiodiagnostic criteria are discussed and the combination of urogenital and extraurogenital anomalies is referred to. (orig.)

Osteodystrophy in liver cirrhosis. Its demonstration by 99m Tc methylene diphosphonate bone scintigraphy

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Sezai, Shu-ichi; Ishizawa, Suguru; Yoshino, Katsumasa

1987-10-01

In order to investigate the osteodystrophy in liver cirrhosis, 21 liver cirrhotic patients having no malignancy and normal renal function were examined by 99m Tc Methylene Diphosphonate (MDP) bone scintigraphy. The cirrhotic subjects consisted of 14 males and 7 females. Their age was 31 - 80, average 55.7 years. The causes of their cirrhotic damage were 1 primary biliary cirrhosis, 9 alcoholic, 2 HB viral and 9 cryptogenic. The contents of their illness showed 9 cases in A, 4 in B and 8 in C of Child's classification. Abnormal hot spot(s) on bone in the cirrhotics could be observed very frequently in 99m Tc MDP bone scintigraphy (47.6 %; 10/21 cases). Those spots were seen more frequently in female and advanced stage of cirrhosis. The number of spot(s) increased also in advanced liver cirrhosis. Serum Ca, P and PTH were in normal range. All of three vitamin D/sub 3/ fractions decreased and especially 1,25 (OH)/sub 2/D/sub 3/ was depressed more in scinti-positive cases. Metacarpal bone X-p with an alumimum step wedge as a reference was analyzed by a microdensitometry (MD) method (Inoue T et al) and the pattern of osteopathy (i.e. porosis, malacia and poromalacia) was examined according to Sumi Y et al. MD method was not known yet if there was any definite correlation with bone scintigraphy and the osteopathic pattern belonged to border categories. In conclusion, more attension on hepatic osteodystrophy will be significantly necessary due to the fact that it has been found very frequently in liver cirrhosis. 99m Tc MDP bone scintigraphy is a good means for detection of the hepatic osteodystrophy.

Hepatobiliary scintigraphy

International Nuclear Information System (INIS)

Velchik, M.G.

1988-01-01

This chapter describes the role of nuclear medicine in the evaluation of the hepatobiliary system. The technical aspects of hepatobiliary scintigraphy, or cholescintigraphy (radiopharmaceutical, radiation dosimetry, instrumentation, and method) are briefly presented, followed by a discussion of each of the indications for such examination. Its relative advantages and disadvantages with respect to alternative radiographic examinations are emphasized. Logical, efficient, cost-effective sequences of diagnostic studies are recommended whenever appropriate in order to derive the maximum information with the least time and expense. It is hoped that the reader will come away with an appreciation of the type of diagnostic information provided by hepatobiliary scintigraphy, its accuracy, its application in the workup of the patient with hepatobiliary disease, and its strengths and limitations compared with other radiologic studies

Effect of a reduction in uric acid on renal outcomes during losartan treatment

DEFF Research Database (Denmark)

Miao, Yan; Ottenbros, Stefan A; Laverman, Goos D

2011-01-01

Emerging data show that increased serum uric acid (SUA) concentration is an independent risk factor for end-stage renal disease. Treatment with the antihypertensive drug losartan lowers SUA. Whether reductions in SUA during losartan therapy are associated with renoprotection is unclear. We...

Indications for scintigraphy with 67Ga

International Nuclear Information System (INIS)

Plechl, S.C.; Berges, G.; Blut, J.; Bohle, H.; Gessat, C.; Hethey, B.; Linneborn, G.; Ostermann, W.; Prack, G.; Scheitza, B.

1976-01-01

The validity and exactness of 67 Ga scintigraphy was tested in more than 70 patients by a comparison with clinical, radiological and histological findings as well as with scintigraphs obtained with other nuclides. It was found that 67 Ga scintigraphy is a good and often even a vital supplementation to the other methods. Its main field of application, according to the authors' obervations, is the differential diagnosis of three-dimensional changes in the thorax region, in particular the diagnosis of malignant tumours of the lungs in combination with X-ray examinations. Furthermore, 67 Ga may be of use in localization diagnoses of non-malignant changes, e.g. abscesses. 67 Ga scintigraphy, which is non-hazardous and does not involve discomfort to the patients, appears to be particularly useful for course control after surgical treatment of breast cancer and for early diagnoses of metastases, provided that examination starts early enough and is repeated at regular intervals, not only in the soft parts but also in the skeleton. The question whether 67 Ga scintigraphy may be a substitute for scintigraphy with other nuclides in these fields still remains to be solved. (orig.) [de

Esophageal scintigraphy: A comparison with esophagoscopy

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Kjellen, G.; Andersson, P.; Sandstroem, S.

1987-01-01

Fifty consecutive patients with different esophageal symtoms were investigated with esophageal endoscopy, transit scintigraphy, and gastroesophageal (GE) scintigraphy with extra-abdominal compression. Scintigraphic findings were abnormal in 27 of those 31 patients (87%) who were classified as abnormal at endoscopy. A prolonged transit time was the commonest finding, but hiatal hernia and GE reflux were also found. However, the scintigraphic procedure showed abnormalities in 6 of 19 (31%) patients who were classified as normal at endoscopy. Esophageal scintigraphy is recommended as a screening test before endoscopy is decided on. 20 refs.

Myocardial scintigraphy

International Nuclear Information System (INIS)

Bunko, Hisashi; Hisada, Kinichi

1982-01-01

Among the various methods of image diagnosis of the cardiovascular disorder, nuclear cardiology provides noninvasive means for evaluation of myocardial perfusion as well as morphological and functional informations. In this article, clinical application and image diagnosis of myocardial scintigraphy including Tl-201 myocardial perfusion scintigraphy, single photon emission computed tomography with Tl-201, acute myocardial infarction scintigraphy with Tc-99m-pyrophosphate and Ga-67 imaging of the heart, were discussed. Multiplanar imaging of the heart with Tl-201 after stress and at redistribution was the accepted method for detection and evaluation of the ischemic heart disease. Although it achieved high sensitivity and specificity for ischemic heart disease, detection of the small ischemia and quantation of the regional Tl-201 accumulation were difficult with conventional multiplanar imaging. Application of emission computed tomography improved detectability and quantitativity of the ischemia. However, 7-pinhole tomography did not increase the diagnostic accuracy significantly. It had limited clinical applicability due to poor quantitativity in spite of improved image contrast and its tomographic nature. Advantage and limitation of these tomographic imaging and multiplanar imaging were discussed. Problems and prognostic significance of pyrophosphate imaging of the acute myocardial infarction were also discussed. Visualization of the heart with Ga-67 was helpful for identification of the tumor or inflammation of the heart as well as evaluation of the effect of the therapy. (author)

Use of Contrast-Enhanced Ultrasound to Study Relationship between Serum Uric Acid and Renal Microvascular Perfusion in Diabetic Kidney Disease

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Ling Wang

2015-01-01

Full Text Available Purpose. To investigate the relationship between uric acid and renal microvascular perfusion in diabetic kidney disease (DKD using contrast-enhanced ultrasound (CEUS method. Materials and Methods. 79 DKD patients and 26 healthy volunteers were enrolled. Renal function and urine protein markers were tested. DKD patients were subdivided into two groups including a normal serum uric acid (SUA group and a high SUA group. Contrast-enhanced ultrasound (CEUS was performed, and low acoustic power contrast-specific imaging was used for quantitative analysis. Results. Normal controls (NCs had the highest levels of AUC, AUC1, and AUC2. Compared to the normal SUA DKD group, high SUA DKD patients had significantly higher IMAX, AUC, and AUC1 (P<0.05. DKD patients with low urinary uric acid (UUA excretion had significantly higher AUC2 compared to DKD patients with normal UUA (P<0.05. Conclusion. Hyperuricemia in DKD patients was associated with a renal ultrasound image suggestive of microvascular hyperperfusion. The CEUS parameter AUC1 holds promise as an indicator for renal microvascular hyperperfusion, while AUC2 might be a useful indicator of declining glomerular filtration rate in DKD patients with decreased excretion of uric acid.

Multidetector spiral CT renal angiography in the diagnosis of renal artery fibromuscular dysplasia

International Nuclear Information System (INIS)

Sabharwal, Rohan; Vladica, Philip; Coleman, Patrick

2007-01-01

Objective: The aim of this study was to evaluate the role and detection rate of multidetector spiral CT renal angiography (CTA) as compared with conventional angiography (CA), the commonly accepted gold standard, in the diagnosis of renal artery fibromuscular dysplasia (FMD). In addition, the role of CTA reconstructions (multiplanar reformatted images (MPR), maximum intensity projections (MIP) and shaded-surface display (SSD)) in the detection of FMD was also evaluated. Materials and methods: CTA results were retrospectively reviewed in 21 hypertensive patients with CA-proven FMD. Clinical indications for referral included resistant hypertension (requiring greater than three antihypertensive medications), labile hypertension, hypertension in combination with renal impairment and the presence of abdominal bruits in the context of systemic hypertension. In some cases, these clinical indications were supplemented by positive results in other tests, including plasma renin assay, captopril scintigraphy and/or Doppler ultrasound. The findings of CA in these 21 patients were compared to CTA. Results: Mean patient age was 62.33 + 14.32 years (range 24-85 years). CTA identified all 42 main renal arteries (100%) and all 10 accessory renal arteries (100%) visualized on CA. In the diagnosis of FMD, CTA detected all 40 (100%) lesions detected by CA. No single CTA reconstruction technique was able to detect all lesions noted on corresponding CA, however, upon review of all CTA reconstructions (MPR, MIP and SSD) in each case, every lesion was correctly identified by CTA. Conclusion: Our experience suggests that CTA is a non-invasive, reliable and accurate method for the diagnosis of renal artery fibromuscular dysplasia. Moreover, in our experience CTA has many advantages as a diagnostic screening tool over CA, including accessibility, speed, lower complication profile, versatility and cost-effectiveness. CTA shows great potential as a guiding tool for directing subsequent

Usefulness of parametric renal clearance images in the assessment of basic risk factors for renalnal clearance images in the assessment of basic risk factors for renal scarring in children with recurrent urinary tract infections.

Science.gov (United States)

Pietrzak-Stelasiak, Ewa; Bieńkiewicz, Małgorzata; Woźnicki, Wojciech; Bubińska, Krystyna; Kowalewska-Pietrzak, Magdalena; Płachcińska, Anna; Kuśmierek, Jacek

2017-01-01

Clinically confirmed incidents of acute pyelonephritis (APN) following recurrent infections of urinary tract (UTI) form basic risk factors for renal scarring in children. Vesico-uretheral reflux (VUR) of higher grade is additional risk factor for this scarring. Opinions on diagnostic value of summed sequential images of renal uptake phase (SUM) of dynamic renal scintigraphy in detection of renal scars are diverse. However, several publications point to higher diagnostic efficacy of clearance parametric images (PAR) generated from this study. To establish a clinical value of parametric renal clearance images in detection of renal scarring. A prospective study was performed in a group of 91 children at the age of 4 to 18 years with recurrent UTI. Clinically documented incidents of APN were noted in 32 children: in 8 cases - one and in the remaining 24 - 2 to 5 (mean 3) incidents. In the remaining 59 patients only infections of the lower part of urinary tract were diagnosed. Static renal 99mTc-DMSA SPECT study and after 2-4 days dynamic renal studies (99mTc-EC) were performed in every patient not earlier than 6 months after the last documented incident of UTI. PAR images generated from a dynamic study by in-house developed software and SUM images were compared with a gold standard SPECT study. Percentages of children with detected renal scar(s) with SPECT and PAR methods amounted to 55% and 54%, respectively and were statistically significantly higher (p children with history of APN detected with SPECT and PAR methods were significantly more frequent than with infections of only lower part of urinary tract (72% vs. 46%; p = 0.017 and 69% vs. 46%; p = 0.036, respectively). A SUM method did not reveal statistically significant differences between frequencies of detection of scars in groups specified above - 38% vs. 27% (p = 0.31). Both SPECT and PAR methods showed also that frequencies of occurrence of renal scars in children with higher grades of VUR were higher than

[Surgical model of chronic renal failure: study in rabbits].

Science.gov (United States)

Costa, Andrei Ferreira Nicolau da; Pereira, Lara de Paula Miranda; Ferreira, Manoel Luiz; Silva, Paulo Cesar; Chagar, Vera Lucia Antunes; Schanaider, Alberto

2009-02-01

To establish a model of chronic renal failure in rabbits, with perspectives of its use for therapeutic and repairing actions. Nineteen males, adults rabbits (New Zealand) randomly distributed into three groups were used: Group 1 - Control (n =5); Group 2-Sham (n =7); and Group 3 - Experimental (n =7). They were anaesthetized by using intramuscular Cetamine, Diazepam and Fentanyl followed by Sevorane with vaporizer device. In Group 3, a bipolar left nephrectomy was carried out and after four weeks, it was also done a right nephrectomy. All the samples of the renal tissue were weighed. The Group 2 was only submitted to both abdominal laparotomies, without nephrectomy. Biochemical evaluations, with urea, creatinina, sodium and potassium measurement; abdominal ultrasound scan; scintigraphy and histological analysis were performed in all animals. In group 3 there was a progressive increase of urea (p=0.0001), creatinine (p=0.0001), sodium (p = 0,0002) and potassium (p=0,0003). The comparison of these results with those one of the Groups 1 and 2, in all intervals, revealed blood rising with statistical significant level (p < 0,05). In Group 3, the ultrasound scan identified an increasing of the left kidney size, after 16 weeks and at the 4th week the scintigraphy confirmed the loss of 75% of the left renal mass. In the same group, the histological evaluation showed subcapsular and intersticial fibrosis and also tubular regeneration. The experimental model of IRC is feasible, with animal's survival in middle term which allows the use of this interval like a therapeutic window for testing different approaches in order to repair the kidney damages.

Contribution of kidneys scintigraphy in etiologic anuria diagnosis of the kidneys transplanted person in the first month post graft. Apport de la scintigraphie renale dans le diagnostic etiologique de l'anurie du transplante renal dans le premier mois post greffe

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Pouteil-Noble, C.; Yatim, A.; Najem, R.; Colon, S.; Peyrin, J.O.; Touraine, J.L. (Hopital Edouard-Herriot, 69 - Lyon (France))

1992-12-01

The quickness of the response, the non traumatic character, the absence of contrast product injection and the repeatability of the kidney scintigraphy make of this investigation, a chosen and emergency examination in the etiologic diagnosis of the kidney transplanted person in the first month post transplantation. 9 refs.

Scintigraphy of the heart using sup(99m)Tc diphosphonate in combination with selective coronary perfusion scintigraphy and coronaroangiography

International Nuclear Information System (INIS)

Neumann, G.; Trenckmann, H.; Duck, H.J.; Katzschmann, R.; Neugebauerova, A.; Schneider, G.; Gottschild, D.

1980-01-01

In 45 patients with ischemic heart disease the results obtained by myocardial scintigraphy using technetium-99m diphosphonate (Tc-99m-DP) were compared with those obtained at selective coronary angiography and selective coronary perfusion scintigraphy. The cumulation of activity in the heart muscle was seen in twelve patients. This group is analyzed in the present paper in more detail. The ventriculographic examination of the left ventricle showed disturbed motility of the wall in six patients, of whom five had a positive myocardial scintigram. In view of this, myocardial scintigraphy using Tc-99m-DP may be considered a complementary, non-invasive method for proving significant disturbances of the motility of the heart wall. Positive myocardial scintigrams were also found in angna pectoris, in a patient after aorto-coronary bypass, in cardiomyopathy and myocarditis. In view of the fact that myocardial scintigraphy using Tc-99m-DP is capable of proving disturbances of cells of the heart muscle taking place at the moment, conclusions can be drawn as to the activity in the heart muscle. It further follows that myocardial scintigraphy may be significant in indicating the aorto-coronary bypass. We failed to prove an unequivocal correlation between myocardial scintigraphy, the number of sclerotically changed coronary vessels and the degree of their narrowing. An immediate relationship could not be proved between the extent of perfusion disturbance and the results of myocardial scintigraphy

Relationship between evaluation by quantitative fatty acid myocardial scintigraphy and response to {beta}-blockade therapy in patients with dilated cardiomyopathy

Energy Technology Data Exchange (ETDEWEB)

Ito, Tatsuo; Hoshida, Shiro; Nishino, Masami; Aoi, Toshiyuki; Egami, Yasuyuki; Takeda, Toshihiro; Kawabata, Masayoshi; Tanouchi, Jun; Yamada, Yoshio; Kamada, Takenobu [Div. of Cardiology, Osaka Rosai Hospital (Japan)

2001-12-01

Predicting the effect of {beta}-blockade therapy on the clinical outcome of patients with dilated cardiomyopathy (DCM) is difficult prior to the initiation of therapy. Myocardial fatty acid metabolism has been shown to be impaired in patients with DCM. We examined whether the extent of myocardial injury, as assessed by iodine-123 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) myocardial scintigraphy, is related to the response of patients with DCM to {beta}-blockade therapy. Thirty-seven patients with DCM were examined using BMIPP myocardial scintigraphy before and after 6 months of treatment with metoprolol. Myocardial BMIPP uptake (%BM uptake) was estimated quantitatively as a percentage of the total injected count ratio. The left ventricular end-diastolic and end-systolic dimensions (LVDd, LVDs) and ejection fraction (LVEF) were also evaluated. The patients were divided into two groups according to their functional improvement (>10% elevation of LVEF) after 6 months of metoprolol therapy. Twenty-eight patients responded to the therapy, while nine did not. Prior to the therapy, no significant differences in LVDd, LVDs or LVEF were observed between the responders and non-responders. However, the %BM uptake was significantly lower in the non-responders than in the responders (1.0%{+-}0.2% vs 2.1%{+-}0.5%, P<0.001). The %BM uptake could be used to distinguish the responders from the non-responders with a sensitivity of 0.93 and a specificity of 1.00 at a threshold value of 1.4. After the metoprolol therapy, the %BM uptake improved significantly in the responders (2.5%{+-}0.5%, P<0.01) but did not change in the non-responders. These results indicate that myocardial BMIPP uptake could predict the response of DCM patients to {beta}-blockade therapy. (orig.)

Assessment of β-methyl iodophenyl pentadecanoic acid myocardial scintigraphy in patients with chronic pulmonary diseases

International Nuclear Information System (INIS)

Matsumoto, Hiroyuki; Takeuchi, Katsuro; Ogasa, Tomoyuki

1999-01-01

The purpose of this study was to determine whether impaired fatty acid metabolism occurs in the right ventricle of patients with chronic pulmonary diseases (TB sequelae, TB seq.: 8, and chronic pulmonary emphysema, CPE: 14). 123 I-BMIPP myocardial scintigraphy was performed on 22 subjects. The RV-BMIPP index (ratio of radioactivity in the right ventricle to that in the upper mediastinum), LV-BMIPP index (ratio of radioactivity in the left ventricle to that in the upper mediastinum), and RVc/LVc (ratio of radioactivity in the right ventricle to that in the left ventricle) were calculated to compare the distribution of radioactivity in the right and left ventricles. We also examined the correlations between these parameters and parameters of blood gas analysis and pulmonary hemodynamics. The RV-BMIPP index, LV-BMIPP index, and RVc/LVc were elevated in the TB seq. and CPE patient groups compared to the control group. The RV-BMIPP and LV-BMIPP indices demonstrated significant, negative correlations with PaO 2 ; also a significant positive correlation was observed between the RV-BMIPP index and mean pulmonary arterial pressure. On the other hand, no significant correlation was found between the LV-BMIPP index and mean pulmonary arterial pressure. In the arm-stretching test under right heart catheterization, the RV-BMIPP and LV-BMIPP indices demonstrated significant, positive correlations with the cardiac index during exercise. These results suggest that hypoxemia accelerates fatty acid metabolism in the myocardium, and that local pressure overloading accelerates fatty acid metabolism in the right ventricle. Anomalies of fatty acid metabolism in the right ventricle may appear in patients with chronic pulmonary disease, and could be an adaptation to hypoxemia and overload, not an impairment. (author)

Clinical evaluation of sup 123 I-BMIPP myocardial scintigraphy in patients with hypertrophic cardiomyopathy

Energy Technology Data Exchange (ETDEWEB)

Ohtsuki, Katsuichi; Sugihara, Hiroki; Umamoto, Ikuo (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

1992-02-01

{sup 123}I-{beta}-methyl-p-iodophenylpentadecanoic acid ({sup 123}I-BMIPP) myocardial scintigraphy was performed in 13 patients with hypertrophic cardiomyopathy and compared with {sup 201}Tl myocardial scintigraphy performed within 3 months for evaluating the clinical significance of {sup 123}I-BMIPP myocardial scintigraphy. SPECT images were divided into 13 segments and segmental images were visually scored on a 4 (increased tracer uptake) to 0 (severely decreased tracer uptake) scale according to the tracer uptake. In comparison of {sup 123}I-BMIPP early images and {sup 201}Tl perfusion images, mismatches were seen in about 70% of all segments. The number of segments demonstrating lower myocardial uptake of {sup 123}I-BMIPP was larger than that of {sup 201}Tl. In hypertrophic regions, the tracer uptake of {sup 123}I-BMIPP early images was significantly lower than that of {sup 201}Tl images and the lower uptake of {sup 123}I-BMIPP delayed images was more marked. In non-hypertrophic regions, no significant difference was seen between the tracer uptakes of {sup 123}I-BMIPP early images and {sup 201}Tl images but the tracer uptake of {sup 123}I-BMIPP delayed images was significantly lower than that of {sup 201}Tl images. The mismatch between the tracer uptakes of {sup 123}I-BMIPP images and {sup 201}Tl images was thought to be a reflection of disordered myocardial fatty acid metabolism. 'Washout', the difference between the tracer uptakes of {sup 123}I-BMIPP early images and delayed images was also thought to be a reflection of disordered myocardial fatty acid metabolism. These results suggest that {sup 123}I-BMIPP is a promising radiopharmaceutical for evaluating disordered myocardial fatty acid metabolism in patients with HCM. (author).

Dynamic Contrast-Enhanced MR Imaging of Renal Ischemia-Reperfusion Injury

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Baik, Jun Hyun; Ahn, Myeong Im; Park, Young Ha; Chung, Soo Kyo [Catholic University, Seoul (Korea, Republic of)

2010-02-15

To evaluate the usefulness of magnetic resonance imaging (MRI) in a renal ischemia-reperfusion injury. Twenty-four rabbits were randomly divided into four groups, including a sham operated group (n=3). Renal ischemia was induced for 30 minutes (group 1), 60 minutes (group 2) and 120 minutes (group 3). MR imaging was performed before ischemia as well as one hour, 24 hours, and 72 hours after reperfusion. A 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy was performed before ischemia, as well as 24 hours and 72 hours after reperfusion. The signal-to-noise ratio (SNR) on the T2WI, time-relative signal intensity (%RSI) curve on dynamic enhanced images, and relative left renal uptake (%) on DMSA scan were obtained and compared to the histologic findings. The SNR of the cortex on the T2WI changed significantly over the course of the reperfusion time (p<0.001), but was not significantly different among the ischemia groups. The area under the time-%RSI curve gradually decreased from cortex to inner medulla before ischemia, which was reversed and gradually increased after reperfusion. The areas under the time-%RSI curve of outer and inner medulla were significantly different among the ischemia groups (p=0.04, p=0.008). The relative renal uptake (%) of left kidney decreased significantly over the reperfusion time (p=0.03), and was also significantly different among the ischemia groups (p=0.005). Tubular cell necrosis was observed in 16 rabbits (76.2%). The histologic grades of group 3 were higher than those of group 1 and group 2 (p=0.002). Even in rabbits without tubular cell necrosis, the areas under the time-%RSI curves of the cortex, outer, and inner medulla after a 72 hour reperfusion time were significantly lower than those before ischemia (p=0.007, p=0.005, p=0.004). The results of this study suggest that dynamic enhanced MR imaging could be a useful tool for the evaluation of renal ischemia and reperfusion injury.

Contrast-enhanced dynamic MR nephrography using the TurboFLASH navigator-gating technique in children

International Nuclear Information System (INIS)

Boss, Andreas; Schaefer, Juergen F.; Claussen, Claus D.; Kueper, Klaus; Schlemmer, Heinz-Peter; Martirosian, Petros; Schick, Fritz; Hacker, Hans-Walter; Darge, Kassa

2006-01-01

The purpose of this work was to test the feasibility of an MR examination protocol for the comprehensive assessment of renal morphology, excretion and split renal function using a navigator-gated TurboFLASH sequence. A navigator-gated T1-weighted single-slice TurboFLASH sequence suitable for dynamic MR urography and nephrography was implemented. A protocol was developed allowing for assessment of urinary excretion and split renal function by recording the renal clearance of a gadolinium (Gd) diethylene-triamine-pentacetic-acid (DTPA) bolus. Ten patients aged between 14 months and 14 years (mean age 4.8±4.6 years) were evaluated with the following indications: pelvicalyceal dilatation (n=4), follow-up after pyeloplasty (n=1), duplex systems (n=3), large renal cyst (n=1), and renal insufficiency (n=1). Dynamic MR urography and MR split renal function were compared to MAG3 scintigraphy. Evaluation of morphology, excretion and function required 50-60 minutes examination time, plus 10 minutes for post-processing. The TurboFLASH sequence yielded image acquisition at nearly identical diaphragm positions allowing for accurate region-of-interest evaluation within the renal parenchyma and the urinary passage. Static and dynamic MR urography showed the morphology of the urinary tract and excretion with sufficient diagnostic imaging quality, and the results were in diagnostic compliance with scintigraphy. MRI and scintigraphy yielded similar results for split renal function with a correlation coefficient of R=0.968 determined by linear regression. Our conclusions were that the method is robust, easy to perform on a clinical 1.5 T MRI system, rapid to evaluate and post-process and, therefore, easy to incorporate into clinical routine. Compared to scintigraphy, the higher spatial resolution of the MR examination provides additional important information improving the management of the pediatric patients without the application of radioactive tracers. (orig.)

Recent advances in gastric emptying scintigraphy

International Nuclear Information System (INIS)

Urbain, J.L.C.; Mayeur, S.M.

1996-01-01

Gastric emptying scintigraphy was introduced more than 25 years ago by Grittith and still remains the gold standard to assess gastric emptying. Test meals, radiopharmaceuticals and acquisition procedures have been refined and optimized over the years and the test procedure is now pretty well standardized. However, in its most common use, gastric emptying scintigraphy provides little information on gastric physiology. Over the last decade, modelling of the liquid and solid emptying curves have brought some insight in the complex gastric physiology. Compartmental analysis of the stomach has also provided information on the pathophysiological mechanisms of delayed gastric emptying. Over the past 5 years, the most dramatic development in gastric emptying scintigraphy has been the introduction of Digital Antral Scintigraphy (DAS). Digital Antral scintigraphy basically consists in dynamically imaging of the stomach and the use of a refined Fourier transform processing method. This new procedure allows for the visualization of antral contractions and, alike manometry, permits quantitative characterization on the frequency and amplitude of these contractions. Overall, this new procedure provides a unique, non invasive tool to characterize gastric motility, to define the pathophysiologic mechanisms of gastric motor disorders and to evaluate the effect of new gastro-kinetic compounds. (authors). 241 refs., 5 figs

A parathyroid scintigraphy case study

International Nuclear Information System (INIS)

O'Leary, Desiree

2005-01-01

Background: There has been much debate concerning the most suitable protocol for parathyroid scintigraphy; the merits of various radiopharmaceuticals versus the correct imaging protocol to visualise both ectopic and anatomically placed adenomas against the various equipment choices have been debated. Aim: To demonstrate, through the use of a case study, the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion. Method: Use is made of Tc99mMIBI, full field chest scintigraphy, a clearly defined imaging protocol and SPECT imaging to locate ectopic parathyroid tissue in a female patient with significant symptoms of parathyroid hyperfunction. Results: A single hyperfunctioning adenoma is located in the pre-carinal area of the mediastinum. Using a radioguided surgical technique the hyperfunctioning tissue is excised and confirmed by histopathology. Conclusion: Whilst a dramatic reduction in patient symptoms was not seen immediately in this patient, the symptoms of the illness have been subsiding since January 2003. This case study demonstrates the necessity of changing imaging protocols for parathyroid scintigraphy where a definitive imaging diagnosis is absent in the face of strong clinical suspicion

Interaction between cellular retinoic acid-binding protein II and histone hypoacetylation in renal cell carcinoma

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Viroj Wiwanitkit

2008-04-01

Full Text Available Renal cell carcinoma is a rare but serious malignancy. Since a reduction in the level of retinoic acid receptor beta 2 (RARbeta2 expression in cancer cells due in part to histone hypoacetylation which is controlled by histone deacetylase (HD, the study on the interaction between cellular retinoic acid-binding proteins II (CRABP II, which is proposed to have its potential influence on retinoic acid (RA response, and HD can be useful. Comparing to CARBP II and HD, the CARBP II-HD poses the same function and biological process as HD. This can confirm that HD has a significant suppressive effect on the expression of CARBP II. Therefore, reduction in the level of RARbeta2 expression in cancer cells can be expected and this can lead to failure in treatment of renal cell carcinoma with RA. The author hereby purpose that additional HD inhibitor should be added into the regiment of RA to increase the effectiveness of treatment.

Reconsideration of the indication of Ga-67 scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Takanashi, Toshiyasu; Komatani, Akio; Yamaguchi, Koichi (Yamagata Univ. (Japan))

1984-11-01

In order to establish proper indication of Ga-67 scintigraphy, its actual utilization in our hospital was reviewed. Although a large number of Ga-67 scintigraphy over 500 cases a year had been done, the clinical efficacy was found in limited conditions such as small cell carcinoma of the lung, malignant lymphoma, anaplastic carcinoma of the thyroid and abscess. In the other conditions, Ga-67 scintigraphy had little significance clinically and was not effective for seeking metastasis. Based on such situations, we emphasized that the indication of Ga-67 scintigraphy should be more limited under the better understanding of its characteristics.

Improved measurement of the glomerular filtration rate from Tc-99m DTPA scintigraphy in patients following nephrectomy

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Kim, Yong-il; Ha, Seunggyun [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seongnam-si, Gyeonggi-do (Korea, Republic of); So, Young [Konkuk University School of Medicine, Department of Nuclear Medicine, Chungju (Korea, Republic of); Lee, Won Woo [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University, Institute of Radiation Medicine, Medical Research Center, Seoul (Korea, Republic of); Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seongnam-si, Gyeonggi-do (Korea, Republic of); Byun, Seok-Soo [Seoul National University College of Medicine, Department of Urology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kim, Sang Eun [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University, Institute of Radiation Medicine, Medical Research Center, Seoul (Korea, Republic of)

2014-02-15

We aimed to improve Tc-99m DTPA glomerular filtration rate (GFR) scintigraphy (Gates' method) in a prospective study using Cr-51 EDTA GFR test as a gold standard. Fifty-seven Tc-99m DTPA GFR scintigrams in 45 subjects (male/female = 33:12, age = 45.9 ± 17.6 years, 14 healthy volunteers and 31 nephrectomised patients) were compared using Cr-51 EDTA GFR tests. Using the %renal uptake of Tc-99m DTPA and Cr-51 EDTA GFR, a revised equation for GFR was established through linear regression analysis. The revised equation for improved GFR was GFR(mL/min) = (%renal uptake x 11.7773) - 0.7354. Gates' original GFRs (70.1 ± 20.5 mL/min/1.73 m{sup 2}) were significantly lower than Cr-51 EDTA GFRs (97.0 ± 31.9 mL/min/1.73 m{sup 2}; P < 0.0001), but the improved GFRs (98.0 ± 26.3 mL/min/1.73 m{sup 2}) were not different from (P = 0.7360) and had a significant correlation with (r = 0.73, P < 0.0001) the Cr-51 EDTA GFRs. The revised GFR equation effectively demonstrated perioperative GFR changes in kidneys that were operated on and the contralateral kidneys at 3 and 6 months post-partial nephrectomy (n = 25). GFR measurement using Tc-99m DTPA scintigraphy could be significantly improved by a revised equation derived from the comparison with Cr-51 EDTA GFR. (orig.)

Differential diagnosis between secondary hyperparathyroidism and aluminum intoxication in uremic patients: Usefulness of 99mTc-pyrophosphate bone scintigraphy

International Nuclear Information System (INIS)

Kinnaert, P.; Van Hooff, I.; Schoutens, A.

1989-01-01

Forty-one patients in chronic end-stage renal failure and 4 patients with a functioning kidney transplant presented with spontaneous hypercalcemia or intolerance to vitamin D3 sterols and/or oral calcium supplements. Bone iliac crest biopsy with aluminum staining and Tc-pyrophosphate bone scintigraphy with determination of Fogelman score were performed in all cases. Two patients had aluminum-induced osteomalacia (AL O). Thirty-eight biopsies showed renal osteodystrophy (secondary hyperparathyroidism or various combinations of osteitis fibrosa and osteomalacia): 19 with positive staining for aluminum (RO + AL) and 19 without aluminum deposits (RO). The series also comprised 2 cases of pure osteomalacia (OM), 2 cases of osteoporosis (OP), and 1 case of osteoporosis with aluminum accumulation (OP + AL). Mean Fogelman score in RO patients (9.1 +/- 0.3) was significantly higher than in all other categories (5.9 +/- 0.5 for RO + AL, and scores ranging from 0 to 8 in the last 7 patients, p less than 0.01). Patients with massive aluminum accumulation in bone (greater than 75% of the total trabecular surface) showed no or very low uptake of the isotope by the skeleton. Fogelman scores of 9 or higher were always associated with histological secondary hyperparathyroidism. 99m Tc-pyrophosphate bone scintigraphy is helpful to distinguish aluminum intoxication from secondary hyperparathyroidism in uremic patients

Evaluation of renal allograft with 99mTc-mononuclear leukocytes

International Nuclear Information System (INIS)

Souza, S.A.L.; Oliveira, H.S.; Goncalves, R.T.; Pontes, D.S.; Fonseca, L.B.M.; Gutfilen, B.

2002-01-01

Aim: Because kidney biopsy is an invasive procedure that carries a small but significant risk of major complications, a noninvasive test that detects rejection before it is clinically apparent is very much needed. The reversibility of acute rejection is related to the promptness with which treatment is begun. Here we show the evaluation of rejection in the first week post-transplant with 99m Tc-mononuclear leukocyte scintigraphy (99mTc-MLS). Materials and Methods: 70 patients submitted to renal transplant at the Hospital Universitario Clementino Fraga Filho (HUCFF/UFRJ) underwent 99m Tc-MLS at the 1st and 5th post-transplant days. The labeled cells were administered (444MBq) and scans were carried out 3 and 24h post injection. A region of interest (ROI) was drawn at the allograft image and statistics compared between the 3 and 24h images. Percentages above 15% in the 24h image relating to the 3h image were considered abnormal and suspect of rejection. 25 of the 70 patients rejected the renal allograft in the 1st week post-transplant. Results: 99m Tc-MLS has detected rejection in 20 of the 25 patients. Color Doppler was also carried out in all the patients and has detected 16 rejections. Sensitivity and specificity were 80% and 100% for scintigraphy and 64% and 100% for Ultrasound. 99m Tc-MLS is more sensitive in humoral rejection than color Doppler. The latter is better to identify the vascular rejection. Conclusion: In order to evaluate renal allograft and improve the rejection diagnosis the combination of both techniques should be applied. More studies are now in progress

Bone scintigraphy for horses

International Nuclear Information System (INIS)

Jahn, Werner

2010-01-01

Scintigraphy (bone scan) is being used approximately since 1980 in the horse under general anaesthesia. With the construction of custom-made overhead gantries for gamma-cameras scintigraphy found widespread entry in big equine referral hospitals for bone-scanning of the standing horse. Indications for the use of a bone scan in the horse are inflammatory alterations in the locomotor apparatus. It is primarily used for diagnosis of lameness of unknown origin, suspect of stress fracture or hairline fracture and for horses with bad riding comfort with suspected painful lesions in the spine. (orig.)

Safe and effective inhibition of renal uptake of radiolabelled octreotide by a combination of lysine and arginine

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Rolleman, Edgar J.; Valkema, Roelf; Jong, Marion de; Kooij, Peter P.M.; Krenning, Eric P. [Department of Nuclear Medicine, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD Rotterdam (Netherlands)

2003-01-01

As scintigraphy with [{sup 111}In-DTPA{sup 0}]octreotide has become a standard technique in analysing somatostatin receptor-receptor positive lesions such as neuroendocrine tumours, a logical next step is peptide receptor radionuclide therapy (PRRT). Initial studies on PRRT were performed with high doses of [{sup 111}In-DTPA{sup 0}]octreotide, and recently other radionuclides coupled to other somatostatin analogues have been used for this purpose. However, the dose delivered to the kidney is a major dose-limiting factor. Amino acid solutions have previously been used to reduce renal uptake of radioactivity, but these solutions have some disadvantages, i.e. their hyperosmolarity and their propensity to cause vomiting and metabolic changes. In this study we tested various amino acid solutions in patients receiving [{sup 111}In-DTPA{sup 0}]octreotide PRRT in order to assess their safety and their capacity to inhibit the renal uptake of radioactivity. Patients served as their own non-infused control. Renal radioactivity at 24 h following the injection of [{sup 111}In-DTPA{sup 0}]octreotide was inhibited by (1) a commercially available amino acid solution (AA) (21%{+-}14%, P<0.02), (2) by 25 g (17%{+-}9%, P<0.04), 50 g (15%{+-}13%, P<0.04) or 75 g of lysine (44%{+-}11%, P<0.001) and (3) by a combination of 25 g of lysine plus 25 g of arginine (LysArg) (33%{+-}23%, P<0.01). Fluid infusion alone (500, 1,000 or 2,000 ml of saline/glucose) did not change renal uptake of radioactivity. In patients studied with 75 g of lysine (Lys75) and LysArg, serum potassium levels rose significantly. Maximal potassium levels were within the toxic range (6.3, 6.7 and 6.8 mmol/l) in three out of six patients infused with Lys75, whereas with LysArg the highest concentration measured was 6.0 mmol/l. Electrocardiographic analysis did not reveal significant changes in any of the patients. Vomiting occurred in 50% of patients infused with AA, but in only 6% of patients receiving no amino acid

Acid-base transport by the renal proximal tubule.

Science.gov (United States)

Skelton, Lara A; Boron, Walter F; Zhou, Yuehan

2010-01-01

Each day, the kidneys filter 180 L of blood plasma, equating to some 4,300 mmol of the major blood buffer, bicarbonate (HCO3-). The glomerular filtrate enters the lumen of the proximal tubule (PT), and the majority of filtered HCO3- is reclaimed along the early (S1) and convoluted (S2) portions of the PT in a manner coupled to the secretion of H+ into the lumen. The PT also uses the secreted H+ to titrate non-HCO3- buffers in the lumen, in the process creating "new HCO3-" for transport into the blood. Thus, the PT - along with more distal renal segments - is largely responsible for regulating plasma [HCO3-]. In this review we first focus on the milestone discoveries over the past 50+ years that define the mechanism and regulation of acid-base transport by the proximal tubule. Further on in the review, we will summarize research still in progress from our laboratory, work that addresses the problem of how the PT is able to finely adapt to acid-base disturbances by rapidly sensing changes in basolateral levels of HCO3- and CO2 (but not pH), and thereby to exert tight control over the acid-base composition of the blood plasma.

Chemical renal denervation in the rat.

Science.gov (United States)

Consigny, Paul M; Davalian, Dariush; Donn, Rosy; Hu, Jie; Rieser, Matthew; Stolarik, Deanne

2014-02-01

The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose-response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography-mass spectrometry. Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10(-5) M through 10(-2) M paclitaxel. We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel.

Clinical experience of 123I-IMP scintigraphy in detecting vertebral bone metastases of hepatocellular carcinoma. A comparison with bone scintigraphy with 99mTc-MDP

International Nuclear Information System (INIS)

Suto, Y.; Iwamiya, T.; Tanigawa, N.; Shabana, M.; Ohta, Y.

1994-01-01

123 I-IMP and bone scintigraphy with 99m Tc-MDP were consecutively performed in patients with vertebral bone metastases from hepatocellular carcinoma and lumbar spondylosis deformans in a 7-day interval or shorter. The intensity of uptake was compared. Eighteen of the 20 metastatic lesions (90%) were classified as increased uptake areas in 123 I-IMP scintigraphy. MDP-scintigraphy disclosed 16 metastatic lesions (80%), 9 as ''hot'' lesions (56%) and 7 as ''cold'' lesions (44%). 123 I-IMP scintigraphy was negative in all 12 lesions of lumbar spondylosis deformans. Compared to MDP-scintigraphy, 123 I-IMP scintigraphy was more sensitive in detecting vertebral bone metastases of hepatocellular carcinoma with smaller rates of false-positive and false-negative findings. (orig./MG)

Indications for scintigraphy with /sup 67/Ga

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Plechl, S C; Berges, G; Blut, J; Bohle, H; Gessat, C; Hethey, B; Linneborn, G; Ostermann, W; Prack, G; Scheitza, B [Berufsgenossenschaftliche Krankenanstalten Bergmannsheil, Bochum (Germany, F.R.)

1976-06-01

The validity and exactness of /sup 67/Ga scintigraphy was tested in more than 70 patients by a comparison with clinical, radiological and histological findings as well as with scintigraphs obtained with other nuclides. It was found that /sup 67/Ga scintigraphy is a good and often even a vital supplementation to the other methods. Its main field of application, according to the authors' obervations, is the differential diagnosis of three-dimensional changes in the thorax region, in particular the diagnosis of malignant tumours of the lungs in combination with X-ray examinations. Furthermore, /sup 67/Ga may be of use in localization diagnoses of non-malignant changes, e.g. abscesses. /sup 67/Ga scintigraphy, which is non-hazardous and does not involve discomfort to the patients, appears to be particularly useful for course control after surgical treatment of breast cancer and for early diagnoses of metastases, provided that examination starts early enough and is repeated at regular intervals, not only in the soft parts but also in the skeleton. The question whether /sup 67/Ga scintigraphy may be a substitute for scintigraphy with other nuclides in these fields still remains to be solved.

Renal Ammonia Metabolism and Transport

Science.gov (United States)

Weiner, I. David; Verlander, Jill W.

2015-01-01

Renal ammonia metabolism and transport mediates a central role in acid-base homeostasis. In contrast to most renal solutes, the majority of renal ammonia excretion derives from intrarenal production, not from glomerular filtration. Renal ammoniagenesis predominantly results from glutamine metabolism, which produces 2 NH4+ and 2 HCO3− for each glutamine metabolized. The proximal tubule is the primary site for ammoniagenesis, but there is evidence for ammoniagenesis by most renal epithelial cells. Ammonia produced in the kidney is either excreted into the urine or returned to the systemic circulation through the renal veins. Ammonia excreted in the urine promotes acid excretion; ammonia returned to the systemic circulation is metabolized in the liver in a HCO3−-consuming process, resulting in no net benefit to acid-base homeostasis. Highly regulated ammonia transport by renal epithelial cells determines the proportion of ammonia excreted in the urine versus returned to the systemic circulation. The traditional paradigm of ammonia transport involving passive NH3 diffusion, protonation in the lumen and NH4+ trapping due to an inability to cross plasma membranes is being replaced by the recognition of limited plasma membrane NH3 permeability in combination with the presence of specific NH3-transporting and NH4+-transporting proteins in specific renal epithelial cells. Ammonia production and transport are regulated by a variety of factors, including extracellular pH and K+, and by several hormones, such as mineralocorticoids, glucocorticoids and angiotensin II. This coordinated process of regulated ammonia production and transport is critical for the effective maintenance of acid-base homeostasis. PMID:23720285

Alterations of the blood pool in the femoral head before and after renal transplantation

International Nuclear Information System (INIS)

Hamaguchi, Hiroyuki; Fujioka, Mikihiro; Inoue, Shigehiro; Shibatani, Masahiko; Kubo, Toshikazu; Kubota, Takao; Ushijima, Yo; Nishimura, Tsunehiko

2003-01-01

The pathogenesis of idiopathic osteonecrosis of the femoral head (ION) is thought to be an ischemic event. The purpose of this study is to investigate alterations of the blood pool in the femoral head before and after renal transplantation. After renal transplantation, all patients received the same immunosuppressive therapy: corticosteroids, cyclosporin-A, and azathioprine. We performed 3-phase bone scintigraphy on 16 renal allograft recipients within 1 week before renal transplantation, and between week 4 and 9 after renal transplantation. Regions of interest (ROI) were assigned bilaterally in the femoral head, diaphysis, and soft tissue. The head-to-diaphysis ratios (HD ratios) were then calculated. Idiopathic osteonecrosis of the femoral head occurred in 2 femoral heads of 1 patient. The HD ratio before renal transplantation (mean HD±SD, 1.52±0.30) and the HD ratio after renal transplantation (1.28±0.30) were significantly different (P=0.000024). The HD ratios before and after renal transplantation were significantly different, indicating that the administration of steroids diminished the blood pool in the femoral head. A low HD ratio before renal transplantation revealed a poor blood pool in the femoral head, which may be a risk factor for ION. (author)

Renal Blood Flow, Glomerular Filtration Rate, and Renal Oxygenation in Early Clinical Septic Shock.

Science.gov (United States)

Skytte Larsson, Jenny; Krumbholz, Vitus; Enskog, Anders; Bragadottir, Gudrun; Redfors, Bengt; Ricksten, Sven-Erik

2018-06-01

Data on renal hemodynamics, function, and oxygenation in early clinical septic shock are lacking. We therefore measured renal blood flow, glomerular filtration rate, renal oxygen consumption, and oxygenation in patients with early septic shock. Prospective comparative study. General and cardiothoracic ICUs. Patients with norepinephrine-dependent early septic shock (n = 8) were studied within 24 hours after arrival in the ICU and compared with postcardiac surgery patients without acute kidney injury (comparator group, n = 58). None. Data on systemic hemodynamics and renal variables were obtained during two 30-minute periods. Renal blood flow was measured by the infusion clearance of para-aminohippuric acid, corrected for renal extraction of para-aminohippuric acid. Renal filtration fraction was measured by renal extraction of chromium-51 labeled EDTA. Renal oxygenation was estimated from renal oxygen extraction. Renal oxygen delivery (-24%; p = 0.037) and the renal blood flow-to-cardiac index ratio (-21%; p = 0.018) were lower, renal vascular resistance was higher (26%; p = 0.027), whereas renal blood flow tended to be lower (-19%; p = 0.068) in the septic group. Glomerular filtration rate (-32%; p = 0.006) and renal sodium reabsorption (-29%; p = 0.014) were both lower in the septic group. Neither renal filtration fraction nor renal oxygen consumption differed significantly between groups. Renal oxygen extraction was significantly higher in the septic group (28%; p = 0.022). In the septic group, markers of tubular injury were elevated. In early clinical septic shock, renal function was lower, which was accompanied by renal vasoconstriction, a lower renal oxygen delivery, impaired renal oxygenation, and tubular sodium reabsorption at a high oxygen cost compared with controls.

Renal uptake of dimercaptosuccinic acid and glomerular filtration rate in chronic nephropathy at angiotensin converting enzyme inhibition

DEFF Research Database (Denmark)

Kamper, A L; Thomsen, H S; Nielsen, S L

1990-01-01

function. Scintigrams of the kidneys showed an unaltered distribution of DMSA during treatment. GFR estimated by 51Cr-EDTA plasma clearance fell by 14% (P less than 0.01), but renal uptake of 99mTc-DMSA increased by 10% (P less than 0.01). It is concluded that DMSA in chronic renal failure is mainly taken......Glomerular filtration rate (GFR) and renal uptake of dimercaptosuccinic acid (DMSA) were measured in 31 patients with progressive chronic nephropathy before and immediately after the start of treatment with angiotensin converting enzyme (ACE) inhibitor in order to control adverse effects on kidney...

Vesicoureteral refluxed volume and renal function

International Nuclear Information System (INIS)

Markovic, V.; Capkun, V.; Eterovic, D.; Stanicic, A.; Saraga, M.

1994-01-01

The therapeutical approach to vesicoureteral reflux (VUR) depends on assessment of the renal involvement. The effective renal plasma flow (ERPF) and parenchymal mean transit time of radiotracer (pMTT) of the affected kidney are sensitive functional parameters. We investigated the association of these functional indices with the volume of refluxed urine. In 64 children (mean age 6.4 yrs) the presence of VUR was confirmed with direct radionuclide cystography in 80 ureters (48 unilateral and 32 bilateral) and the maximal volume of refluxed urine (MVRU) was determined for each uretero-renal unit. All patients also underwent dynamic renal scintigraphy with I-131-hippuran, providing the values of pMTT and relative renal hippuran clearances of the respective kidneys by deconvolution analysis. In 37 of the affected kidneys ERPF was also determined by combining the latter results with total ERPF, determined by plasma clearance of hippuran. Using the borderline value of MVRU of 4 ml, the group with higher MVRU exhibited significantly lower ERPF of the affected kidney (194±93 vs. 270±77 ml/min/1.73 m2, p=.002) and significantly higher proportion of pMTT's over 3.5 min (31/33 vs. 17/47, p=.003). The negative linear correlation between MVRU and ERPF was found (r=-.45, p=.006). We conclude that quantitative radionuclide cystography, aside from diagnosis and follow-up of VUR, may also provide insight in the function of the affected kidney and thus contribute in designing the therapeutical approach. (author)

Renal-protective and ameliorating impacts of omega-3 fatty acids against aspartame damaged MDCK cells.

Science.gov (United States)

Pandurangan, Muthuraman; Enkhtaivan, Gansukh; Veerappan, Muthuviveganandavel; Mistry, Bhupendra; Patel, Rahul; Moon, So Hyun; Nagajyothi, Patnamsetty Chidanandha; Kim, Doo Hwan

2017-11-01

Aspartame is widely used artificial sweeteners as food additives. Several researchers have pointed that the controversial report on the use of aspartame over more than decades. Omega-3 fatty acids are essential and unsaturated fatty acids, and it plays a remarkable role in vision, intelligence, neural development, and metabolism of neurotransmitters. Therefore, the present study was aimed to investigate the effect of omega-3 fatty acids on aspartame treated renal cells. Experimental groups were divided into three such as sham control, aspartame treated, and aspartame with omega-3 fatty acids. Cell viability was determined by sulforhodamine-b assay and flow cytometric analysis. The experimental results showed that the aspartame induced altered cell viability were reduced following treatment of aspartame with omega-3 fatty acids. Altered cell morphology was recovered by omega-3 fatty acids. DNA damage appeared in the highest concentration of aspartame used in this study. DNA damage characteristics such as comet tail and tiny head sections did not appear in the omega-3 fatty acids treated cells. Several microvilli and vesicular structures were found in aspartame treated cells. Altered morphology such as rounding, microvilli, and formation of dome-like structures did not appear in the omega-3 fatty acids with aspartame treated cells. Caspase-3 mRNA and protein expression were increased in aspartame treated cells, and these levels were reduced following omega-3 fatty acids treatment. Taking all these data together, it is suggested that the omega-3 fatty acids may be a therapeutic agent to reduce the aspartame induced biochemical and morphological alterations in normal renal cells. © 2017 BioFactors, 43(6):847-857, 2017. © 2017 International Union of Biochemistry and Molecular Biology.

The intrinsic renal compartment syndrome: new perspectives in kidney transplantation.

Science.gov (United States)

Herrler, Tanja; Tischer, Anne; Meyer, Andreas; Feiler, Sergej; Guba, Markus; Nowak, Sebastian; Rentsch, Markus; Bartenstein, Peter; Hacker, Marcus; Jauch, Karl-Walter

2010-01-15

Inflammatory edema after ischemia-reperfusion may impair renal allograft function after kidney transplantation. This study examines the effect of edema-related pressure elevation on renal function and describes a simple method to relieve pressure within the renal compartment. Subcapsular pressure at 6, 12, 24, 48 hr, and 18 days after a 45 min warm ischemia was determined in a murine model of renal ischemia-reperfusion injury. Renal function was measured by Tc-MAG3 scintigraphy and laser Doppler perfusion. Structural damage was assessed by histologic analysis. As a therapeutic approach, parenchymal pressure was relieved by a standardized circular 0.3 mm incision at the lower pole of the kidney capsule. Compared with baseline (0.9+/-0.3 mm Hg), prolonged ischemia was associated with a sevenfold increase in subcapsular pressure 6 hr after ischemia (7.0+/-1.0 mm Hg; P<0.001). Pressure levels remained significantly elevated for 24 hr. Without therapy, a significant decrease in functional parameters was found with considerably reduced tubular excretion rate (33+/-3.5%, P<0.001) and renal perfusion (64.5+/-6.8%, P<0.005). Histologically, severe tissue damage was found. Surgical pressure relief was able to significantly prevent loss of tubular excretion rate (62.5+/-6.8%, P<0.05) and renal blood flow (96.2+/-4.8%; P<0.05) and preserved the integrity of renal structures. Our data support the hypothesis of the existence of a renal compartment syndrome as a consequence of ischemia-reperfusion injury. Surgical pressure relief effectively prevented functional and structural renal impairment, and we speculate that this approach might be of value for improving graft function after renal transplantation.

Effect of folic acid on methionine and homocysteine metabolism in end-stage renal disease

NARCIS (Netherlands)

Stam, F.; van Guldener, C.; ter Wee, P.M.; Jakobs, C.A.J.M.; van der Meer, K.; Stehouwer, C.D.A.

2005-01-01

Background. The pathogenesis of hyperhomocysteinemia in end-stage renal disease (ESRD) is unclear. Folic acid lowers, but does not normalize, the plasma homocysteine level in patients with ESRD, but its effect on whole body metabolism of homocysteine is unknown. Methods We studied the effect of 3

Association of Lead Exposure, Serum Uric Acid and Parameters of Renal Function in Nigerian Lead-Exposed Workers

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DD Alasia

2010-09-01

Full Text Available Background: The presence of hyperuricemia and renal function impairment, especially in the absence of urate stone formation is strongly suggestive of lead nephropathy. The evaluation of this association is essential in areas where lead exposure is still prevalent and uncontrolled. Objective: To determine the relationship between serum uric acid and renal function indices in lead-exposed workers. Methods: A cross-sectional study of 190 adults with occupational lead exposure and 80 adults (comparison group, matched for age and sex was performed in Port Harcourt, South-south Nigeria. Blood lead was used as the biomarker of lead exposure while serum urea, serum creatinine, urine albumin (using urine albumin:creatinine ratio, estimated glomerular filtration rate (GFR and serum uric acid were the renal function indices measured. Results: Occupationally lead-exposed subjects had a significantly (p = 0.008 higher mean±SD blood lead levels (50.37±24.58 μg/dL than the comparison group (41.40±26.85. The mean±SD serum urea (8.6±2.3 mg/dL, creatinine (1.0±0.2 mg/dL and serum uric acid (4.6±1.2 mg/dL were significantly (p < 0.01 higher in the study subjects than the comparison group (7.6±2.4, 0.9±0.2, and 3.9±1.1 mg/dL, respectively. The mean±SD creatinine clearance was significantly (p = 0.002 lower in the study subjects than the comparison group (98.9±21.3 vs. 108.2±25.2 mL/min/1.72 m2. Serum uric acid level correlated positively with serum creatinine (r = 0.134 and negatively with GFR (r = ‑0.151. Conclusion: People with occupational lead exposure are at risk of developing hyperuricemia and renal impairment.

Chemical Renal Denervation in the Rat

Energy Technology Data Exchange (ETDEWEB)

Consigny, Paul M., E-mail: paul.consigny@av.abbott.com; Davalian, Dariush, E-mail: dariush.davalian@av.abbott.com [Abbott Vascular, Innovation Incubator (United States); Donn, Rosy, E-mail: rosy.donn@av.abbott.com; Hu, Jie, E-mail: jie.hu@av.abbott.com [Abbott Vascular, Bioanalytical and Material Characterization (United States); Rieser, Matthew, E-mail: matthew.j.rieser@abbvie.com; Stolarik, DeAnne, E-mail: deanne.f.stolarik@abbvie.com [Abbvie, Analytical Pharmacology (United States)

2013-12-03

Introduction: The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Methods: Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose–response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography–mass spectrometry. Results: Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10{sup −5} M through 10{sup −2} M paclitaxel. Conclusion: We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel.

Chemical Renal Denervation in the Rat

International Nuclear Information System (INIS)

Consigny, Paul M.; Davalian, Dariush; Donn, Rosy; Hu, Jie; Rieser, Matthew; Stolarik, DeAnne

2014-01-01

Introduction: The recent success of renal denervation in lowering blood pressure in drug-resistant hypertensive patients has stimulated interest in developing novel approaches to renal denervation including local drug/chemical delivery. The purpose of this study was to develop a rat model in which depletion of renal norepinephrine (NE) could be used to determine the efficacy of renal denervation after the delivery of a chemical to the periadventitial space of the renal artery. Methods: Renal denervation was performed on a single renal artery of 90 rats (n = 6 rats/group). The first study determined the time course of renal denervation after surgical stripping of a renal artery plus the topical application of phenol in alcohol. The second study determined the efficacy of periadventitial delivery of hypertonic saline, guanethidine, and salicylic acid. The final study determined the dose–response relationship for paclitaxel. In all studies, renal NE content was determined by liquid chromatography–mass spectrometry. Results: Renal NE was depleted 3 and 7 days after surgical denervation. Renal NE was also depleted by periadventitial delivery of all agents tested (hypertonic saline, salicylic acid, guanethidine, and paclitaxel). A dose response was observed after the application of 150 μL of 10 −5  M through 10 −2  M paclitaxel. Conclusion: We developed a rat model in which depletion of renal NE was used to determine the efficacy of renal denervation after perivascular renal artery drug/chemical delivery. We validated this model by demonstrating the efficacy of the neurotoxic agents hypertonic saline, salicylic acid, and guanethidine and increasing doses of paclitaxel

RI scintigraphy in myasthenia gravis

International Nuclear Information System (INIS)

Kuroda, Yoshikazu; Miyamoto, Mariko; Maki, Masako; Yamazaki, Toshiro.

1982-01-01

35 cases of myasthenia gravis were studied with RI scintigraphy. 67 Ga-citrate was used in 34 patients and 76 Se-selenomethionine in 5 patients for thymus scintigraphy. RI scintigram was negative in non-tumorous thymus, regardless of the severity of illness and it was positive in seven of nine patients with thymomas. RI accumulation in thymus was found both in benign and malignant thymomas. RI seems to accumulated in lymphocytic and mixed thymus more than epithelial type. (author)

[Quantitative determination of the main metabolites of acetylsalicylic acid/2nd communication: the concentrations of salicylic acid and its metabolites in patients with renal insufficiency (author's transl)].

Science.gov (United States)

Daneels, R; Loew, D; Pütter, J

1975-07-01

Quantitative Determination of the Main Metabolites of Acetylsalicylic Acid / 2nd Communication: The concentrations of salicylic acid and its metabolies in patients with renal insufficiency 9 patients suffering from renal insufficiencies of varing degrees and treated regularly by hemodialysis were given 1.5 g Colfarit (microcapsulated acetyl salicylic acid) as a single dose. The concentrations of salicylic acid (SA), salicyluric acid (SU), further salicylic acid conjugates (SAC) and salicyluric acid conjugates (SUC) were determined in the blood plasma. Likewise urea and creatinine were determined. SA concentration decreased continually and, at the end of the trial (72 h after application), had vanished almost completely from the plasma of most patients. SU increased at first and decreased afterwards. With the exception of the dailysis time SAC and SUC increased during the trial. After 3 days the SUC level was more than 50% of total salicylate (SSS) in most patients. SSS (the sum of SA + SU + SAC + SUC) did not change very much before dialysis, but showed a rather high decrease during the first hours of dialysis. tafter dialysis the SSS levels rose again, apparently as a consequence of a redistribution and of the synthesis of conjugates with decreased tissue affinity. It could be shown that SSS in the blood plasma does not parallel SSS in the whole body. The interindividual variation of SA metabolism as well as the variation of the biological blank values was rather high. The results are discussed with regard to salicylate pharmacokinetics in renal insufficiency and to normal salicylate metabolism.

Interaction between cellular retinoic acid-binding protein II and histone hypoacetylation in renal cell carcinoma

OpenAIRE

Viroj Wiwanitkit

2008-01-01

Renal cell carcinoma is a rare but serious malignancy. Since a reduction in the level of retinoic acid receptor beta 2 (RARbeta2) expression in cancer cells due in part to histone hypoacetylation which is controlled by histone deacetylase (HD), the study on the interaction between cellular retinoic acid-binding proteins II (CRABP II), which is proposed to have its potential influence on retinoic acid (RA) response, and HD can be useful. Comparing to CARBP II and HD, the CARBP II-HD poses the ...

Iodine-123 BMIPP Scintigraphy in the Evaluation of Patients with Heart Failure

Energy Technology Data Exchange (ETDEWEB)

Nakae, I.; Matsuo, S.; Koh, T.; Mitsunami, K.; Horie, M. [Shiga Univ. of Medical Science, Otsu (Japan). Depts. of Cardiovascular and Respiratory Medicine, and of General Medicine

2006-10-15

Purpose: To investigate whether cardiac parameters obtained by I-123 15-(p-iodophenyl)-3-methyl pentadecanoic acid (BMIPP, a radioactive fatty acid analogue) myocardial scintigraphy are useful as indicators of disease severity and predictors of cardiac events in congestive heart failure (CHF). Material and Methods: Thirty-two CHF patients (functional class: 17 in NYHA II and 15 in NYHA III at the time of this study) were compared with 18 normal control subjects. Myocardial scintigraphy was performed 15 min and 3 hours after I-123 BMIPP injection. The heart-to-mediastinum count ratio of I-123 BMIPP on the initial (H/Mi) and delayed (H/Md) images and the washout rate (WR) were calculated. Results: Both H/Mi and H/Md were lower in CHF than in controls (H/Mi 1.96{+-}0.18 vs. 2.30{+-}0.29; H/Md 1.72{+-}0.15 vs. 1.97{+-}0.21; both P <0.001), but WR was higher in CHF than in controls (WR (%) 23.7{+-}5.7 vs. 18.2{+-}6.0, P <0.01). Both H/Mi (R = 0.42, P <0.05) and H/Md (R = 0.45, P <0.05) correlated positively with the left ventricular (LV) ejection fraction (EF), estimated by echocardiography. The WR correlated positively with the plasma B-type natriuretic peptide (BNP) level (R = 0.47, P <0.01). Kaplan-Meier analysis showed an earlier CHF progression for patients with a lower H/Mi (<1.94). Conclusion: Myocardial metabolic abnormality evaluated by I-123 BMIPP scintigraphy is related to the severity of CHF. Furthermore, it may be useful as a predictor for cardiac events.

Studies of the skeletal pathophysiology of renal osteodystrophy using nucleomedical procedures

Energy Technology Data Exchange (ETDEWEB)

Otsuka, Nobuaki (Kawasaki Medical School, Kurashiki, Okayama (Japan))

1988-12-01

Bone scintigraphy with Tc-99m labeled phosphorous compounds has been performed in a series of 160 long-term hemodialysis patients with chronic renal failure. Renal osteodystrophy (ROD) was classified by five features of RI uptake in the entire skeleton: type A (low turn-over type) - a relatively decreased RI uptake in the bone tissue and an increased uptake in the soft tissue; type C (normal type) - normal findings; type D (osteomalacia type) - a strong RI uptake in the costochondral joints; type F (hyperparathyroid type) - strong RI uptake in the skull and submandible; and type G (calcification type) - an ectopic calcification. The group of type F had elevated levels of both alkaline phosphatase (ALP) and parathyroid hormones (PTH); on the contrary, both ALP and PTH were decreased in the group of type A. This suggested an increased and decreased bone metabolism in type F and A, respectively. The group of type D was characterized by having hypophosphatemia. Pathophysiologic types of ROD varied from day to day. Bone mineral density (BMD) tended to decrease in the radius. For the spine, however, BMD increased in some cases and decreased in the other cases with prolonging the duration of hemodialysis. Bone scintigraphy and BMD determination in both the cortical and cavernous bone tissue may provide integrated information about ROD presenting with heterogeneity of the entire skeleton. (Namekawa, K).

Radionuclide bone scintigraphy in pediatric orthopedics

International Nuclear Information System (INIS)

Conway, J.J.

1986-01-01

Radionuclide bone scintigraphy is highly sensitive and specific for diagnosing the musculoskeletal disorders of childhood. Conditions such as neonatal osteomyelitis, septic arthritis, diskitis of childhood, Legg-Calve-Perthes disease, the osteochondroses, the toddler's fracture, sports injuries, spondylolysis, myositis ossificians, and reflex sympathetic dystrophy are readily defined. High-quality state-of-the-art scintigraphy is essential in infants and young children. 64 references

No effect of dietary fish oil on renal hemodynamics, tubular function, and renal functional reserve in long-term renal transplant recipients

DEFF Research Database (Denmark)

Hansen, J M; Løkkegaard, H; Høy, Carl-Erik

1995-01-01

Dietary supplementation with fish oil rich in n-3 polyunsaturated fatty acids has been suggested to protect the kidney against cyclosporin A (CsA) toxicity. This study investigated the effects of a 10-wk dietary supplementation with fish oil on renal function and renal functional reserve in healt...... transplant recipients treated with a low maintenance dose of CsA had a well-preserved renal functional reserve, and dietary supplementation with fish oil in these patients did not improve renal function.......Dietary supplementation with fish oil rich in n-3 polyunsaturated fatty acids has been suggested to protect the kidney against cyclosporin A (CsA) toxicity. This study investigated the effects of a 10-wk dietary supplementation with fish oil on renal function and renal functional reserve in healthy...... volunteers (N = 9) and two groups of stable long-term kidney-transplanted patients treated with maintenance low-dose CsA (3.0 +/- 0.6 mg/kg; N = 9) or without CsA (N = 9). After an overnight fast, the subjects were water loaded, and clearance studies were performed, postponing morning medication. GFR...

RI scintigraphy in myasthenia gravis

Energy Technology Data Exchange (ETDEWEB)

Kuroda, Yoshikazu; Miyamoto, Mariko (Tokyo Metropolitan Fuchu Hospital (Japan)); Maki, Masako; Yamazaki, Toshiro

1982-10-01

35 cases of myasthenia gravis were studied with RI scintigraphy. /sup 67/Ga-citrate was used in 34 patients and /sup 76/Se-selenomethionine in 5 patients for thymus scintigraphy. RI scintigram was negative in non-tumorous thymus, regardless of the severity of illness and it was positive in seven of nine patients with thymomas. RI accumulation in thymus was found both in benign and malignant thymomas. RI seems to accumulated in lymphocytic and mixed thymus more than epithelial type.

The value of scintigraphy in skeleton diagnostics

International Nuclear Information System (INIS)

Wickenhauser, J.

1976-01-01

The complex topic of diagnostics of the numerous skeleton diseases was enriched by nuclear medicine, for it is now possible to complete the static picture of morphologic changes resulting from radiologic examinations by its functional component, shown in scintigraphy. This shows that maximal information can only be obtained if the results of skeleton scintigraphy are, according to their importance, integrated into the total picture of the diagnostical decision procedure the centre of which is taken by radiology as was always the case. Because of the different results they lead to, none of the methods can be replaced by another, but they can only complete one another. For the reasons mentioned, the isolated use of skeleton scintigraphy, as it is usual in many places, does not seem not purposeful. Using 8 cases, the author tried to show the problems of skeleton scintigraphy and its position in the diagnostical decision procedure in osteology. (orig.) [de

Revisiting normal {sup 51}Cr-ethylenediaminetetraacetic acid clearance values in children

Energy Technology Data Exchange (ETDEWEB)

Piepsz, A.; Tondeur, M. [Department of Radioisotopes, CHU St Pierre, Brussels (Belgium); Ham, H. [Department of Nuclear Medicine, UZ Ghent, Ghent (Belgium)

2006-12-15

Normal {sup 51}Cr-ethylenediaminetetraacetic acid (EDTA) clearance values as a function of age were published a number of years ago. These values were based on data from children with a normal left to right ratio and a normal appearance on DMSA scintigraphy, despite the presence of an acute renal infection. At that time, the authors were unaware that hyperfiltration is a common phenomenon in patients with acute renal infection and that their normal values could have been significantly overestimated. The present work therefore aimed to re-appraise these normal values. In a first step, in order to verify the previous results, the same type of population was selected, namely patients with present or past urinary tract infection but normal images and a normal left to right ratio on DMSA scintigraphy. In a second step, the selection was based on patients who had had no recent urinary tract infection. In both series, a single blood sample method was used for the evaluation of {sup 51}Cr-EDTA clearance. In the first group of patients, the results obtained were almost identical to those previously published. In the second group of patients, the results were significantly lower: after 2 years of age, the mean GFR value was 104 ml/min/1.73 m{sup 2} (10th and 90th percentiles 81 and 135 ml/min/1.73 m{sup 2}, respectively), compared with 117 ml/min/1.73 m{sup 2} in the first group. The data of the second group are probably more representative of the true normal GFR values and can be applied to the entire paediatric population. (orig.)

Bone scintigraphy in psoriasis

Energy Technology Data Exchange (ETDEWEB)

Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.

1980-08-01

Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

Radioindication of hemodynamics and functional state of parenchyma of the kidneys in stenosis of renal arteries

International Nuclear Information System (INIS)

Efimov, O.N.; Gabuniya, R.I.; Kamynin, Yu.F.; Matveenko, E.G.; Buyuklyan, A.N.; Skoropad, L.S.; Syzgantseva, L.M.

1978-01-01

Hemodynamics and functional state of parenchyma of the kidney were studied in 39 patients with stenosis of the renal arteries by means of pertechnetate 99 Tc, hippuran 131 I and chlormerodrine 197 Hg. In patients with vasorenal hypertension the following changes in the stenosed kidney were revealed: a significant decrease in the renal blood flow, renal fraction, volume of maximal saturation, specific blood flow, systolic renal index; elevation of the intrarenal vascular resistance; and impairment of the functional state of the renal parenchyma. It was established that there was a direct dependence between the renal blood flow and the volume of maximal saturation and a reverse dependence between the renal blood flow and intrarenal vascular resistance. Hemodynamic changes in the stenosed kidney played an important role and led at first to a bias in renographic indices and then - to a decrease in accumulation of chlormerodrine 197 Hg in the kidneys. It was noted that changes in the functional state of the renal parenchyma tended to be dependent upon the level of the renal blood flow, and indices of the renal blood flow - upon the values of arterial pressure. From diagnostic point of view, methods of radioiangiography, as compared with renography and scintigraphy, were found to be the most informative

Somatostatin receptor scintigraphy on thyroid carcinoma

International Nuclear Information System (INIS)

Pan Weimin; Tan Tianzhi

2004-01-01

Purpose: To study the diagnostic value and clinical method of somatostatin receptor scintigraphy on thyroid carcinoma using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent; Methods: Somatostatin receptor scintigraphy (SRS) were performed on 25 patients with thyroid carcinoma, using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent, controlling with 131 I- whole- body- imaging(1312 -WBI). Results: Of 4 patients with MTC (medullary thyroid carcinoma), positive metastasis and primary tumour were detected on 3 patients by SRS, negative results were obtained by 131 I-WBI, the positive detective rate by SRS is 3/4; of 12 patients with PTC (papillary thyroid carcinoma), positive metastasis and primary tumour were detected on 2 patients by SRS or 131 I-WBI,1 of which only by SRS, while negative results were obtained by 131 I- WBI, the positive detective rate by SRS is 3/12; of 8 patients with FTC(follicular thyroid carcinoma), positive metastasis and primary tumour were detected on 1 patients by SRS or 131 I-WBI, and 2 positive results were obtained only by SRS, while negative by 131 I-WBI, the positive detective rate by SRS is 3/8; of 1 patients with HCC (hurthle cell carcinoma ), positive metastasis and primary tumour were detected by SRS, while negative by 131 I-WBI; Conclusions: SRS using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent has high diagnostic value on thyroid carcinoma, especially on MTC and HCC. (authors)

Radionuclide bone scintigraphy in pediatric orthopedics

Energy Technology Data Exchange (ETDEWEB)

Conway, J.J.

1986-12-01

Radionuclide bone scintigraphy is highly sensitive and specific for diagnosing the musculoskeletal disorders of childhood. Conditions such as neonatal osteomyelitis, septic arthritis, diskitis of childhood, Legg-Calve-Perthes disease, the osteochondroses, the toddler's fracture, sports injuries, spondylolysis, myositis ossificians, and reflex sympathetic dystrophy are readily defined. High-quality state-of-the-art scintigraphy is essential in infants and young children. 64 references.

Dual-phase 99mTc-MIBI scintigraphy with delayed neck and thorax SPECT/CT and bone scintigraphy in patients with primary hyperparathyroidism. Correlation with clinical or pathological variables

International Nuclear Information System (INIS)

Qiu, Zhongling; Shen, Chentian; Zhu, Ruisen; Luo, Quanyong; Wu, Bo

2014-01-01

The purpose of this study was to assess the relationship between 99m Tc-MIBI and 99m Tc-MDP bone scintigraphy and clinical or pathological variables, including preoperative serum PTH levels and tumor diameter, in patients with newly diagnosed PHPT. Dual phase 99m Tc-MIBI planar scintigraphy was performed in 244 patients with PHPT. Of these patients, 155 underwent 99m Tc-MDP bone scintigraphy to detect bone changes before parathyroidectomy. Factors influencing 99m Tc-MIBI scintigraphy and 99m Tc-MDP bone scintigraphy detection rate were assessed using univariate and multivariate logistic regression analysis; optimal cutoff values for predicting positive 99m Tc-MIBI and 99m Tc-MDP bone scintigraphy were evaluated using ROC analysis. Among 244 patients, 174 (71.31%) patients with 181 foci had a positive 99m Tc-MIBI planar scintigraphy; delayed neck and thorax SPECT/CT could identify and locate the 99m Tc-MIBI lesions but could not find more lesions than planar scintigraphy. 70 (28.69%) patients had a negative 99m Tc-MIBI planar scintigraphy. Tumor diameter, serum PTH level and symptoms were statistically significant predictive factors in predicting positive 9m Tc-MIBI scintigraphy both univariate and multivariate logistic regression analyses. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.03 cm and 127.60 ng/L, respectively. Among 155 patients with bone scintigraphy, 99m Tc-MDP bone scintigraphy showed positive finding in 80 (51.61%) patients and negative finding in 75 patients. Univariate logistic regression analysis showed that patient age, sex, tumor diameter and PTH level (≥150 ng/L) were statistically significant in predicting positive 99m Tc-MDP bone scintigraphy. Multivariate logistic regression analysis showed both tumor diameter and PTH ≥150 ng/L were statistically significant in predicting positive 99m Tc-MDP bone scintigraphy. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.96 cm and 163

Scintigraphy with radioiodinated free fatty acids

International Nuclear Information System (INIS)

Visser, F.C.

1985-01-01

In this thesis several clinical and animal experimental studies of free fatty acids labeled with radioiodine are discussed. These radiolabeled fatty acids are used for cardiac imaging. Besides, the elimination rate of the radioactivity from the myocardium, as observed during a scintigraphic study, is correlated with fatty acid metabolism. Uptake and distribution of I-heptadecanoic acid (I-HDA) and I-phenylpentadecanoic acid (I-PPA) are compared with those of thallium-201 (Tl-201) in the normal and ischemic canine myocardium. For determination of the elimination rate (expressed in terms of halftime values) of the radioactivity from the myocardium, regions of interest have to be drawn over a scintigram. A method is described resulting in more reliable demarcation of normal and abnormal regions within the scintigram. (Auth.)

Procedure guideline for thyroid scintigraphy (version 3)

International Nuclear Information System (INIS)

Dietlein, M.; Schicha, H.; Eschner, W.; Deutsche Gesellschaft fuer Medizinische Physik; Koeln Univ.; Leisner, B.; Allgemeines Krankenhaus St. Georg, Hamburg; Reiners, C.; Wuerzburg Univ.

2007-01-01

The version 3 of the procedure guideline for thyroid scintigraphy is an update of the procedure guideline previously published in 2003. The interpretation of the scintigraphy requires the knowledge of the patients' history, the palpation of the neck, the laboratory parameters and of the sonography. The interpretation of the technetium-99m uptake requires the knowledge of the TSH-level. As a consequence of the improved alimentary iodine supply the 99m Tc-uptake has decreased; 100 000 counts per scintigraphy should be acquired. For this, an imaging time of 10 minutes is generally needed using a high resolution collimator for thyroid imaging. (orig.)

Evaluation of renal allografts using {sup 99m} Tc mononuclear leukocytes; Avaliacao de transplantes renais utilizando-se {sup 99m} Tc-leucocitos mononucleares

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Souza, Sergio Augusto Lopes de; Martins, Flavia Paiva Proenca; Carvalho, Antonio Carlos Pires; Gutfilen, Bianca [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: sergioalsouza@ufrj.br; Goncalves, Renato Torres; Pontes, Daniela Salomao [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Nefrologia; Fonseca, Lea Mirian Barbosa da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Medicina Nuclear

2004-02-01

Renal allograft acute rejection must be promptly diagnosed since its reversibility is related to the readiness in which treatment is initiated. The aim of this study was: to establish a quantitative method to evaluate kidney rejection and acute tubular necrosis (Attn); to assess the potential role of {sup 99m} Tc-mononuclear leukocytes scintigraphy in the diagnosis of renal rejection and differential diagnosis of Attn. One hundred and sixty studies were performed in 80 renal transplant patients at the first and fifth day after transplantation. Autologous cells were used for labeling. Images were obtained at 30 minutes, 3 hours and 24 hours after intravenous administration of 444 MBq (12 mCi) of labeled cells. There was abnormal labeled cells uptake in 27 of 31 cases of rejection and in 6 of 8 cases of Attn. The results of each patient were compared with clinical findings. Doppler scanning detected 18 of 31 cases of rejection. Rejection diagnosis sensitivity and specificity rates using scintigraphy were 87.1 per cent and 100 per cent, respectively, and 58.1 per cent and 100 per cent, respectively using ultrasound. Renal biopsy was performed in eight patients which demonstrated seven cases of rejection and one case of ATN. These results suggest that {sup 99m} Tc-mononuclear leukocytes imaging may be useful in the early diagnosis of rejection and in the differential diagnosis of ATN. (author)

Clinical experience of [sup 123]I-IMP scintigraphy in detecting vertebral bone metastases of hepatocellular carcinoma. A comparison with bone scintigraphy with [sup 99m]Tc-MDP

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Suto, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Iwamiya, T. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Tanigawa, N. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Shabana, M. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Ohta, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan))

1994-03-01

[sup 123]I-IMP and bone scintigraphy with [sup 99m]Tc-MDP were consecutively performed in patients with vertebral bone metastases from hepatocellular carcinoma and lumbar spondylosis deformans in a 7-day interval or shorter. The intensity of uptake was compared. Eighteen of the 20 metastatic lesions (90%) were classified as increased uptake areas in [sup 123]I-IMP scintigraphy. MDP-scintigraphy disclosed 16 metastatic lesions (80%), 9 as ''hot'' lesions (56%) and 7 as ''cold'' lesions (44%). [sup 123]I-IMP scintigraphy was negative in all 12 lesions of lumbar spondylosis deformans. Compared to MDP-scintigraphy, [sup 123]I-IMP scintigraphy was more sensitive in detecting vertebral bone metastases of hepatocellular carcinoma with smaller rates of false-positive and false-negative findings. (orig./MG).

Chondromalacia patellae: Bone scintigraphy correlated with arthroscopic findings

International Nuclear Information System (INIS)

Kohn, H.S.; Guten, G.N.; Collier, B.D.; Veluvolu, P.; Whalen, J.P.

1987-01-01

Fifty adult sports medicine patients with anterior knee pain and other clinical findings of chondromalacia patellae unresponsive to more than 3 months of conservative therapy were evaluated with bone scintigraphy with subsequent arthroscopic correlation. There was significant correlation (Sperman rank correlation = .545, P < .001) between the intensity of increased patellar scintigraphic activity and the Metcalf grade of chondromalacia seen at arthroscopy. Bone scintigraphy also disclosed clinically unsuspected torn menisci. Bone scintigraphy contributes to accurate diagnostic evaluation and appropriate surgical planning for adult sports medicine patients with chronic anterior knee pain

Renal imaging in paediatrics; Nuklearmedizinische Nierendiagnostik in der Paediatrie

Energy Technology Data Exchange (ETDEWEB)

Porn, U.; Hahn, K.; Fischer, S. [Klinik und Poliklinik fuer Nuklearmedizin, Ludwig-Maximilians-Univ. Muenchen (Germany)

2003-09-01

The most frequent renal diseases in paediatrics include urinary tract infections, hydronephrosis, kidney anomalies and reflux. The main reason for performing DMSA scintigraphy in paediatrics is the detection of cortical abnormalities related to urinary tract infection. Because the amount of tracer retained in the tubular cells is associated with the distribution of functioning renal parenchyma in the kidney, it is possible, to evaluate the split renal function. In comparison to ultrasound and intravenous urography the sensitivity in the detection of acute as well as chronic inflammatory changes is very high, however less specific. An indication for a renography in neonates and children is beside an estimation of the total renal function and the calculation of the split renal function, the assessment of renal drainage in patients with unclear dilatation of the collecting system in ultrasound. The analysis of the time activity curve provides, especially for follow-up studies, a reproducible method to assess the urinary outflow. The diuretic scintigraphy allows the detection of urinary obstruction. Subsequently it is possible to image the micturition phase to detect vesico-ureteric reflux (indirect MCU) after drainage of tracer from the renal pelvis. An reflux in the ureters or the pelvicalyceal system is visible on the scintigraphic images and can be confirmed by time activity curves. A more invasive technique is the direct isotope cystography with bladder catheterization. The present paper should give an overview about the role of nuclear medicine in paediatric urology. (orig.) [German] Die haeufigsten nephrourologischen Erkrankungen in der Paediatrie umfassen die entzuendlichen Veraenderungen des Nierenparenchyms, Harnstauungen, Nierenanomalien und Refluxerkrankungen. Die statische Nierenszintigraphie mit {sup 99m}Tc-DMSA hat in der Paediatrie vor allem zur Evaluierung von Narbenbildungen bei Pyelonephritis ihren Stellenwert. Da die tubulaere Speicherung von DMSA

Radiography and bone scintigraphy in bone marrow transplant multiple myeloma patients

International Nuclear Information System (INIS)

Aagren, B.; Aspelin, P.

1997-01-01

Purpose: To compare conventional radiography and bone scintigraphy in relation to clinical outcome in bone marrow transplant multiple myeloma patients. Material and Methods: A total of 70 radiographies and 70 bone scintigraphies were compared in 35 patients. Results: The skull, the extremities, the iliac and public bones were better assessed with radiography. For new vertebral lesions and for lesions in the ribs and sternum, bone scintigraphy proved superior. For the sacrum, the methods were equal. When bone scintigraphy was used as a complement to radiography, 4% more pathological sites were found. No patient had both a normal radiography and a pathological bone scintigraphy, but 5 patients had both a normal bone scintigraphy and a pathological radiography. The results of the radiological examinations did not always correlate with the clinician's grading of the patient's disease. The radiological examinations had no prognostic value for the 7 patients examined on several occasions. Conclusion: The ability of conventional radiography and bone scintigraphy to disclose myeloma lesions varies, depending on location and size of the lesions. Radiography should remain the primary examination modality also for bone marrow transplant multiple myeloma patients. Bone scintigraphy can severe as a complement for investigating unexplained pain, e.g. caused by lesions in vertebrae or ribs. (orig.)

Diagnostic approach to reflex sympathetic dystrophy after fracture: radiography or bone scintigraphy?

International Nuclear Information System (INIS)

Todorovic-Tirnanic, M.; Obradovic, V.; Han, R.; Goldner, B.; Stankovic, D.; Sekulic, D.; Lazic, T.; Djordjevic, B.

1995-01-01

The aim of this paper was to compare the value of bone scintigraphy and radiography in the early diagnosis of post-fracture reflex sympathetic dystrophy (RSD). Thirty-seven adult patients with post-fracture RSD (28 in the first and nine in the second clinical stage of RSD), as well as seven patients with fracture but without RSD (control group), were investigated by radiography and bone scintigraphy. All of them were immobilized (duration of immobilization: 4-22 weeks). In 21 persons three phase bone scintigraphy was performed. The best distinction between the control group and the RSD patients was achieved by delayed bone scintigrams. The sensitivity (97%), positive predictive value (97%) and accuracy (95%) of delayed bone scintigraphy were very high compared to the values for radiography, which were 73%, 90% and 70% respectively. Bone scintigraphy also displayed higher specificity (86%) and negative predictive value (86%) than radiography (57% and 29% respectively). In the first clinical stage the difference between the accuracy of bone scintigraphy (97%) and radiography (63%) was greater than for the whole group. In the second stage of RSD the accuracy of bone scintigraphy (86%) and radiography (81%) was similar. Three-phase bone scintigraphy is not necessary for the diagnosis of post-fracture RSD: it is sufficient to perform delayed bone scintigraphy. It is concluded that bone scintigraphy is to be preferred to radiography for the early diagnosis of post-fracture RSD in the first clinical stage. In the second stage the diagnostic capabilities of bone scintigraphy and radiography are more comparable. (orig.)

Variability in the interpretation of DMSA scintigraphy after urine infection

International Nuclear Information System (INIS)

Craig, J.; Howman-Giles, R.; Uren, R.; Irwig, L.; Bernard, E.; Knight, J.; Sureshkumar, P.; Roy, L.P.

1997-01-01

Full text: This study investigated the extent of and potential reasons for interpretation disagreement of 99m Tc-DMSA scans after urine infection in children. Methods: 441 scans were selected from children with first urine infection (UTI) from 1993-1995. 294 scans were performed at a median time of seven days after UTI and 147 in children free from infection over one year follow-up. Two nuclear medicine physicians independently reported according to whether renal abnormality was present or absent and used the four level grading system described by Goldraich: grade 1-no more than two cortical defects; grade 2 -more than 2 defects; grade 3-diffuse reduction in uptake with or without defects; grade 4 -shrunken kidney <10% function. Indices for variability used were the percentage of agreement and kappa statistic, expressed as a percentage. For the grading scale used, both measures were weighted with integers representing the number of categories from perfect agreement. Disagreement was analysed for children, kidneys and kidney zones. Results: There was agreement in 86 per cent (kappa 69%) for the normal-abnormal DMSA scan dichotomy, the weighted agreement was 94 per cent (kappa 82%) for the grading scale. Disagreement of DMSA scan interpretation ≥ two grades was present in three cases (0.7%). The same level of agreement was present for the patient, kidney and kidney zones comparisons. Agreement was not influenced by age or the timing of scintigraphy after urine infection. Conclusion: Two experienced physicians showed good agreement in the interpretation DMSA scintigraphy in children after urine infection and using the grading system of Goldraich

Creatine Depletion and Altered Fatty Acid Metabolism in Diseased Human Hearts: Clinical Investigation Using 1H Magnetic Resonance Spectroscopy and 123I BMIPP Myocardial Scintigraphy

International Nuclear Information System (INIS)

Nakae, I.; Mitsunami, K.; Matsuo, S.; Horie, M.

2007-01-01

Background: In the heart, the creatine kinase system plays an important role in energy reserves, and myocardial energy production essentially depends upon fatty acid metabolism. Purpose: To examine myocardial creatine (CR) concentration and altered cardiac fatty acid metabolism in various forms of heart disease. Material and Methods: Myocardial CR concentration of the septum was measured by gated 1 H magnetic resonance spectroscopy (MRS), applying a point-resolved spectroscopy (PRESS) sequence in 34 patients with heart disease. Of these patients, 14 underwent 123 I BMIPP (radioactive fatty acid analogue) myocardial scintigraphy to evaluate myocardial fatty acid metabolism. Cardiac 123 I BMIPP uptake was calculated as the heart-to-mediastinum count ratio. Results: Myocardial CR concentration correlated positively with the left ventricular ejection fraction (LVEF) by echocardiography (R = 0.61, P 123 I BMIPP uptake also correlated positively with LVEF (initial image, R 0.60, P 123 I BMIPP uptake (initial image, R = 0.77, P<0.01; delayed image, R = 0.82, P<0.001; n = 14). Conclusion: Our study suggests an association between CR depletion and impaired fatty acid metabolism in various forms of heart diseases

Radionuclide and/or radiological technique as a comprehensive renal function study in clinical pediatric pratice

International Nuclear Information System (INIS)

D'Errico, G.; La Vecchia, G.; Nodari, A.; Cenci, F.

1984-01-01

84 patients with clinically suspected urinary pathway pathology always underwent CRRA (Computerized Radionuclide Renal Angiography) and IVP (Intra Venous Pyelography); in some selected children RC (Retrograde Cystography) and CRDC (Computerized Retrograde Cysto Scintigraphy) and/or RCS (Retrograde Cysto Scintigraphy) and/or RCS (Retrograde Cysto Scintigraphy) were performed. These children, ranging from 1 day to 14 years of age, were classified, on the basis of clinical features, as: glomerulonephritis (34 cases); pyelonephritis (7 cases); vesico-ureteral reflux (15 cases); kidney and/or urinary tract malformations (29 cases). Clinical suspicion was proven by radioisotope and radiographic studies in 55 patients, namely: glomerulonephritis (23 cases); pyelonephritis (5 cases); vesico-ureteral reflux (11 cases); kidney and/or urinary tract malformation (16 cases). Among complications of the last pathology two cases of pyelo-pyelic reflux in a Y shaped duplication, cause of recurrent lumbar pain and urinary infection, not detected by IVP and RC, were discovered by CRRA; in addition two cases of vesico-ureteral reflux in patients with recurrent urinary infection were detected by CRDC but not confirmed by RC (these refluxes were considered as insignificant and transient). In our opinion, radioisotope studies (CRRA-CRDC-RCS) by i.v. injection (99m-Tc-DTPA; 0.30 MBq/kg) or by vesical catheterisation (99m-Tc-pertecnetate; 18 MBq) are particularly useful to differentiate complete from incomplete, organic from functional urinary tract obstruction, since they allow a quantitative assessment of both kidney function and unilateral renal impairment. Radiographic examination (IVP and RC), on the other hand, provide more detailed anatomical information, but are less suitable for monitoring treatment because of the higher radiation dose delivered to the patients. (Author)

Bone scintigraphy in psoriasis

International Nuclear Information System (INIS)

Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.; Frankfurt Univ.

1980-01-01

Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones. (orig.) [de

[The scintigraphy of somatostatin receptors in the carcinoid tumor].

Science.gov (United States)

Banzo, J; Abós, M D; Prats, E; Delgado , M; Razola, P; García, S; Gomollón, F; García, F

2001-02-01

This study aimed to evaluate the diagnostic utility of 111In-DTPA-D-Phe1-octreotide scintigraphy in the different situations that can be present when an examination is requested during the clinical course of the carcinoid tumor (CT). We have performed 41 scintigraphies with 111In-octreotide (145-185 MBq) in 35 patients (19 females and 16 males) with clinically suspected or confirmed CT. The patients were classified into five groups: Group A: Indolent symptoms of CT (n=9); B: CT staging located in lung (n=4), stomach (n=2), cecum (n=1), thymus (n=1) and pancreas (n=1); C: Carcinoid syndrome (n=1); D: CT staging after surgery located in pancreas (n=1), ovary (n=1), cecum (n=1), stomach (n=1), appendix (n=1) and ileum (n=1); and E: Post-treatment follow-up (n=13), with CT located in bronchial tree (n=5), small intestine (n=3), appendix (n=2), thymus (n=1), ovary (n=1) and unknown primary tumor (n=1). Three patients of this group had one scintigraphic study before the treatment. Head and neck, thorax and abdomen images were obtained at 4 and 24 h in all of the patients and SPECT images of the abdomen (n=14), thorax (n=10), and brain (n=1) were obtained at 24 h in 25 patients. Group A: In the 3 patients with a positive scintigraphy, the definitive diagnosis was meningioma, Hurtle cell's carcinoma and lung adenocarcinoma. The clinical follow-up in the six other patients, at least during one year, did not show any evidence of CT. Group B: Six of the 9 CT were detected with the scintigraphy. In 2 cases of bronchial CT, the scan showed sarcoidotic regional lymph node involvement and CT hepatic and bone metastases, respectively. Group C: The scintigraphy detected hepatic metastases from an unknown primary tumor. Group D: The scintigraphy was positive in 3 cases (hepatic or/and abdominal metastases) and was normal in the other 3. The scintigraphy was negative in one patient with peritoneal metastases. Group E: The scintigraphy was normal in 7 patients in concordance with the

Does the serum uric acid level have any relation to arterial stiffness or blood pressure in adults with congenital renal agenesis and/or hypoplasia?

Science.gov (United States)

Yazici, Raziye; Guney, İbrahim; Altintepe, Lutfullah; Yazici, Mehmet

2017-01-01

The relationship between serum uric acid and arterial stiffness or blood pressure is not clear. The serum uric acid level and its association with cardiovascular risk is not well known in patients with reduced renal mass. We aimed to investigate the relation between serum uric acid levels and arterial stiffness and also blood pressure in patients with congenital renal agenesis and/or hypoplasia. In this single center, cross-sectional study, a total of 55 patients (39 (% 70.9) with unilateral small kidney and 16 (%29.1) with renal agenesis) were included. The median age was 35 (21-50) years. The study population was divided into tertiles of serum uric acid (according to 2.40-3.96, 3.97-5.10, and 5.11-9.80 mg/dl cut-off values of serum uric acid levels). Official and 24-h ambulatory non-invasive blood pressures of all patients were measured. The arterial stiffness was assessed by pulse wave velocity (PWV). PWV values were increased from first to third tertile (5.5 ± 0.6, 5.7 ± 0.8, 6.1 ± 0.7, respectively), but this gradual increase between tertiles did not reach significance. Linear regression analyses showed a positive correlation between serum uric acid levels and PWV (β = 0.40, p = 0.010), but no correlation was found between uric acid and daytime systolic blood pressure (β = 0.24, p = 0.345). In congenital renal agenesis/hypoplasia, the serum uric acid level was positively correlated with arterial stiffness, but there was no correlation with blood pressure.

Use of /sup 99m/Tc diethylenetriaminepentaacetic acid for assessment of renal function in dogs with suspected renal disease

International Nuclear Information System (INIS)

Krawiec, D.R.; Twardock, A.R.; Badertscher, R.R. II; Daniel, G.B.; Dugan, S.J.

1988-01-01

The effectiveness of technetium /sup 99m/-labeled diethylenetriaminepentaacetic acid (/sup 99m/Tc DTPA) to assess renal function in 13 dogs with suspected renal disease was evaluated. Glomerular filtration rates (actual GFR) were determined on the basis of endogenous creatinine clearance. Predicted GFR were determined by using /sup 99m/Tc DTPA within 72 hours after the determination of creatinine clearance. The percentage of an IV administered dose of /sup 99m/Tc DTPA in the kidneys (percentage dose) was determined. Two equations were used to calculate predicted GFR, which were derived from previously reported linear regression analysis of inulin (In) and creatinine (Cr) GFR vs percentage dose /sup 99m/Tc DTPA in dog kidneys. The correlations of actual GFR vs predicted GFR (In) and actual GFR vs predicted GFR (Cr) were both r = 0.92. The dogs' mean actual GFR was 1.73 +/- 1.35 ml/min/kg. Their mean predicted GFR (In) and predicted GFR (Cr) were 1.92 +/- 1.42 ml/min/kg and 1.85 +/- 1.27 ml/min/kg, respectively. Therefore, /sup 99m/Tc DTPA can be used with high accuracy as an agent to predict GFR in dogs with suspected renal disease. The procedure for determining GFR by use of nuclear medicine was rapid and noninvasive and appeared to induce little stress in the animals evaluated

Study of kidney damage in paediatric patients with neurogenic bladder and its relationship with the pattern of bladder function and treatment received.

Science.gov (United States)

Rodríguez-Ruiz, M; Somoza, I; Curros-Mata, N

2016-01-01

Kidney failure is the main cause of morbidity and mortality in patients with myelodysplasia. We analysed the presence of renal lesions in these patients using dimercaptosuccinic acid scintigraphy and related their presence with the type of vesical function and the delay in receiving appropriate management. We performed a retrospective study of patients with myelodysplasia treated in our hospital since 2004. We analysed the epidemiological and clinical data and the pattern of bladder function according to urodynamic studies. We classified the patients into 4 urodynamic patterns according to detrusor and sphincter behaviour. We linked this behaviour to renal function in the scintigraphy and the care received since birth. The study included 39 patients with myelodysplasia. The most common bladder pattern was type A (61.5%), with sphincter and detrusor hyperactivity, followed by type D (20.5%), C (7.8%) and B (5.1%). Some 38% of our patients (n=15) had some type of nephropathy. Some 92.9% of the children who were properly treated during the first year of their life had no renal lesions in the scintigraphy. We found some type of nephropathy in 56% of the patients for whom appropriate treatment was delayed for more than a year. The nephropathy was more severe the later the management was started. There is a statistically significant relationship between a delay in treatment and impairment in renal scintigraphy in patients with neurogenic bladders. The early study and treatment of patients is essential for decreasing renal impairment, reducing the need for surgery and improving the continence options. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Experimental study of per-rectal portal scintigraphy using 99mTc-EHIDA

International Nuclear Information System (INIS)

Tamaki, Satoshi; Shinotsuka, Akira; Takenaka, Hiroki

1991-01-01

We discovered that 99m Tc-diethyl iminodiacetic acid ( 99m Tc-EHIDA) commonly used for hepatobiliary scintigraphy could also be administered per-rectally, with adequate absorption and optimal visualization of the portal system. To evaluate its usefulness, we experimented on rabbits using the method. Portal scintigraphy with rectal administration of 99m Tc-EHIDA, 123 I-N-isopropyl-p-iodoamphetamine ( 123 I-IMP) and 99m Tc-red blood cell ( 99m Tc-RBC) were performed in normal rabbits and in extrahepatic portal shunt model rabbits. Images of the liver and thorax were obtained and shunt indices were calculated from the count values of liver and lung or heart. Then the shunt indices were compared with shunt rate derived from direct injection of 99m Tc-macroaglutinated albumin ( 99m Tc-MAA) into inferior mesenteric vein. Correlation between shunt rate of 99m Tc-MAA and shunt indices of 99m Tc-RBC, 123 I-IMP and 99m Tc-EHIDA were 0.64, 0.75 and 0.78, respectively, with 99m Tc-EHIDA having the most favorable results. We concluded that 99m Tc-EHIDA per-rectal portal scintigraphy is a noninvasive, quantitative, inexpensive and simple method for evaluation of portal circulation system. Also, we think that this method would be applicable to human usage from our experience with normal volunteers. (author)

Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

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Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

1995-06-15

Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.