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Sample records for cintigrama renal dmsa

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

    International Nuclear Information System (INIS)

    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)

  2. Is the renal uptake of 99mTc-DMSA decreased in microalbuminuric diabetic patient?

    International Nuclear Information System (INIS)

    Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of 99mTc-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of 99mTc-DMSA in predicting early diabetic nephropathy. 99mTc-DMSA scan was performed and a total renal uptake of 99mTc-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases ), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of 99mTc-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of 99mTc-DMSA and other clinical parameters were analyzed. The total renal uptake of 99mTc-DMSA of Group II (40.8±11.0%) was significantly lower than that of Group I (54.4±6.3%, p99mTc-DMSA total renal uptakes correlated negatively with serum creatinine level (r=0.629, p99mTc-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, 99mTc-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy

  3. The role of DMSA renal scintigraphy in the first episode of urinary tract infection in childhood

    International Nuclear Information System (INIS)

    The role of dimercaptosuccinic acid (DMSA) renal scintigraphy in the first episode of urinary tract infection (UTI) has been the subject of debate for many years. The aim of this study was to evaluate the relationship of voiding cystourethrography (VCUG), renal ultrasonography and DMSA renal scintigraphy and to detect renal parenchymal changes by performing DMSA renal scintigraphy at 6 months after the first episode of UTI. A prospective study was conducted in 67 hospitalized children (46 boys, 21 girls). Mean age of the patients was 0.97±1.57 years (0.02-7.26 years). All children received VCUG, renal ultrasonography and DMSA renal scintigraphy. DMSA renal scintigraphy was performed at 1 and 6 months after UTI. Of 67 children, 17 (25.4%), 23 (34.3%) and 20 (29.9%) had vesicoureteral reflux (VUR), abnormal renal ultrasonography and abnormal DMSA renal scintigraphy, respectively. Unilateral hydronephrosis had a significant correlation with VUR at p value 0.024. In renal units, abnormal renal ultrasonography and hydronephrosis had significant correlations with VUR at p values 0.039 and 0.021, respectively. In patients and renal units, hydronephrosis had no significant correlation with abnormal DMSA renal scintigraphy at 1 month after UTI. However, abnormal renal ultrasonography and VUR had significant correlations with abnormal DMSA renal scintigraphy at p values 0.022 and <0.001 in patients and at p values 0.024 and <0.001 in renal units, respectively. Both in patients and renal units, VUR (Grade I-III) had no significant correlation with abnormal DMSA renal scintigraphy. However, severe VUR (Grade IV-V) had significant correlations with abnormal DMSA renal scintigraphy at p values <0.001 and <0.001, respectively. Seventeen patients underwent DMSA renal scintigraphy at 6 months after UTI. In addition, 15 (88.2%) developed persistent renal scarring. Abnormal renal ultrasonography and severe VUR identify renal parenchymal changes. DMSA renal scintigraphy in the first

  4. A clinical study of the influence of percutaneous nephroureterolithotomy on renal function using 99mTc-DMSA renal scintigraphy

    International Nuclear Information System (INIS)

    To clarify the influence of percutaneous nephroureterolithotomy (PNL) on renal function, 99mTc-DMSA renal scientigraphy was performed preoperatively and 3, 6 and 12 months after the procedure. In 50 stone-containing renal units, 48 patients, changes of DMSA renal uptake rate were investigated for determination of individual renal function. In 3 cases with staghorn calculi which complicated with pyelonephritis during PNL procedure, DMSA renal uptake rate was decreased after PNL. On the other hand, DMSA renal uptake rate was almost stationary after PNL in other cases. In 21 renal units (42 %), the postoperative renal scintigrams showed low uptake or cold areas at nephrostomy tracts. These results indicate that control of infection during PNL is important to maintain renal function. (author)

  5. Is the renal uptake of {sup 99m}Tc-DMSA decreased in microalbuminuric diabetic patient?

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    Kim, Seong Jang; Kim, In Ju; Kim, Yong Ki [College of Medicine, Pusan National Univ., Pusan (Korea, Republic of)

    1999-08-01

    Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of {sup 99m}Tc-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of {sup 99m}Tc-DMSA in predicting early diabetic nephropathy. {sup 99m}Tc-DMSA scan was performed and a total renal uptake of {sup 99m}Tc-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases ), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of {sup 99m}Tc-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of {sup 99m}Tc-DMSA and other clinical parameters were analyzed. The total renal uptake of {sup 99m}Tc-DMSA of Group II (40.8{+-}11.0%) was significantly lower than that of Group I (54.4{+-}6.3%, p<0.001). The uptake of Group III (27.7{+-}12.0%) was significantly lower than those of both Group I and Group II (p<0.001). {sup 99m}Tc-DMSA total renal uptakes correlated negatively with serum creatinine level (r=0.629, p<0.001) and positively correlated with creatinite clearance rate (r=0.702, p<0.001). {sup 99m}Tc-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, {sup 99m}Tc-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy.

  6. 99mTc-DMSA Scintigram for Renal Function Recovery after Therapy in Infants and Children

    International Nuclear Information System (INIS)

    Authors retrospectively analysed 20 cases of follow-up 99mTc-DMSA renal scans to evaluate renal function recovery after treatment in urological disorders of infants and children. There were 20 cases with both 99mTc-DMSA renal scans prior to and after therapy in 15 patients below 9 years old. Among them, 10 patients underwent ureteroneocystostomy under the diagnosis of vesicoureteral reflux, two patients pyeloplasty because of obstructive uropathy and one was treated with antibiatics even diagnosis of UPJ stricture. We have got the quantified uptake rate of Tc-DMSA renal scan by using the regression equation as y=0.591 X 2.105 (y=the quantified uptake rate, x=the sirnple uptake rate). The number of kidneys performed proper therapy were 29, and the cases with more increased radiotracer uptake rate in the follow-up 99mTc-DMSA renal scans were 20 in number as 69% in frequency. 19 cases with improved renal function on 99mTc-DMSA renal scans didn't show any significant difference related to aging or recovery duration after therapy. The 99mTc-DMSA renal scans were not useful to evaluate renal function recovery in infants and children, but could be good tests to assess residual renal function prior to or after treatment.

  7. Evaluation of renal scarring in children with primary VUR by 99mTc-DMSA renoscintigraphy

    International Nuclear Information System (INIS)

    Renal scarring in 271 kidneys of 172 children with primary vesicoureteral reflux (VUR) was evaluated by 99mTc-DMSA (dimercaptosuccinic acid) renoscintigraphy. 58% of refluxing kidneys were with renal scar by the initial DMSA renoscintigraphy. Only 52% of these kidneys showed good correlation between the findings on intravesical pressure (IVP) and DMSA renoscintigram. Of the 144 refluxing kidneys with normal, 41% had renal scarring on DMSA renoscintigram. DMSA renoscintigram revealed widespread renal scarring in 28% of kidneys with only calyceal clubbing and in 60% of those with segmental cortical thinning of IVP. It is realized that IVP was an in-sensitive method to evaluate renal scarring of refluxing kidneys and such kidneys with segmental renal scar on IVP accompanies more widespread scar on DMSA renoscintigram. These cases were allocated to 2 age groups, younger than 3 years and older than 4 years. In the former group less than 10% of kidneys with low grade VUR and about 40% with high grade VUR had widespread renal scarring. On the contrary, in the latter group several renal scar was recognized in more than 20% of kidneys with low grade VUR and in about 60% with high grade VUR. (author)

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

    International Nuclear Information System (INIS)

    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)

  9. Digital simulation method for analyzing renal function by using sup(99m)Tc-DMSA

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    Ishine, Masahiro (Ehime Univ., Matsuyama (Japan))

    1984-10-01

    A digital simulation method for quantitative evaluation of renal function by using sup(99m)Tc-DMSA was proposed. The ultimate renal DMSA uptake rate, saturation time, and percent renal blood volume were calculated by this method, and its clinical usefulness was evaluated. This analytical method was thought to be reliable from the fact that calculated renal uptake rates showed a significant correlation with observed values after 2hrs' administration. Furthermore, calculated renal uptake rates were significantly correlated with the values of renal plasma flow and creatinine clearance. In the cases with obstructive uropathy, calculated renal uptake rate, saturation time, and percent renal blood volume were thought to reflect the grade and the feature of the disease. From these results, my proposed method was considered to be clinically useful as a quantitative renal function test.

  10. Changes in DMSA scan after PCNL procedure in children with renal calculi

    International Nuclear Information System (INIS)

    Percutaneous nephrolithotomy (PCNL) is an established technique for the management of renal calculi. However there is limited data on the effects of PCNL on the renal parenchyma especially in the paediatric population. This study was aimed to determine the effects of PCNL on the renal parenchyma in children with renal calculi using DMSA scan. Medical records of 37 patients who had undergone PCNL over a five-year period from 1999 to 2003 were reviewed. Details of imaging were not available in 11 patients and these were excluded from the study; only patients who had both preoperative and post operative DMSA scans or a normal postoperative DMSA scan were included. 26 patients (26 renal units) were therefore available for the review. The age of the patients ranged from 1 year to 12.5 years (median, 3.75 years) at the time of PCNL. DMSA scans was done from 1 day to 47 months (median, 2 months) before the PCNL and 2 months to 27 months (median, 3.5 months) after the procedure. Two independent observers interpreted the scans and any discrepancy was reviewed and the Conclusion was reached with mutual agreement. Regions of interest around each kidney were drawn to determine the percent uptake of DMSA. 20 patients (76.9%) showed no change or improvement in post-procedure scans. The uptake of DMSA was 43.63±10.11% (mean±SD) before and 42.79±11.80% after the PCNL procedure. This change did not reach the statistically significant level (p=0.334). Hence DMSA scans showed that PCNL procedure does not produce significant changes in the renal parenchyma in more than three quarters of the patients who undergo this procedure. (authors)

  11. Morphological classification of Renal Disease Using {sup 99m}Tc-DMSA Scintigram

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    Moon, Tae Yong [Pusan National University College of Medicine, Pusan (Korea, Republic of)

    1991-07-15

    {sup 99m}Tc-DMSA renal scan has been evaluated not only the renal functional cell mass but also some anatomical structures at a loss of the renal parenchymal function. The author classified a renal morphology of the posterior image of {sup 99m}Tc-DMSA renal scan as the groups of symmetic and asymmetric morphology, the groups of the large, normal and small sized kidneys, the groups of the central photon defects (PD) which could be noted in a dilated pelvocalyceal system due to obstructive uropathy and the cortical photon defects (CD) due to focal parenchymal lesions or scars after a loss of function and the last groups of the single and multiple CD for a suggestion of the clinical usefulness. Regarding to measurement of norrnal renal size, the longest size of the kidneys were evaluated with 5 cm of a lead scale on the posterior renal image, and those were decided to the limits beteen 104.1 and 119. 4 mm as comparison with the renal size of intravenous pyelogram (IVP) in 59 cases who were underwent {sup 99m}Tc-DMSA and IVP concommitantly. Among 85 cases of PD in {sup 99m}Tc-DMSA renal scan, the 61 (71.8%) were cases of a dilated pelvocalyceal system related with obstructive uropathy, meanwhile the 28 (27.0%) of 162 cases with CD were cases of obstructive and infectious uropathy. The probability of a presence of some uropathy in cases of CD were 99.3%, meanwhile that of the presence of CD in cases of some uropathy were 37.9%. Besides, there were some specific anatomical findings such as polycystic kidneys with symmetric enlarged kidneys with multiple CD and the kidneys of chronic renal failure and/or hypertension with syrnmetric small size in {sup 99m}Tc-DMSA renal scan.

  12. Morphological classification of Renal Disease Using 99mTc-DMSA Scintigram

    International Nuclear Information System (INIS)

    99mTc-DMSA renal scan has been evaluated not only the renal functional cell mass but also some anatomical structures at a loss of the renal parenchymal function. The author classified a renal morphology of the posterior image of 99mTc-DMSA renal scan as the groups of symmetic and asymmetric morphology, the groups of the large, normal and small sized kidneys, the groups of the central photon defects (PD) which could be noted in a dilated pelvocalyceal system due to obstructive uropathy and the cortical photon defects (CD) due to focal parenchymal lesions or scars after a loss of function and the last groups of the single and multiple CD for a suggestion of the clinical usefulness. Regarding to measurement of norrnal renal size, the longest size of the kidneys were evaluated with 5 cm of a lead scale on the posterior renal image, and those were decided to the limits beteen 104.1 and 119. 4 mm as comparison with the renal size of intravenous pyelogram (IVP) in 59 cases who were underwent 99mTc-DMSA and IVP concommitantly. Among 85 cases of PD in 99mTc-DMSA renal scan, the 61 (71.8%) were cases of a dilated pelvocalyceal system related with obstructive uropathy, meanwhile the 28 (27.0%) of 162 cases with CD were cases of obstructive and infectious uropathy. The probability of a presence of some uropathy in cases of CD were 99.3%, meanwhile that of the presence of CD in cases of some uropathy were 37.9%. Besides, there were some specific anatomical findings such as polycystic kidneys with symmetric enlarged kidneys with multiple CD and the kidneys of chronic renal failure and/or hypertension with syrnmetric small size in 99mTc-DMSA renal scan.

  13. Paediatric renal length measurements from ultrasound and DMSA scans: does clinical practice reflect theoretical normal values?

    International Nuclear Information System (INIS)

    Full text: Renal length measurement is a routine part of ultrasound examination in children and those results are plotted on a normogram style graph, so that each child's results are compared to a normal range (mean ± 2 S.D.). Renal length measurements from the posterior oblique views of dimercaptosuccinic acid (DMSA) scans in our department have not always correlated well with the ultrasound measurements on the same patients. Renal lengths from the DMSA scans of 120 patients with apparently normal kidneys were recorded and used to generate a normogram of renal length at different ages (0.5-7 years). This DMSA normogram was compared to the ultrasound (US) normogram used in the Paediatric Radiology Department, and it showed slight differences in renal lengths (3-8 mm), but that the US normogram had smaller coefficients of variation (US = 6.6%, NM 8.3%), implying a 'tighter' normal range. 39 of these patients had DMSA and ultrasound measurements of renal length within 3 months, and these were studied first by calculating the mean and CV values for different age groups, and then by plotting individual renal lengths on the appropriate normograms. The measured data produced much greater variability in the ultrasound measurements than the DTPA measurements, and the individual points produced 4/78 (5.1%) abnormal results for DMSA, but 21/78 (26.9%) abnormal results for ultrasound. Thus, in routine clinical use, using patients with apparently normal kidneys, ultrasound was unable to match the 'normal range' set by their current normogram, but the nuclear medicine showed 5.1% of values outside the normal (DMSA) range, which was completely appropriate for a range of ± 2 standard deviations

  14. Reduction of 4 hours absolute DMSA uptake when renal damage is bilateral

    International Nuclear Information System (INIS)

    Introduction: There is currently controversy concerning the use of absolute DMSA uptake (AU) as an indicator of renal function, with the literature containing articles either supporting or questioning the use of DMSA scans in this way. This paper offers some additional data, and a possible explanation of how best to use DMSA if absolute function is desired. Method: Absolute DSMA uptake was measured in patients referred for DMSA renal scan. These uptakes required corrections for the injected dose (MBq), the camera sensitivity (c/s/MBq), the delay after injection, and the renal depths. The results were grouped according to the (visual) status of the kidneys. Results: The total AU (R + L kidneys) for each group are presented, and indicate that if there is one normal kidney, or if renal parenchymal damage is minor, the 4 hour AU is normal. The 4 hour AU is only reduced when both kidneys show significant parenchymal renal damage. Conclusion: At 4 hours, AU is only useful when renal damage is severe. An explanation is proposed, whereby the value of AU would be greatest early, e.g. at 20 minutes when there would be the maximum separation between patients with normal and abnormal renal function

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

    International Nuclear Information System (INIS)

    Objective: Acute pyelonephritis (APN) is a common infectious disease in childhood. APN may result in ineversible renal scarring. 99Tcm-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 99Tcm-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 the

  16. Comparative assessment of renal Tc-99m DMSA scan and renal sonography findings in complication of urinary tract infections

    International Nuclear Information System (INIS)

    Urinary tract infection is a common disease in childhood specially in female. In this study 50 patients with established diagnosis of urinary tract infection were evaluated by both renal scan with Tc-99m DMSA and renal sonography. The study revealed that most urinary tract infections are in children, female sex between 5-9 years of age. Therefore the most important complications (renal scarring) are also common in this age-sex distribution. Occurrence of renal scars increase with increasing the number of recurrent infections. Vesicoureteral reflux is one of the most important, common risk factors for renal scarring. Renal Tc-99m Dmsa scan is more sensitive than renal sonography in detecting the renal scars

  17. Differential uptake of Tc-99m DMSA and Tc-99m EC in renal tubular disorders: Report of two cases and review of the literature

    International Nuclear Information System (INIS)

    Tc-99m DMSA and Tc-99m EC studies are invaluable functional imaging modalities for renal structural and functional assessment. Normally, the relative renal function estimated by the two methods correlates well with each other. We here present two patients with renal tubular acidosis who showed impaired/altered DMSA uptake with normal EC renal dynamic study depicting the pitfall of DMSA imaging in tubular disorders. The two presented cases also depict distinct pattern of Tc-99m DMSA scintigraphic findings in patients with proximal and distal renal tubular acidosis, thus highlighting the factors affecting DMSA kinetics

  18. 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

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    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)

  19. Computer analysis of the amount functioning renal parenchyma according scintigraphy with 99mTc - DMSA

    International Nuclear Information System (INIS)

    To assess the definition of information values of focal changes in the renal parenchyma as a fuzzy set according kidney scan with 99mTc-DMSA. The results of kidney scan of 99mTc-DMSA 15 patients. It is shown that it is advisable to determine the degree of damage to the renal parenchyma as a fuzzy set, it count lower, upper limits of defeat and 'average' rating. Segmentation algorithms developed scintigraphic imaging of the kidneys are informative, independent and requires their simultaneous use

  20. Quantitative renal function study using TC-99mDTPA and TC-99mDMSA

    International Nuclear Information System (INIS)

    In quantitative renal function studies using Tc-99m DTPA and Tc-99m DMSA, the kidney depth is an important factor to control the gamma rays' absorption by the soft tissue. However, to date, this renal depth has been estimated from the patient's height and weight according to the formula of Toennesen. In the present study, we measured the kidney depth by ultrasonography and so determined the renal uptake of Tc-99m DTPA and Tc-99m DMSA. Using the kidney depth as measured by ultrasonography, the correlation coefficient between renal uptake of Tc-99m DTPA and GFR (determined by the clearance method) was 0.878 and that between renal uptake of Tc-99m DMSA and ERPF (determined from paraaminohippuran clearance) was 0.945. On the other hand, using the kidney depth as calculated by Toenneren's formula, the correlation coefficient between Tc-99m DTPA uptake and GFR was 0.849 and that between Tc-99m DMSA uptake and ERPF was 0.891. Thus, the renal depth measured by ultrasonography provided a closer correlation than that calculated according to Toenesen's formula. (author)

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

    International Nuclear Information System (INIS)

    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)

  2. Renal dysplasia in infants: appearance on 99mTc DMSA scintigraphy

    International Nuclear Information System (INIS)

    Infantile renal dysplasias, including multicystic dysplastic kidneys (MCDK), are reported rarely to accumulate radiopharmaceuticals on renal scintigraphy. 99mTc DMSA is a highly sensitive tracer for detecting functioning renal cortical tissue and may be more suited to studying renal dysplasia than 99mTc DTPA. We reviewed the ultrasound studies and 99mTc DMSA scintigrams of 42 infants (age range 1-12 months) with known or suspected MCDK. Overall, uptake on 99mTc DMSA scintigraphy was evident in 6/41 (15%) dysplasic kidneys. Of the 18 patients who underwent nephrectomy, histopathological examination revealed that uptake correlated closely with the presence of mature remal cortical tissue in the affected kidney. Our study shows that a small, but significant number of MCDK will show lo-grade uptake on DMSA scintigraphy. This finding may be relevant given the reliance placed on renal scintigraphy in planning treatment for infants with suspected MCDK, particularly with the increasing trend for the non-operative management of this condition. (orig.)

  3. Renal dysplasia in infants: appearance on {sup 99m}Tc DMSA scintigraphy

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    Roach, P.J. [Dept. of Radiology, Div. of Nuclear Medicine, The Children`s Hospital and Harvard Medical School, Boston, MA (United States); Paltiel, H.J. [Dept. of Radiology, Div. of Nuclear Medicine, The Children`s Hospital and Harvard Medical School, Boston, MA (United States); Perez-Atayde, A. [Dept. of Pathology, The Children`s Hospital and Harvard Medical School, Boston, MA (United States); Tello, R.J. [Dept. of Radiology, Div. of Nuclear Medicine, The Children`s Hospital and Harvard Medical School, Boston, MA (United States); Davis, R.T. [Dept. of Radiology, Div. of Nuclear Medicine, The Children`s Hospital and Harvard Medical School, Boston, MA (United States); Treves, S.T. [Dept. of Radiology, Div. of Nuclear Medicine, The Children`s Hospital and Harvard Medical School, Boston, MA (United States)

    1995-08-01

    Infantile renal dysplasias, including multicystic dysplastic kidneys (MCDK), are reported rarely to accumulate radiopharmaceuticals on renal scintigraphy. {sup 99m}Tc DMSA is a highly sensitive tracer for detecting functioning renal cortical tissue and may be more suited to studying renal dysplasia than {sup 99m}Tc DTPA. We reviewed the ultrasound studies and {sup 99m}Tc DMSA scintigrams of 42 infants (age range 1-12 months) with known or suspected MCDK. Overall, uptake on {sup 99m}Tc DMSA scintigraphy was evident in 6/41 (15%) dysplasic kidneys. Of the 18 patients who underwent nephrectomy, histopathological examination revealed that uptake correlated closely with the presence of mature remal cortical tissue in the affected kidney. Our study shows that a small, but significant number of MCDK will show lo-grade uptake on DMSA scintigraphy. This finding may be relevant given the reliance placed on renal scintigraphy in planning treatment for infants with suspected MCDK, particularly with the increasing trend for the non-operative management of this condition. (orig.)

  4. {sup 99m}Tc-DMSA Scintigram for Renal Function Recovery after Therapy in Infants and Children

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    Moon, Tae Yong; Son, In Ju; Yoon, Chong Byung; Lee, Surk Hong; Kim, Byung Soo [Busan National University College of Medicine, Busan (Korea, Republic of)

    1994-03-15

    Authors retrospectively analysed 20 cases of follow-up {sup 99m}Tc-DMSA renal scans to evaluate renal function recovery after treatment in urological disorders of infants and children. There were 20 cases with both {sup 99m}Tc-DMSA renal scans prior to and after therapy in 15 patients below 9 years old. Among them, 10 patients underwent ureteroneocystostomy under the diagnosis of vesicoureteral reflux, two patients pyeloplasty because of obstructive uropathy and one was treated with antibiatics even diagnosis of UPJ stricture. We have got the quantified uptake rate of Tc-DMSA renal scan by using the regression equation as y=0.591 X 2.105 (y=the quantified uptake rate, x=the sirnple uptake rate). The number of kidneys performed proper therapy were 29, and the cases with more increased radiotracer uptake rate in the follow-up {sup 99m}Tc-DMSA renal scans were 20 in number as 69% in frequency. 19 cases with improved renal function on {sup 99m}Tc-DMSA renal scans didn't show any significant difference related to aging or recovery duration after therapy. The {sup 99m}Tc-DMSA renal scans were not useful to evaluate renal function recovery in infants and children, but could be good tests to assess residual renal function prior to or after treatment.

  5. THE IMPORTANCE OF 99m-Tc DMSA RENAL SCINTIGRAPHY IN EVALUATION OF RENAL LESIONS IN CHILDREN WITH ACUTE PYELONEPHRITIS

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    N Ataei

    2008-11-01

    Full Text Available "nUrinary tract infection (UTI may lead to irreversible changes in renal parenchyma. Early diagnosis using scintigraphy with technetium-99m-labeled dimercaptosuccinic acid (DMSA scan and early treatment may decrease or prevent development of renal parenchymal lesions. The aim of this study was to assess the occurrence of renal parenchymal lesion in children admitted with a first-time symptomatic UTI and to evaluate the relation between renal parenchymal damage and severity of vesicoureteral reflux (VUR. A total of 102 children with first time acute pyelonephritis (APN were enrolled in the study. All children studied with DMSA scan and ultrasonography (US. Voiding cystourethrography (VCUG was performed in 98 children when urine culture became negative. Changes on the DMSA scan and US were found in 178 (88% and 5 (2.4% out of 203 renal units during the acute phase, respectively. All abnormal renal units on US showed severe parenchymal involvement on DMSA. We also found significant correlation between severity of VUR and abnormal US results on kidneys. Of 40 kidneys with reflux, 38 (95% were found to have abnormal renal scan. Among 155 kidneys with non-refluxing ureters 132 (85.2% revealed parenchymal changes on renal cortical scintigraphy. Kidneys with moderate to severe reflux were more likely to have severe renal involvement. We found a high incidence of renal parenchymal changes in children with APN. Additionally, renal involvement was significantly higher in children with moderate to severe reflux. When there are high-grade VUR and female gender, the risk of renal parenchymal involvement is higher.

  6. Formal Charts for Quantified 99mTc-DMSA Renal Uptake Rates

    International Nuclear Information System (INIS)

    To Assessment of the quantified renal uptake rates in every 99mTc-DMSA scan tests of patients is actually difficult because of time consumption and complicated calculations required to measure the correct dose of the infused radionuclide and radiation decay, the adjustment for the depth of kidney and the subtraction of background count. We've formulated two regression models for the quantified renal uptake rates[I] from the simple renal uptake rates[H] with a square shaped ROI (Region-of-Interest) in 25 cases (Group 1) and with a kidney shaped ROI in 37 cases (Group 2), respectively. The regression model for the Group 1 was [I]1=0.885 [H]1-4.575 (P2=0.591 [H]2-2.105 (p99mTc-DMSA renal scan.

  7. 99mTc-DMSA renal scintigraphy in children with urinary tract infections and vesicouretheric reflux

    International Nuclear Information System (INIS)

    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

  8. Evaluation of renal scarring in children with primary VUR by /sup 99m/Tc-DMSA renoscintigraphy

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    Konda, Ryuichiro; Orikasa, Seiichi; Sakai, Kiyohide; Ota, Shozo; Kuji, Satoru; Ioritani, Naomasa; Nakamichi, Goro.

    1989-06-01

    Renal scarring in 271 kidneys of 172 children with primary vesicoureteral reflux (VUR) was evaluated by /sup 99m/Tc-DMSA (dimercaptosuccinic acid) renoscintigraphy. 58% of refluxing kidneys were with renal scar by the initial DMSA renoscintigraphy. Only 52% of these kidneys showed good correlation between the findings on intravesical pressure (IVP) and DMSA renoscintigram. Of the 144 refluxing kidneys with normal, 41% had renal scarring on DMSA renoscintigram. DMSA renoscintigram revealed widespread renal scarring in 28% of kidneys with only calyceal clubbing and in 60% of those with segmental cortical thinning of IVP. It is realized that IVP was an in-sensitive method to evaluate renal scarring of refluxing kidneys and such kidneys with segmental renal scar on IVP accompanies more widespread scar on DMSA renoscintigram. These cases were allocated to 2 age groups, younger than 3 years and older than 4 years. In the former group less than 10% of kidneys with low grade VUR and about 40% with high grade VUR had widespread renal scarring. On the contrary, in the latter group several renal scar was recognized in more than 20% of kidneys with low grade VUR and in about 60% with high grade VUR. (author).

  9. Radiation burden during renal scintigraphy with sup(99m)Tc-DMSA

    International Nuclear Information System (INIS)

    The radiation burden associated with renal scintigraphy using sup(99m)Tc-DMSA is shown up by use of data from the literature as well as of own data including a re-evaluation of the radiation dose. Kinetic data were obtained from six patients without kidney disease by measuring serum and urine activity. For calculation of the radiation doses the experimental data were fitted to pluricompartmental models in order to permit the calculation of the radiation doses according to the MIRD-method. The kidney cortex is the critical organ, with a radiation dose of 0.9 rd/mCi sup(99m)Tc-DMSA, the whole body radiation dose is calculated at 0.014 rd/mCisup(99m)Tc-DMSA. (orig.)

  10. Renal size in children with normal DMSA scintigraphy (DS): building a nomogram with scintigraphic data

    International Nuclear Information System (INIS)

    The aim of this was to evaluate the renal size in children with different ages, based in normal DMSA scintigraphic data. Material and Methods: We studied the length and width of kidneys measured from normal DMSA scans in children whose age varied from 1 month to 16 years old (91 men, 162 women, age average: 4.3 yr). We built nomograms of renal size vs age and a regression analysis of the data was done. We compared the distribution of scintigraphic data classified by sex and with published US data. Results: The scintigraphic distribution of the renal length vs age is presented. The best fitting regression equation for the whole data was y = 4.3349x 0.1456 with r:0.88. The lineal regression equation for 1 to 12 month was y = 0.1524x + 4.5668 and for 1-16 years was y = 0.0215x +6.3415. We did not find significant differences between boys and girls and between scintigraphic and published echographic data. Conclusion: 1) Our results support that renal DMSA scan size data are comparable with echographic renal size data. 2) Our data indicate that the growing rate of kidneys by month in the first year is similar to the growing rate by year later, without gender differences

  11. Renal cortical scarring and renal length measurement as assessed by 99mTc-DMSA and ultrasound examination - pathological correlation using the pig model

    International Nuclear Information System (INIS)

    Full text; The aims of this study were to validate DMSA appearances with histopathological features of scarring, to evaluate the sensitivity and specificity of DMSA and ultrasound (US) for the detection of renal scarring, to compare planar, pinhole and SPECT when performing DMSA and to compare DMSA and US renal length measurement. Reflux nephropathy was induced in large white pigs, using established methods. To ensure that the abnormalities detected were scars and not inflammatory changes, the pigs were not studied until three months following the treated episode of acute pyelonephritis confirmed by DMSA. Twenty-four pigs were enrolled in the study of which 11 reached the end-point. However, only nine pigs (18 kidneys) were available for analysis. Thirty-four scars were identified pathologically; 24 were present macroscopically and a further 10 were seen on microscopy only. DMSA abnormalities correlated with scars histopathologically with an accuracy of 92 per cent versus that of ultrasound, 25 per cent (p<0.001). DMSA more accurately identified scarring with a higher sensitivity (76% v 29%) and specificity (98% (92%) than US. On the DMSA study, pinhole imaging had the highest accuracy (92%) when compared with planar (90%) and SPECT (87%) data. Renal lengths as measured on DMSA were more closely correlated with length measurement at pathological examination than US. DMSA measurement was on average 6 per cent higher than pathology and US was on average 22 per cent lower. In conclusion, DMSA appears to be the preferred method for the detection of renal cortical scarring accurate renal length measurement when compared with ultrasound examination

  12. 99MTc - DMSA renal scintigraphy in the diagnosis and follow-up of acute pyelonephritis in children

    International Nuclear Information System (INIS)

    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

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

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    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.

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

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    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.

  15. An analysis of motion correction for 99Tcm DMSA renal imaging in paediatrics

    International Nuclear Information System (INIS)

    Movement artefact during paediatric 99Tcm DMSA renal imaging can reduce image quality and therefore render images non-diagnostic. This research assessed software used for the correction of movement artefact in children. The software comprised a count rate dependent dynamic acquisition with a 256 x 256 pixel frame-shift motion correction algorithm. A Williams' phantom was used to generate data during dynamic (experimental) and static (control) image acquisitions. During image acquisition, the Williams' phantom was moved to simulate seven typical paediatric patient movements; acquisitions also considered no movement (Gold Standard). Seven image data sets with motion artefact were corrected using the frame-shift software. The corrected, uncorrected, and static images were rated for quality by suitably qualified and experienced nuclear medicine professionals. The images were scored using an image quality assessment instrument, based on a Likert rating scale. Inferential statistics were applied to these data. The image quality ratings demonstrated a statistically significant (P 99Tcm DMSA renal scans

  16. Can MRI replace DMSA in the detection of renal parenchymal defects in children with urinary tract infections?

    International Nuclear Information System (INIS)

    Renal parenchymal defects may be a consequence of urinary tract infections (UTI) in childhood. MRI is a non-radiation imaging modality compared with DMSA scanning. To compare DMSA with MRI for the detection of renal parenchymal defects in children presenting for radiological investigation after a first UTI. Both DMSA and MRI were performed at the same appointment in 37 children (aged 4 months-13 years; mean 4.5 years) with a history of UTI. Both planar and SPECT DMSA were performed. MRI of the kidneys employed axial and coronal T1-, T2- and fat-saturated T1-weighted (T1-W) sequences. Some children had imaging after IV contrast medium. The coronal fat-saturated T1-W sequence was the best sequence and it detected all the findings on MRI. MRI had a sensitivity of 77% and a specificity of 87% for the detection of a scarred kidney using DMSA as the gold standard. MRI diagnosed pyelonephritis in two children that had been interpreted as scarring on DMSA. Renal MRI using a single, coronal, fat-saturated T1-W sequence is a rapid, accurate and minimally invasive technique for the detection of renal scarring that does not employ ionizing radiation. (orig.)

  17. Renal SPECT with {sup 99m} Tc-Dmsa. Reorientation and processing; SPECT renal con {sup 99m} Tc-Dmsa. Reorientacion y procesamiento

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, J.L.; Perera, A.; Fraxedas, R. [Centro de InvestigacionesClinicas 34 no.4501 e/45 y 47 Kohly, Playa C. Habana (Cuba)

    1998-12-31

    For the study of different renal affections with repercussion in the parenchyma is widely used the plane gammagraphy wit {sup 99m} Tc-Dmsa though not in the same way the SPECT technique. In general, the different inclination and orientation of the longitudinal axes of both kidneys in the patients entail aid to high variability in the detection of the different types of defects which leads to a possible mistaken diagnostic. With a view to this,it was developed in our centre a methodology for the automated reorientation of the different renal volumes obtained by SPECT and its posterior processing, obtaining as result a software with a high grade of independence from the operator. In this way, it is obtained a procedure standardization and so it let us with major rigor to realize evolutive studies of the patients. (Author)

  18. A comparative study of evaluating renal scars by [sup 99m]Tc-DMSA planar and SPECT renal scans, intravenous urography, ultrasonography

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    Yen, Tzu-Chen; Chen, Wei-Perng; Chang, Shu-Lian; Huang, Yan-Cherng; Yeh, Shih-Hwa; Lin, Ching-Yuang (Veterans General Hospital, Taipei, TW (China)); Hsieh, Chung-Pin

    1994-05-01

    The purpose of this prospective study is to compare 3 types of [sup 99m]Tc-dimercaptosuccinic acid (DMSA) renal scan [(a) planar, (b) x-ray type film static SPECT presentation (SPECT-1) and (c) dynamic three-view display of SPECT slices (SPECT-2)], intravenous urography, and ultrasonography in the diagnosis of renal scars. All these studies were performed in 130 pediatric patients, with urinary tract infection (42 patients), vesicoureteral reflux (37), and unilateral or bilateral small kidney(s) (51). The number of renal scars detected was highest with the [sup 99m]Tc-DMSA renal SPECT-1 scan and next came the [sup 99m]Tc-DMSA renal SPECT-2 studies. There is a significant difference (p<0.05) between the ability of planar and SPECT-1 to recognize renal defects. However, SPECT-2 may provide the best stereotactic localization and image quality of all the methods. (author).

  19. 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)

    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) 99mTc 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.)

  20. The determination of relative renal function in a pediatric population using Tc-99m DTPA and Tc-99m DMSA

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    Rosen, P.R.; Kuruc, A.; Treves, S.T.

    1985-05-01

    Three methods for evaluating relative renal function in a pediatric population were compared. The clinical and nuclear medicine data of 73 patients were reviewed. Pertinent data included patient age, serum creatinine and the referral diagnosis (reflux, hypertension, obstructive uropathy). Time activity curves for renal regions of interest (ROI) were obtained by renography with Tc-99m DTPA, and deconvolved by an externally detected blood pool curve Furosemide was then administered to evaluate the renal collecting system (if indicated). This was followed by DMSA administration. Relative function was determined in 3 ways: 1) Accumulated renal DTPA activity 60-120 sec. following injection. 2) Amplitude of the tubular phase of the deconvolved renal curve and, 3) Accumulated Tc-99m DMSA activity in renal ROI 4 or 24 hrs. post-injection. Regression analysis revealed: 1) The basic relationship of relative functional data obtained by all three methods was not affected by creatinine, age or other factors. 2) The relationship between the three methods is linear and highly correlated. 3) The DMSA values may be predicted from either method of analyzing the DTPA study using appropriate predictor equations. The authors conclude that Tc-99m DMSA, due to its higher cost and more radiation exposure should not be used for the routine evaluation of relative renal function.

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

    International Nuclear Information System (INIS)

    Objective: To study the value of 99Tcm-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 99Tcm-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 99Tcm-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: 99Tcm-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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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)

    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)

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

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    Kawamura, Juichi (Kyoto Univ. (Japan). Faculty of Medicine)

    1982-08-01

    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.

  5. Evaluation of Renal Function Determined by Relative Renal Uptake of '99mTc-DMSA and Relative Glomerular Filteration Rate of 99mTc-DTPA

    International Nuclear Information System (INIS)

    The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. We measured 2 hour, 4 hour and 24 hour relative renal uptake of '99mTc-DMSA and relative glomerular filtration rate of 99mTc-DTPA with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of 99mTc-DMSA and relative glomerular filtration rate. The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of 99mTc-DMSA and relative glomerular filtration rate of 99mTc-DTPA were R=0.9190 (p99mTc-DMSA had the best correlation with relative glomerular filtration rate of 99mTc-DTPA and that might be useful in evaluation of chronic renal disease in which showed increased background activity or acute obstructive uropathy.

  6. Tc-99m DMSA scan and quantification for renal calculus disease

    International Nuclear Information System (INIS)

    Full text: The DMSA renal quantification, as a prognostic test in kidney stone disease, was studied in 33 patients with staghorn calculi imaged with Tc-99m DMSA before nephrectomy (irrecoverable loss of the renal function, persistent pyonephrosis or urinary infection). Scintigraphic degrees were A- 30,8% (normal) B- 10,8% (focal defect with incomplete photon loss), C- 40,0% (focal defect with incomplete photon loss) and D- 18,4% (uptake absent). In the removed kidneys we found A- 0%, B- 5,9%, C- 58,8% and D- 35,5%. In all cases except one the absolute uptake index of the removed kidneys (AURK) was below 5,0 (mean 1,75). The image length of the removed kidneys (ILRK) in this group was ranged from 5,47 to 9,79 cm (mean 7,9 cm). In the 20 cases with unilateral kidney disease all of the removed kidneys presented the RU below 50% including the total functional absence (7 of 20). In all cases except one the AURK was below 5,0 (mean 2,4). The ILRK in this group was ranged from 3,77 to 11,05 cm (mean 6,57 cm). The differences were significant between ILPK (preserved kidney) and ILRK (p=0,002) AUPK and AURK (p<0,0001) and RUPK and RURK (p<0,0001). Both RU and AU appear to correlate well with the medical decision of nephrectomy

  7. Renal SPECT with 99m Tc-Dmsa. Reorientation and processing

    International Nuclear Information System (INIS)

    For the study of different renal affections with repercussion in the parenchyma is widely used the plane gammagraphy wit 99m Tc-Dmsa though not in the same way the SPECT technique. In general, the different inclination and orientation of the longitudinal axes of both kidneys in the patients entail aid to high variability in the detection of the different types of defects which leads to a possible mistaken diagnostic. With a view to this,it was developed in our centre a methodology for the automated reorientation of the different renal volumes obtained by SPECT and its posterior processing, obtaining as result a software with a high grade of independence from the operator. In this way, it is obtained a procedure standardization and so it let us with major rigor to realize evolutive studies of the patients. (Author)

  8. Validity of {sup 99m}Tc-DMSA renal uptake by planar posterior-view method in children

    Energy Technology Data Exchange (ETDEWEB)

    Tsukamoto, Eriko; Katoh, Chietsugu; Mochizuki, Takafumi; Shiga, Toru; Morita, Koichi; Tamaki, Nagara [Hokkaido Univ., Sapporo (Japan). School of Medicine; Itoh, Kazuo

    1999-12-01

    Renal uptake {sup 99m}Tc-DMSA has been quantified by various methods. The aim of this study is to obtain a normal value for {sup 99m}Tc-DMSA renal uptake calculated by the posterior view method and age variation, and to assess its clinical validity. Scintigrams of 238 children (0-12 years) with {sup 99m}Tc-DMSA were reviewed. All the children had a clinical history of primary vesicoureteral reflux and/or neurogenic bladder, ureteral or urethral anomalies. Their kidneys were divided into two groups, ''normal'' and abnormal'' according to their scintigraphic findings and split renal functions. Percent renal uptake per injected dose (% RU) was quantitated from planar images at 2 hours after injection of an age-adjusted dose (26-95 MBq) of {sup 99m}Tc-DMSA. Calculated total % RU, individual % UR of the right and left kidneys (mean{+-}sd) in patients with normal kidneys were 40.7{+-}5.0%, 20.2{+-}3.0%, 20.4{+-}2.7%, respectively. There was no significant correlation between % RU and age (r=0.231). Longitudinal variation in the % RU in 9 patients ranged from 1.2% to 18%. Our conventional method for quantifying % RU is simple, practical and feasible in routine clinical practice, especially for children under follow up. (author)

  9. A study of child movement during 99Tcm DMSA renal imaging procedures

    International Nuclear Information System (INIS)

    Movement artefact during paediatric nuclear medicine imaging can, on occasion, reduce image quality and therefore render images non-diagnostic. To minimise such problems, immobilisation, distraction, and sedation techniques may be employed. The associated risks of sedation, its unpredictability and the requirement of ward admission are the point of much concern. This study aimed to establish the types of movement children display during nuclear medicine scans, focusing particularly on 99Tcm Static DMSA renal imaging - where the majority of scan requests are for paediatrics. A triangulated research method was used, comprising a literature review; observation of children during DMSA image acquisition (age range 0-10 years); and a focus group discussion with dedicated paediatric nuclear medicine professionals. Seven archetypal paediatric patient movements were identified and are described within this paper. The awareness of these findings should allow the health care worker to predict, with more confidence, how children of varying ages may move during an imaging procedure. This should allow immobilisation and distraction techniques to be used more appropriately in the clinical setting

  10. A study of renal leak of 99mTc-DMSA in maleate-treated rats by factor analysis

    International Nuclear Information System (INIS)

    To elucidate renal leak of 99mTc-dimercaptosuccinic acid (99mTc-DMSA) in maleate-treated rats, plasma amino acid levels and urinary excreted %doses of 99mTc-DMSA and 131I-orthoiodohippurate (131I-OIH) were studied by factor analysis. 0.4 m mol of Na-maleate dissolved in 2 ml of saline was intraperitoneally injected twice at an interval of 20 hours. Four hours later after second injection, mixture of 99mTc-DMSA and 131I-OIH was injected from tail vein. Urine was collected 15 minutes later to calculate the excretion ratios. Then rats were sacrificed by decapitation and blood samples were taken by cardiac puncture to determine plasma levels of amino acids and their metabolites. Urinary excreted %doses of 99mTc-DMSA were 10.1±1.3% in control group (n=5) and 10.6±4.9% in maleate-treated group (n=10). Of the 10 treated rats, only 2 rats showed clearly increased excretion of 99mTc-DMSA (19.1% and 19.4% respectively and others ranged from 6.2% to 12.0%). Fifteen variables used for factor analysis consisted of the %doses of two kinds of radiopharmaceuticals and 13 kinds of the data of amino acids analysis. Statistical procedures were as follows. Varimax rotation was performed, two factors were extracted and factor scores for each rat were plotted to obtain scattergram. Interpretation of the results led to a hypothesis that renal leak of 99mTc-DMSA might be relevant to decreased glutamine metabolism. (author)

  11. Can Tc 99m DTPA be Used in Adult Patients in Evaluation of Relative Renal Function Measurement as the Reference Tc99 DMSA Method ?

    Directory of Open Access Journals (Sweden)

    Hülya Yalçın

    2011-04-01

    Full Text Available Objective: In the literature, there are many reports comparing relative renal function calculated with Tc 99m DTPA and Tc 99m DMSA in adults and children. However, there is no consensus about the results. As there is indeterminacy in the reliability of Tc 99m DTPA for the calculation of the relative renal functions, we retrospectively designed a study to compare the relative renal functions measured with Tc 99m DMSA and Tc 99m DTPA in adult patients with renal diseases Material and Methods: We retrospectively analyzed the data of 144 patients who applied to Nuclear Medicine Department of three hospitals between 2009 and 2010 and who had both dynamic and static renal imaging. Renal dynamic scintigraphies were compared to the relative function measured using Tc 99m DMSA static scintigraphy. Comparison of relative renal function measurements using dynamic and static renal scintigraphies was performed using Pearson correlation test. The comparison results were expressed with Bland-Altman analysis. Results: The study was conducted with 144 patients and 288 kidneys. Fifty six of patients were male. Mean age was 39.9±15.2 years. Thirty four patients had hydronephrosis, 28 pyelonephritis, 53 renal calculi, 3 chronic renal failure, 2 acute renal failure, 1 benign renal neoplasia, 15 renal atrophy, 8 ureteropelvic junction stenosis. Relative renal function was calculated in Tc 99m DMSA and 99m Tc-DTPA studies. The mean relative renal functions measured with Tc 99m DTPA was 52.54±23.09% and 47.25±23.09, with Tc 99m DMSA 52.85±21.80% and 47.07±21.77% for right and left kidneys, respectively. In bivariate correlation analysis (Pearson a significant positive correlation was found between the relative renal functions calculated with Tc 99m DTPA and Tc 99m DMSA (r =0.937, p< 0.001. In Bland-Altman plots, the mean difference between two methods was 0.3 and the correlation limits were between 16.2 to -15.5. Conclusion: As a result, we concluded that Tc 99m

  12. Evaluation of quantitative split renal function testing methods using 99mTc-DTPA and 99mTc-DMSA renoscintigraphy in children with vesicoureteral reflux

    International Nuclear Information System (INIS)

    It is vital to accurately evaluate renal function in children with vesicoureteral reflux. To determine whether quantitative split renal function testing methods using 99mTc-DTPA and 99mTc-DMSA renoscintigraphy reflect renal function as accurately in children as in adults, 99mTc-DTPA and 99mTc-DMSA renoscintigraphies were performed in 21 children with vesicoureteral reflux within 5 days of each other for a total of 40 times. There were 12 boys and 9 girls ranging in age from 2 months to 16 years (mean, 6.8 years). The kidney depth was measured by ultrasonography. The correlation coefficient between 99mTcDTPA and 99mTc-DMSA total renal uptake was 0.275, and the correlation coefficients between 99mTc-DTPA and 99mTc-DMSA total renal uptakes and creatinine clearance were 0.402 and 0.522, respectively. The correlation coefficient between the accumulation count ratio (R/R+L) in 99mTc-DTPA and that in 99mTc-DMSA was 0.974. The total renal uptake obtained from 99mTc-DTPA and 99mTc-DMSA renoscintigraphy is not as reliable in children as in adults, and at present it is most appropriate to use a combination of accumulation count ratio (R/R+L) and 24 hr creatinine clearance value as examinations to evaluate general renal function. (author)

  13. Relative renal function estimate by renal scintigraphy with 99mTc-DMSA: influence of attenuation correction methods

    Directory of Open Access Journals (Sweden)

    Andreia Amaro

    2015-05-01

    Full Text Available Introduction – The estimate of relative renal function (RRF through scintigraphy with dimercaptosuccinic acid labelled with Technetium-99 metastable (99mTc-DMSA may be influenced by kidney depth (KD, due to attenuation by soft tissue surrounding the kidneys. Considering that rarely this KD is known, several methods for attenuation correction (AC have been developed, namely those using empirical formulae, such as Raynaud, Taylor or Tonnesen methods, or by direct calculation of the geometric mean (GM. Objectives – To identify the influence of different AC methods on RRF estimateby scintigraphy with 99mTc-DMSA and to evaluate the respective KD variability. Methods: Thirty-one patients were referred for 99mTc-DMSA scintigraphy and underwent the same acquisition protocol. Processing was performed by 2 independent operators, three times per exam, changing for the same processing the methods for the FRR determination: Raynaud’s method, Taylor’s method, Tonnesen´s method, GM and without AC (WAC. Friedman’s test was used to identify the influence of the different AC methods on RRF estimate and Pearson’s correlation test was used to evaluate the association and significance between KD and the variables age, weight and height. Results – Friedman’s test indicated that there were significant differences between methods (p=0.000, except for WAC/Raynaud, Tonnesen/GM and Taylor/GM (p=1.000 comparisons, for both kidneys. Pearson’stest showed a strong positive correlation between weight and the three methods of KD estimation. Conclusions – Taylor’s method, regarding the three methods of KD calculation, is the closest to GM. The choice of the attenuation correction method influences significantly the quantitative parameters of FRR.

  14. Contribution of the renal scintiscanning with the DMSA in the diagnosis of Pyelonephritides, acute and chronic, of the child

    International Nuclear Information System (INIS)

    In the case of urinary infection of children, a complete clinical and biological picture can be enough to retain the diagnosis of a high attack. However, this possibility is rare. In the contrary cases, a renal scintiscanning with the DMSA must be carried out with the acute phase, to confirm the diagnosis. For the children carrying acute pyelonephritis, a scintigraphic control is necessary to detect the cortical scars.

  15. Clinical study concerning upper urinary tract obstruction, 2. Relationship between sup(99m)Tc-DMSA uptake in obstructed kidneys and their renal function

    Energy Technology Data Exchange (ETDEWEB)

    Murayama, Tetsuo; Yamada, Tetsuo; Taguchi, Hirokazu; Watanabe, Yukio; Tasei, Yukimitsu (Sagamihara National Hospital, Kanagawa (Japan))

    1983-11-01

    To establish a method of detecting divided renal function of the obstructed kidneys non-invasively, comparative studies on sup(99m)Tc-DMSA uptake (60 minutes after injection), I/sup 131/-hippuran renal uptake (1-2 minutes after injection) and divided creatinine clearance immediately after relief of urinary obstruction were made on 24 cases of obstructive uropathy. A close significant correlation was obtained between sup(99m)Tc-DMSA and I/sup 131/-hippuran renal uptakes ..gamma..=0.8809, P < 0.001). Also, a significant correlation was noted between sup(99m)Tc-DMSA renal uptake and divided creatinine clearance ..gamma..=0.7876, P < 0.001), but the latter constantly gave lower values than the former. These observations led us to conclude that sup(99m)Tc-DMSA renal uptake is a reliable indicator of the renal plasma flow in the obstructed kidneys. Quantitative divided renal function of the obstructed kidneys can be estimated by the sup(99m)Tc-DMSA uptake method.

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

    International Nuclear Information System (INIS)

    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 99mTc-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 3rd 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 in

  17. Evaluation of quantitative split renal function testing methods using {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA renoscintigraphy in children with vesicoureteral reflux

    Energy Technology Data Exchange (ETDEWEB)

    Nozaki, Tomoji; Kajimoto, Teruho; Nakamura, Koichiro; Kitatani, Hideki; Konuma, Kunio; Kohno, Miyuki; Okii, Kazuya [Kanazawa Medical Univ., Uchinada (Japan)

    1995-06-01

    It is vital to accurately evaluate renal function in children with vesicoureteral reflux. To determine whether quantitative split renal function testing methods using {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA renoscintigraphy reflect renal function as accurately in children as in adults, {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA renoscintigraphies were performed in 21 children with vesicoureteral reflux within 5 days of each other for a total of 40 times. There were 12 boys and 9 girls ranging in age from 2 months to 16 years (mean, 6.8 years). The kidney depth was measured by ultrasonography. The correlation coefficient between {sup 99m}TcDTPA and {sup 99m}Tc-DMSA total renal uptake was 0.275, and the correlation coefficients between {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA total renal uptakes and creatinine clearance were 0.402 and 0.522, respectively. The correlation coefficient between the accumulation count ratio (R/R+L) in {sup 99m}Tc-DTPA and that in {sup 99m}Tc-DMSA was 0.974. The total renal uptake obtained from {sup 99m}Tc-DTPA and {sup 99m}Tc-DMSA renoscintigraphy is not as reliable in children as in adults, and at present it is most appropriate to use a combination of accumulation count ratio (R/R+L) and 24 hr creatinine clearance value as examinations to evaluate general renal function. (author).

  18. DMSA scan nomograms for renal length and area: Related to patient age and to body weight, height or surface area

    International Nuclear Information System (INIS)

    Aim: To create nomograms for renal size as measured from DMSA renal studies, and to test the nomograms for their ability to separate normal from abnormal kidneys. Method: Renal length was measured from posterior oblique views and renal area from posterior views. Results from 253 patients with bilateral normal kidneys were used to create nomograms for renal size relative to patient age, body height, weight or body surface area (BSA). The nomograms enclosed 95% of the normal kidneys, thus indicating the range for 95% confidence limits, and hence the specificity. Each nomogram was then tested against 46 hypertrophied kidneys and 46 damaged kidneys. Results: The results from nomograms of renal length and renal area, compared to age, body height, body weight and BSA are presented. For each nomogram, the range is presented as a fraction of the mean value, and the number of abnormal kidneys (hypertrophied or damaged) outside the normal range is presented as a percentage (indicating the sensitivity). Conclusion: Renal Area was no better than renal length for detecting abnormal kidneys. Patient age was the least useful method of normalisation. BSA normalisation produced the best results most frequently (narrower ranges and highest detection of abnormal kidneys)

  19. L-Carnitine Protection Against Cisplatin Nephrotoxicity In Rats: Comparison with Amifostin Using Quantitative Renal Tc 99m DMSA Uptake

    OpenAIRE

    Yakup Yürekli; Perihan Ünak; Çiğdem Yenisey; Türkan Ertay; Fazilet Zumrut Biber Müftüler; Emin İlker Medine

    2011-01-01

    Objective: In this study, we aimed to investigate the cytoprotective effect of L-carnitine against cisplatin-induced nephrotoxicity and to compare its efficacy with that of amifostin by quantitative renal Tc 99m DMSA uptake. Material and Methods: Male Wistar rats were randomly divided into six groups of six animals each. 1) Control (saline; 5 ml/kg intraperitoneally); 2) L-carnitine (CAR; 300 mg/kg intraperitoneally); 3) Amifostine (AMI; 200 mg /kg intraperitoneally); 4) Cisplatin (CIS;7 mg/k...

  20. Comparison of differential renal function using technetium-99m mercaptoacetyltriglycine (MAG3) and technetium-99m dimercaptosuccinic acid (DMSA) renography in a paediatric population

    International Nuclear Information System (INIS)

    In children who have undergone both 99mTc-DMSA and 99mTc-MAG3 studies for the assessment of differential renal function (DRF) and drainage, respectively, we have noticed good agreement between the calculated DRF values, and hypothesized that there is no significant difference in DRF values calculated from these tests. Therefore, both tests may not always be necessary. To determine whether there is a statistically significant difference between DRF values calculated using 99mTc-DMSA and those calculated using 99mTc-MAG3. We retrospectively identified children imaged with 99mTc-DMSA and 99mTc-MAG3. We recorded DRF values, age, indication, and renal pelvis diameter. For the 99mTc-DMSA studies we recorded the imaging time after injection. For the 99mTc-MAG3 studies we recorded the delay between injection and data acquisition, diuretic use and evidence of delayed drainage or reflux. We identified 100 episodes in 92 children where both 99mTc-DMSA and 99mTc-MAG3 scans had been performed within a few days. The commonest indication was urinary tract infection or pelviureteric junction obstruction. The mean age of the children was 6.96 years. A significant but clinically acceptable trend was seen between abnormal DRF and difference between tests. A significant link was found with the difference between tests and the time of imaging after DMSA injection, and also with scarring. No significant effect was caused by renal pelvis dilatation, delayed drainage, frusemide administration, or delayed 99mTc-MAG3 imaging. If a 99mTc-MAG3 study has been performed then a 99mTc-DMSA study is unnecessary provided DRF is normal on the 99mTc-MAG3 study and there is no scarring. A change in practice would lead to considerable savings in time, cost and radiation burden. (orig.)

  1. Study of the biokinetic behavior of {sup 99m}Tc-DMSA in renal scintigraphy of pediatric patients; Estudo de comportamento biocinetico do {sup 99m}Tc-DMSA em cintilografia renal de pacientes pediatricos

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Felipe Simas dos

    2013-07-01

    In Brazil, renal studies with {sup 99m}Tc{sub D}TPA and {sup 99m}Tc-DMSA constitute about 18% of pediatric diagnostic procedures. A retrospective non-randomized study was conducted in 2010, for absolute quantification of kidney activities. In 2010,51 patients underwent renal studies in the Hospital of the Rio de Janeiro State University - HUPE-UERJ/ RJ, Brazil. 19 of them with 9±4 years of age and body mass of 31.8±20.8 kg showed relative uptake of {sup 99m}Tc-DMSA between 45% and 55%. Still images (AP, PA and posterior oblique abdomen incidences) were acquired 4 h after intravenous administration of 115.69±42.31 MBq of {sup 99m}Tc-DMSA using gamma camera (Siemens E-Cam), LEHR collimator, matrix of 256x256 and 5min imaging. In 2012, 3 patients (9.3±2.1 years, 31.97±10.75 kg) in the previous study were followed in a prospective study. All urinary excretions samples were collected from administration of {sup 99m}Tc-DMSA to 6 h after, while simultaneously images were acquired AP and PA abdominal region with Philips model Picker Prism 2000XP. Aliquots of each urine sample were measured in gamma counter shaft GenesysTM Gamma 1 with Nal (TI) detector. For whole body, the biological half-life estimate was 11.0±2.0 h, and the residence time was found to be 5.6±0.4 h while the literature suggests 4.l±0.5 h for age range studied. Residence time for kidney was found to be 0.7±0.4 h, while the literature shows, 3.07 h and 1.4 h for patients with normal and renal pathologies, respectively. This difference may be attributed to the methodology because while the images were taken during the first 6 h, SMITH et aI. (1996) performed images of the kidneys and whole body 30 h after administration of 99mTc{sub D}MSA, incorporating the slow term of biological half-life. For liver, it was found the average residence time of 3.0±0.4 min, whereas the literature indicates 20.8 min and 25.1 min, respectively according to SMITH et. ai (1996) and ICRP (1998). The fact that the

  2. Study of the biokinetic behavior of 99mTc-DMSA in renal scintigraphy of pediatric patients

    International Nuclear Information System (INIS)

    In Brazil, renal studies with 99mTcDTPA and 99mTc-DMSA constitute about 18% of pediatric diagnostic procedures. A retrospective non-randomized study was conducted in 2010, for absolute quantification of kidney activities. In 2010,51 patients underwent renal studies in the Hospital of the Rio de Janeiro State University - HUPE-UERJ/ RJ, Brazil. 19 of them with 9±4 years of age and body mass of 31.8±20.8 kg showed relative uptake of 99mTc-DMSA between 45% and 55%. Still images (AP, PA and posterior oblique abdomen incidences) were acquired 4 h after intravenous administration of 115.69±42.31 MBq of 99mTc-DMSA using gamma camera (Siemens E-Cam), LEHR collimator, matrix of 256x256 and 5min imaging. In 2012, 3 patients (9.3±2.1 years, 31.97±10.75 kg) in the previous study were followed in a prospective study. All urinary excretions samples were collected from administration of 99mTc-DMSA to 6 h after, while simultaneously images were acquired AP and PA abdominal region with Philips model Picker Prism 2000XP. Aliquots of each urine sample were measured in gamma counter shaft GenesysTM Gamma 1 with Nal (TI) detector. For whole body, the biological half-life estimate was 11.0±2.0 h, and the residence time was found to be 5.6±0.4 h while the literature suggests 4.l±0.5 h for age range studied. Residence time for kidney was found to be 0.7±0.4 h, while the literature shows, 3.07 h and 1.4 h for patients with normal and renal pathologies, respectively. This difference may be attributed to the methodology because while the images were taken during the first 6 h, SMITH et aI. (1996) performed images of the kidneys and whole body 30 h after administration of 99mTcDMSA, incorporating the slow term of biological half-life. For liver, it was found the average residence time of 3.0±0.4 min, whereas the literature indicates 20.8 min and 25.1 min, respectively according to SMITH et. ai (1996) and ICRP (1998). The fact that the administered activity was higher than the

  3. Technetium-99m-N,N-ethylenedicysteine and Tc-99m DMSA scintigraphy in the evaluation of renal parenchymal abnormalities in children

    International Nuclear Information System (INIS)

    Technetium-99m dimercaptosuccinic acid (Tc-99m DMSA) as a static renal agent is currently the most frequently used agent in the detection of renal scarring, and allows accurate calculation of differential renal function (DRF). But this agent has some disadvantages such as relatively higher radiation dose and time consumption. The purpose of this study was to evaluate the potential of summed image that obtained from parenchymal phase of the dynamic technetium-99m-N,N-ethylenedicysteine (Tc-99m EC) scintigraphy in the detection of renal parenchymal defects and in the estimation of DRF, and to compare the results of this method with those of Tc-99m DMSA scintigraphy. The uptake ratios of the kidney to body background were also calculated for these two methods. Twenty-nine children with various renal disorders underwent both static Tc-99m DMSA and dynamic Tc-99m EC scintigraphy. The cortical analysis of Tc-99m EC scintigraphy was performed on the summed image obtained from dynamic images using the time interval between the first 45-120 sec. There was a very close correlation between these two methods with respect to DRF (r=0.99). In the detection of renal parenchymal lesions, scintigraphy with Tc-99m DMSA detected more lesions, and the sensitivity and specificity of the summed Tc-99m EC images were calculated as 92.6% and 100%, respectively. In addition, the ratios of mean uptake values for Tc-99m DMSA and Tc-99m EC images were 7.59±2.17 and 2.95±0.91, respectively. This ratio of Tc-99m EC seems to be acceptable and allows good delineation of the kidneys. But, the main disadvantages of the summed Tc-99m EC images in comparison with static Tc-99m DMSA images are the use of only posterior projection that may be an important drawback in patients with abnormal kidney positions, lower image counts and higher pixel size because of dynamic acquisition. These results show that summed Tc-99m EC images with an acceptable high image contrast provide an accurate DRF calculation

  4. The importance of using anterior and posterior views in the calculation of differential renal function using 99Tcsup(m)-DMSA

    International Nuclear Information System (INIS)

    Radionuclide techniques for determining relative renal function are well established. One simple method uses the count rate from static images obtained using 99Tcsup(m)-dimercaptosuccinic acid (DMSA). We have reviewed 277 DMSA scans and shown that it is important to obtain the geometric mean of counts from the anterior and posterior views in order to correct for the different amounts of attenuation for each kidney. If counts were obtained from the posterior view only, erroneous results would be obtained in 8% of children under 13 years, in 28% of patients aged between 13 and 20 years and in 32% of patients over 20 years of age. (author)

  5. Cuban typical doses for 99mTc-DMSA renal gammagraphy studies: a methodology for the establishment of reference levels

    International Nuclear Information System (INIS)

    Since a handful of years ago, international rules on Radiological Protection include the principle of optimization of given dose to patients, if this procedure doesn't lessen diagnosis quality, and the establishment of reference levels of activity. For these reasons, the Radiological Protection staff of Cuban Institute of Nephrology's Nuclear Medicine Service, where morpho functional renal studies are carried out, 70% on infants and young children, started a research on that way. Thus, because their biggest incidence, 99mTc -DMSA renal gammagraphy studies were chosen, using a General Electric 400 AT Planar Gamma Camera. Studied sample was randomly selected, including adults (12 peoples) and children (23); divided into 4 groups, lessen given dose step by step. Other items were kept in mind in the research, such age, weight, time delayed between administrations and image getting, getting time of each view and total time of the study, as well as radiopharmaceuticals quality and Gamma Camera performance. Image quality was evaluated for each case, using both, objective and subjective criteria. Objective evaluation was done by using contrast/noise ratios and variance of the random noise. They were used to develop clustering and discriminant analysis over the independent variables to detect groups with differentiated image quality from the physical and mathematical point of view. Subjective evaluation was performed using the criteria of two expert observers who had no information about the activity levels used. They evaluated image quality separately, giving a good, regular or bad evaluation for each image. As a conclusion, we found that it is possible to reduce the given activities in 50% and thus, indirectly, to reduce doses for workers and for the public. Additionally, we propose a methodology for the establishment of reference levels for 99mTc -DMSA renal gammagraphy studies in Cuba, both, for adults and paediatric patients. (author)

  6. L-Carnitine Protection Against Cisplatin Nephrotoxicity In Rats: Comparison with Amifostin Using Quantitative Renal Tc 99m DMSA Uptake

    Directory of Open Access Journals (Sweden)

    Yakup Yürekli

    2011-04-01

    Full Text Available Objective: In this study, we aimed to investigate the cytoprotective effect of L-carnitine against cisplatin-induced nephrotoxicity and to compare its efficacy with that of amifostin by quantitative renal Tc 99m DMSA uptake. Material and Methods: Male Wistar rats were randomly divided into six groups of six animals each. 1 Control (saline; 5 ml/kg intraperitoneally; 2 L-carnitine (CAR; 300 mg/kg intraperitoneally; 3 Amifostine (AMI; 200 mg /kg intraperitoneally; 4 Cisplatin (CIS;7 mg/kg intraperitoneally; 5 Cisplatin plus L-carnitine (CIS + CAR; 6 Cisplatin plus amifostine (CIS + AMI. L-carnitine and amifostine were injected 30 minutes before cisplatin in Group 5 and 6. Tc 99m DMSA, 7.4 MBq/0.2 ml, was injected through the tail vein 72 hours after the drug administration. Rats were killed and kidneys removed by dissection 2 hours after the injection of the radiopharmaceutical. The percentage of the injected dose per gram of kidney tissue (%ID/g was calculated. Renal function was monitored by measuring BUN and plasma levels of creatinine. Lipid peroxidation and glutathione content were determined by measuring malondialdehyde (MDA and reduced glutathione (GSH in kidney tissue homogenates. Results: Tc 99m DMSA uptake per gram tissue of the kidney as %ID/g was 29.54±4.72, 29.86 ± 7.47 and 26.37 ± 4.54 in the control, CAR and AMI groups respectively. %ID/g was the lowest of all the groups, 11.60±3.59 (p<0.01, in the cisplatin group. Carnitine or amifostine administration 30 minutes before cisplatin injection resulted a significant increase in %ID/g, 21.28±7.73 and 18.97±3.24 respectively, compared to those of cisplatin-treated rats (p<0.002. A marked increase in plasma BUN and creatinine indicating nephrotoxicity and acute renal failure was observed in the cisplatin-treated group. MDA and GSH levels were concordant with cisplatin-induced oxidative stress in the kidney tissue. Conclusion: The results showed that L-carnitine significantly

  7. 99mTc-MAG3 vs 99mTc-DMSA early images: A practice options for the study of renal morphology

    International Nuclear Information System (INIS)

    99m Tc- DMSA renal scans are considered a gold standard for the evaluations of cortical defects Nevertheless 99m Tc -MAG3 early images (1-2 min after administration) present clearly defined images of the renal parenchyma. In this work 37 patients with clinical suspicion of upper tract infection were studied with both tracers. Renal ages were evaluated for the presence of cortical defects in a blind fashion by a group of three experts and split function was calculated. Results were highly coincident. It is concluded that early 99mTc -MAG3 can be used to study renal morphology and patient irradiated can be reduced

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

    International Nuclear Information System (INIS)

    This research thesis deals with the study of the dimercaptosuccinic acid (DMSA) marked with 99mTc, 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 99mTc and the biological distribution of 99mTc in order to reach a better understanding of the biological mechanism which results in technetium fixation to the kidney

  9. Comparison of relative split renal function with DMSA using posterior static imaging only with combined anterior-posterior acquisition

    International Nuclear Information System (INIS)

    Aim: Protocols for evaluation of renal function with DMSA vary from simple posterior static imaging to more time-consuming methods including anterior and posterior views with depth correction. The aim of this study was to investigate if there is a clinically significant difference between values of relative split renal function using a single posterior image (SP) or combined data from anterior and posterior acquisitions (AP). Material and Methods: We studied 21 consecutive patients, 14 children (ages 2.34±3 years) and 7 adults (ages 54.6±21 years) with a variety of pathologic conditions referred for renal evaluation. All patients had normotopic, bilaterally functioning kidneys. All were injected intravenously with a dose of 1.48 MBq/kg (0.04 mCi/kg) of 99mTc-DMSA and studies acquired 4-6 hours later. Static images were obtained for 5 minutes each, in the posterior and then in the anterior projection with a large field-of-view rectangular gamma camera equipped with a high resolution collimator, using a 64x64 matrix with zoom factor as required. Regions of interest were drawn using a semi-automatic thresholding method for the kidneys with semi-crescent automatic background (BKG) areas. Relative differential function was then calculated using the software provided with the system. One method uses posterior image only with no depth correction and the other uses both anterior and posterior views, requiring the patient's body thickness in cm for geometrical mean calculation plus depth correction. For the first method, the following simple formula is used: Left (or right) % uptake = Left (or right) BKG corrected cts/Left + right BKG corrected cts. For the second method, each kidney counts are first calculated as follows: Kidney counts √(anterior x posterior BKG corrected cts).eμ.T/2. K, where μ is the linear attenuation coefficient (1.22 cm-1), T is the body thickness in cm and K=1. Results: The following values of relative split functions for SP/AP methods were: 48

  10. Evaluation of Renal Function Determined by Relative Renal Uptake of '9{sup 9m}Tc-DMSA and Relative Glomerular Filteration Rate of {sup 99m}Tc-DTPA

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Byung Chun; Choi, Chang Il; Kim, Kwang Weon; Lee, Jae Tae; Lee, Kyu Bo; Kwon, Tae Hwan; Cho, Dong Kyu [Kyungpook National University School of Medicine, Seoul (Korea, Republic of)

    1991-07-15

    The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. We measured 2 hour, 4 hour and 24 hour relative renal uptake of '9{sup 9m}Tc-DMSA and relative glomerular filtration rate of {sup 99m}Tc-DTPA with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of {sup 99m}Tc-DMSA and relative glomerular filtration rate. The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of {sup 99m}Tc-DMSA and relative glomerular filtration rate of {sup 99m}Tc-DTPA were R=0.9190 (p<0.001), R=0. 9229 (p<0.001) and R=0.9917 (p<0.001). In acute obstructive uropathy, the correlations at 2 hour and 4 hour were poor as R=0.1812 (p<0.05) and R=0.4923 (p<0.05), but the correlation at 24 hour was good as R=0.9942 (p<0.001). We concluded that relative renal uptake at 2 hour and 4 hour had good correlation with relative DTPA uptake ratio in the cases without chronic renal failure and obstructive uropathy. Delayed image with 24 hour relative renal uptake of {sup 99m}Tc-DMSA had the best correlation with relative glomerular filtration rate of {sup 99m}Tc-DTPA and that might be useful in evaluation of chronic renal disease in which showed increased background activity or acute obstructive uropathy.

  11. QC studies and biological evaluations of three locally produced renal pharmaceutical preparations: 99mTc-DTPA, 99mTc-GH, and 99mTc- DMSA

    International Nuclear Information System (INIS)

    Quality control (QC) studies were done of three locally produced renal preparations of 99mTc- DTPA, 99mTc-GH and 99mTc-DMSA, as part of the production activity before the Gulf war. These studies were performed using gel chromatography column scanning (GCS) technique, although there are other alternative techniques. These kits were tested for radiochemical purity, and the labeling yields were found to be excellent. Biological studies included the following parameters: organ distribution (in mice, rats and rabbits), blood clearance in rabbits, and plasma protein binding in rats at different time intervals. Poor renal concentration of three agents in mice was significant at two time intervals. The tissue distribution in mice of DTPA, GH, and DMSA kits, which were stored at 37 deg. C for 30 days, after intravenous injection of the radioactivity at 5, 30, and 60 minutes, respectively, is presented. Blood retention of the renal agents was considerably low compared to those in rats and rabbits at the respective time intervals. The blood clearance of 99mTc-DMSA was relatively slow, and 99mTc-GH has rapid blood clearance, identical with that of 99mTc-DTPA for the first 20 minutes but slower thereafter. The binding of DTPA, GH and DMSA with plasma protein was 5, 65, 95 % at 1 h, respectively. Various amounts of tin (II) (as SnCl2), were used in the kits, with up to 10 times more of the usual dose for respective tin-complex. It was observed that there was no significant variation of the organ distribution in mice

  12. Crossed Fused Renal Ectopia: Presentations on 99mTc-MAG3 Scan, 99mTc-DMSA SPECT, and Multidetector CT.

    Science.gov (United States)

    Moon, Eun Ha; Kim, Min-Woo; Kim, Young Jun; Sun, In O

    2015-10-01

    Crossed renal ectopia is an uncommon developmental anomaly in which both kidneys are located on the same side of the body. The present case describes a 20-year-old man who underwent the military entrance physical examination. The ultrasound showed the right kidney in normal site with slightly increased size, but the left kidney was not identified. Tc-MAG3 scan showed a single kidney with 2 ureters, and the orifices of the ureters were connected at both sides of bladder. Tc-DMSA SPECT and contrast-enhanced multidetector CT were performed and revealed crossed fused renal ectopia. PMID:26252333

  13. Comparative biological parameters for the evaluation of common renal pharmaceutical preparations. 99mTc-DTPA, 99mTc-GH, and 99mTc-DMSA

    International Nuclear Information System (INIS)

    This work is concerned on establishing the necessary comparative quality control biological parameters for the evaluation of locally produced renal pharmaceutical preparations viz. tin complexes of 99mTc-DTPA, 99mTc-GH, and 99mTc-DMSA using gel chromatography column scanning techniques. Radiochemical purity, labeling yields, organ distribution, blood clearance and plasma protein binding were used as a selected indicator for quality control. The higher renal accumulation and tissue distribution were apparent with 99mTc-DTPA in mice, while blood retention was considerably low. The blood clearance of 99mTc-DMSA was relatively slow, while that of 99mTc-GH was rapid. The binding of 99mTc- DTPA, 99mTc-GH and 99mTc-DMSA with plasma protein were found to be 5, 65, and 95 % at 1.0 h, respectively. The stability of these cold kits was not affected on storing at 37 deg C for 30 days. (author)

  14. Which are risk factors developing renal cortical defects on 99mTc-DMSA scintigraphy in children with acute urinary tract infections?

    International Nuclear Information System (INIS)

    To determine (1) the relationship between the cortical defects seen on 99''mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on 99mTc-DMSA renal scans. We studied 134 kidneys in 67 children aged 15 days-10 years (M:F =3D 39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p less than 0.05) and grade of reflux (p less than 0.05). As this latter increased, the extent of cortical defects also increased (p less than 0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesicoureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. Renal cortical defects are significantly related to age

  15. Which are risk factors developing renal cortical defects on {sup 99m}Tc-DMSA scintigraphy in children with acute urinary tract infections?

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Seong Won; Lim, Gye Yeon; Jang, Hae Suk; Lee, Eun Ja; Sohn, Hyung Sun; Hahn, Sung Tae [The Catholic University, Seoul (Korea, Republic of)

    2000-04-01

    To determine (1) the relationship between the cortical defects seen on {sup 99}''mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on {sup 99m}Tc-DMSA renal scans. We studied 134 kidneys in 67 children aged 15 days-10 years (M:F =3D 39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p less than 0.05) and grade of reflux (p less than 0.05). As this latter increased, the extent of cortical defects also increased (p less than 0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesicoureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. Renal cortical defects are

  16. {sup 99m}Tc(V)-DMSA scintigraphy in monitoring the response of bone disease to vitamin D{sub 3} therapy in renal osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Sarikaya, A.; Sen, S.; Hacimahmutoglu, S.; Pekindil, G. [Trakya Univ., Edirne (Turkey). Faculty of Medicine

    2002-02-01

    Renal osteodystrophy (ROD) is a common and serious complication for uremic patients and patients are treated with 1,25-dihydroxyvitamin D{sub 3}. The bone scanning agent {sup 99m}Tc-phosphate has also been used to evaluate in ROD but it is not clear that bone scintigraphy has a role in the follow-up of treatment. In this study {sup 99m}Tc(V)-DMSA scintigraphy was performed in eleven patients [age 40.7{+-}17.3 (mean {+-}SD) yr] with ROD before and after vitamin D{sub 3} therapy. Images were obtained after hemodialysis performed following tracer injection to maintain normal blood levels of the radiopharmaceutical and to reduce soft tissue activity. Lumbar vertebra-to-soft tissue uptake ratios (LUR) were quantified with the planar {sup 99m}Tc(V)-DMSA images. Alkaline phosphatase and parathyroid hormone levels after tretment had significantly decreased compared with pre-therapy. In all patients there was visually decreased uptake in bone structures after treatment. After treatment the mean LUR ratio was significantly lower than those of before treatment (3.59{+-}2.63 vs. 1.65{+-}0.62; p=0.01). LUR values were correlated with pre-therapy alkaline phosphatase and parathyroid hormone. These findings indicate that {sup 99m}Tc(V)-DMSA scintigraphy is sensitive in evaluating the response of ROD to vitamin D{sub 3} therapy. (author)

  17. 99mTc(V)-DMSA scintigraphy in monitoring the response of bone disease to vitamin D3 therapy in renal osteodystrophy

    International Nuclear Information System (INIS)

    Renal osteodystrophy (ROD) is a common and serious complication for uremic patients and patients are treated with 1,25-dihydroxyvitamin D3. The bone scanning agent 99mTc-phosphate has also been used to evaluate in ROD but it is not clear that bone scintigraphy has a role in the follow-up of treatment. In this study 99mTc(V)-DMSA scintigraphy was performed in eleven patients [age 40.7±17.3 (mean ±SD) yr] with ROD before and after vitamin D3 therapy. Images were obtained after hemodialysis performed following tracer injection to maintain normal blood levels of the radiopharmaceutical and to reduce soft tissue activity. Lumbar vertebra-to-soft tissue uptake ratios (LUR) were quantified with the planar 99mTc(V)-DMSA images. Alkaline phosphatase and parathyroid hormone levels after treatment had significantly decreased compared with pre-therapy. In all patients there was visually decreased uptake in bone structures after treatment. After treatment the mean LUR ratio was significantly lower than those of before treatment (3.59±2.63 vs. 1.65±0.62; p=0.01). LUR values were correlated with pre-therapy alkaline phosphatase and parathyroid hormone. These findings indicate that 99mTc(V)-DMSA scintigraphy is sensitive in evaluating the response of ROD to vitamin D3 therapy. (author)

  18. 99Tcm-DMSA absolute uptake an indicator of true renal function: normal paediatric values at 2-4 hours

    International Nuclear Information System (INIS)

    Full text: Absolute uptake of Dimercaptosuccinic acid [DMSA] gives additional information about the functional status of the kidneys and correlates well with creatinine clearance rates. Most investigators recommend quantitative measurements should be carried out at least six hours post injection, however for imaging, a time interval of between two to four hours is optimal. This study aims to determine if the normal absolute uptake values can be accurately predicted over this range of post injection imaging times. 88 normal kidneys were analysed from 44 children with a mean age of 5.4 years (range 0.4 - 15.0). The mean time between injection and scan was 171.7 minutes (range 105 - 230). The absolute uptake as a percentage of the administered activity was found and from this the absolute uptake of DMSA in mg was calculated for each kidney. Absolute uptake of DMSA versus time between injection and scan showed no linear relationship graphically. The Pearson's correlation coefficient [corr] was 0.223 (p = 0.036). When all measured factors were analysed a strong positive linear relationship was found between the absolute uptake of DMSA and the amount of DMSA injected in mg (corr 0.940 (p<0.005)), and the age of the child. (corr = 0.770 (p<0.005)) Multiple linear regression showed that these two factors accounted for 91.9% of the change in absolute DMSA uptake. The F value was 479.21 (p<0.005) indicating very strong evidence for rejection of the null hypothesis that no linear relationship exists. In conclusion time between injection and scan appears to play little role in the absolute uptake of DMSA over two to four hours. The absolute uptake can be accurately predicted using a linear regression equation incorporating the amount of DMSA injected in mg and the patient's age. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  19. DMSA-scintigraphy in paediatrics: is the evaluation of the geometric mean necessary for the calculation of the differential renal function?; Partialfunktionsberechnung der Nieren mit DMSA in der Paediatrie: ist fuer die Bestimmung das geometrische Mittel notwendig?

    Energy Technology Data Exchange (ETDEWEB)

    Porn, U.; Alalp, S.; Fischer, S.; Dresel, S. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany); Rossmueller, B. [Inst. fuer Radiologische Diagnostik, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany); Hahn, K. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany); Inst. fuer Radiologische Diagnostik, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany)

    2001-08-01

    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{sub dors} x Cts{sub ventr})]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (p<0.01). The mean difference between the PF{sub geom} and the PF{sub 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{sub 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

  20. 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)

    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(Ctsdors x Ctsventr)]. Results: The differential function of the right kidney was significantly less when compared to the calculation of the geometric mean (pgeom and the PFdors 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 PFdors 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.)

  1. Prevalence of acute pyelonephritis and incidence of renal scarring in children under the age of two with urinary tract infection evaluated by 99mTc-DMSA renal scintigraphy: the experience of a university hospital

    International Nuclear Information System (INIS)

    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 99mTc-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)

  2. 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)

  3. Study of the optical densitometry measurement for analysis of osseous and renal scintigraphies with MDP-99m Tc and DMSA-99m Tc

    International Nuclear Information System (INIS)

    The optical densitometry can be used as a technique for radiographic images measurement to determine the radiopharmaceutical uptake or reception by human organs. In this paper were studied optical densitometry measurements using about 600 osseous scintigraphies produced with MDP-99mTc in eighteen parts of the human skeleton from 170 healthy and sick people and also in 56 renal scintigraphies produce with DMSA-99mTc in the same number of people both healthy and sick that performed this second examination type. The results showed that for the skeleton, the optical densitometry can give a correct analysis of the person pathological areas and, if it will be automated, through microcomputer it can become a useful instrument to perform diagnoses with smaller probability of mistakes than the visual traditional method performed by the physician, turning the most effective individual treatment. For the kidney, the optical densitometry can visualize the relative renal function showing the uptake percentage of the radiopharmaceutical by the organ, but it is not capable to supply a complete diagnosis. (author)

  4. Quality control studies and biological evaluation of three locally produced renal pharmaceutical preparations: 99mTc-DTPA, 99mTc-GH and 99mTcDMSA

    International Nuclear Information System (INIS)

    Quality control (QC) studies of three locally produced renal preparation of 99mTc-DTPA, 99mTc-GH and 99mTc-DMSA, as a part of the production activity before the Gulf war. The radioanalytical studies were performed using Gel Chromatography column Scanning (GCS) technique, although there are other alternative techniques. These kits tested for radiochemical purity and the labeling yields were found to be excellent. The biological studies included the following parameters; organ distribution (in mice, rats and rabbits), blood clearance in rabbits and plasma protein binding in rats at different time intervals. The poor renal concentration of three agents in mice was significant at two time intervals . The tissue distribution of DTPA, GH and DMSA kits, which were stored at 37 OC for 30 days in mice after intravenous injection of the radioactivity at 5, 30 and 60 minutes. The blood retention of the renal agents was considerably low compared to those in rats and rabbits at the respective time intervals. The blood clearance of 99m'Tc-DMSA was relatively slow and 99mTc-GH has rapid blood clearance identical with that of 99mtc-DTPA for the first 20 minutes but slower thereafter. The binding of DTPA, GH and DMSA with plasma protein was 5, and 95% at 1 hour respectively. Various amounts of tin (11) (as SnCl-2) were used in the kits with up to 10 times more of the usual dose for respective tin-complex and it was observed that there was no significant variation of the usual dose for respective tin-complex and its was observed that there was no significant variation of the organ distribution in mice. (Author)

  5. Short communication: timeline of radiation-induced kidney function loss after stereotactic ablative body radiotherapy of renal cell carcinoma as evaluated by serial 99mTc-DMSA SPECT/CT

    International Nuclear Information System (INIS)

    Stereotactic ablative body radiotherapy (SABR) has been proposed as a definitive treatment for patients with inoperable primary renal cell carcinoma. However, there is little documentation detailing the radiobiological effects of hypofractionated radiation on healthy renal tissue. In this study we describe a methodology for assessment of regional change in renal function in response to single fraction SABR of 26 Gy. In a patient with a solitary kidney, detailed follow-up of kidney function post-treatment was determined through 3-dimensional SPECT/CT imaging and 51Cr-EDTA measurements. Based on measurements of glomerular filtration rate, renal function declined rapidly by 34% at 3 months, plateaued at 43% loss at 12 months, with minimal further decrease to 49% of baseline by 18 months. The pattern of renal functional change in 99mTc-DMSA uptake on SPECT/CT imaging correlates with dose delivered. This study demonstrates a dose effect relationship of SABR with loss of kidney function

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    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.

  8. Potential pitfall of DMSA scintigraphy in patients with ureteral duplication

    International Nuclear Information System (INIS)

    A 5-wk-old male presented with radiographic findings of a duplicated collecting system. A [/sup 99m/Tc]DMSA scan was requested to evaluate cortical function. Images obtained immediately. postinjection showed activity restricted to the upper poles; in contrast, delayed images at 4 hr showed activity in the bladder and throughout both kidneys. Catheterizing the patient drained the activity from the bladder but had little effect on the refluxed renal activity. The early [/sup 99m/Tc]DMSA images were critical in making the proper interpretation. Technetium-99m DMSA is excreted into the urine and this fact needs to be considered when interpreting scans of patients with possible reflux or obstruction. When DMSA scans are obtained in pediatric patients with possible reflux, catheterization prior to the study and early images prior to the appearance of DMSA in the collecting system are recommended

  9. Potential pitfall of DMSA scintigraphy in patients with ureteral duplication

    Energy Technology Data Exchange (ETDEWEB)

    Wu, F.; Snow, B.; Taylor, A. Jr.

    1986-07-01

    A 5-wk-old male presented with radiographic findings of a duplicated collecting system. A (/sup 99m/Tc)DMSA scan was requested to evaluate cortical function. Images obtained immediately. postinjection showed activity restricted to the upper poles; in contrast, delayed images at 4 hr showed activity in the bladder and throughout both kidneys. Catheterizing the patient drained the activity from the bladder but had little effect on the refluxed renal activity. The early (/sup 99m/Tc)DMSA images were critical in making the proper interpretation. Technetium-99m DMSA is excreted into the urine and this fact needs to be considered when interpreting scans of patients with possible reflux or obstruction. When DMSA scans are obtained in pediatric patients with possible reflux, catheterization prior to the study and early images prior to the appearance of DMSA in the collecting system are recommended.

  10. Clinical evaluation of /sup 99m/Tc-DMSA renogram

    Energy Technology Data Exchange (ETDEWEB)

    Van Poppel, H.; Vereecken, R.; Vekemans, K.; Verduyn, H.; Mortelmans, L.; de Roo, M.

    1985-04-01

    Two hundred-two /sup 99m/Tc-DMSA renograms for urologic problems were evaluated. Some technical aspects of the examination and the value of the scintigraphic depth estimation are discussed. Pre- and postoperative uptake values in patients with renal surgery and sequential postoperative examinations are considered. The value of DMSA renograms in predicting recovery in obstructive uropathy and in deciding to opt for conservative therapy or nephrectomy is discussed.

  11. Study of the optical densitometry measurement for analysis of osseous and renal scintigraphies with MDP- sup 9 sup 9 sup m Tc and DMSA- sup 9 sup 9 sup m Tc

    CERN Document Server

    Silva, M C C D

    2001-01-01

    The optical densitometry can be used as a technique for radiographic images measurement to determine the radiopharmaceutical uptake or reception by human organs. In this paper were studied optical densitometry measurements using about 600 osseous scintigraphies produced with MDP- sup 9 sup 9 sup m Tc in eighteen parts of the human skeleton from 170 healthy and sick people and also in 56 renal scintigraphies produce with DMSA- sup 9 sup 9 sup m Tc in the same number of people both healthy and sick that performed this second examination type. The results showed that for the skeleton, the optical densitometry can give a correct analysis of the person pathological areas and, if it will be automated, through microcomputer it can become a useful instrument to perform diagnoses with smaller probability of mistakes than the visual traditional method performed by the physician, turning the most effective individual treatment. For the kidney, the optical densitometry can visualize the relative renal function showing th...

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

    International Nuclear Information System (INIS)

    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)

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

    International Nuclear Information System (INIS)

    Eighteen patients were evaluated before and 5 weeks after the first treatment with extracorporeal shock wave lithotripsy (ESWL) using abdominal plain radiography, 131I-hippuran probe renography, and 99mTc-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.)

  14. Scintigraphy with technetium dimercaptosuccinic acid (99m Tc DMSA)

    International Nuclear Information System (INIS)

    Renal uptake of 99m Tc DMSA was used to evaluate the renal function of 16 healthy subjects (controls) and 115 patients with various urinary tract diseases. Scintigraphic examination was carried out 6 hours after an intravenous injection of the product. In the 16 controls Tc DMSA uptake was 25.7+-2.48% in the right kidney and 24.4+-2.86% in the left kidney. In 36 patients with one single hypertrophied kidney, there was a correlation (r=0.850) between creatinine clearance and Tc DMSA uptake, which was higher than in normal subjects (39.23+-9.9%). In the group of 68 patients with unilateral (31) or bilateral (37) renal disease, a significant correlation (r=0,725) was observed between kidney-to-kidney ratios of urea clearance and Tc DMSA uptake, so that renal impairment could be quantified. Quantitative scintigraphy did not appear to be of assistance in the remaining 11 patients with obstructive uropathy, as it overestimated renal function. The results obtained with 99 m Tc DMSA scintigraphy should be helpful in choosing between nephrectomy and conservative surgery and in assessing the degree of compensatory hypertrophy in single kidneys

  15. Limitations of 99mTc-DMSA scan in diagnosing acute pyelonephritis in children

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    Byung Gee Kim

    2010-03-01

    Full Text Available Purpose : We aimed to prove the relative limitation of 99mTc-DMSA scintigraphy (DMSA compared to computed tomography (CT in diagnosing acute pyelonephritis (APN in children. Methods : Since September 2006, after a 64-channel CT was imported, 10 DMSA false-negative patients have been identified: these patients underwent a CT scan for acute abdomen or acute febrile symptoms and were diagnosed as having APN; however, their DMSA scans were clear. We focused on these 10 DMSA false-negative patients and analyzed their clinical findings and CT results. We used Philips Brilliance Power 64-channel CT scanner for the CT scan and Siemens Orbitor Nuclear Camera 60 Hz for the DMSA scan. Results:The 10 DMSA false-negative patients were mostly males (80% and infants (80%. They had fever for a mean of 1.1-day duration before admission and showed increase in acute reactants: leukocyte, erythrocyte sedimentation rate, and C-reactive protein. The CT findings of renal lesions were focal in 6 (60% cases and diffuse in 4 (40% cases, and most of the lesions were unilateral in 80% of patients. CT proved that 22 renal lesions were neglected by DMSA. Differential renal function test by DMSA was also of no use in the evaluation of renal lesions. Conclusion:In this study, DMSA scan showed limitation in finding renal cortical lesions of CT-proven APN patients. DMSA false-negative results seem to occur at early-phase disease of infantile age, but more prospective studies are needed to determine the reasons and their prevalence.

  16. DMSA study performed during febrile urinary tract infection: a predictor of patient outcome?

    International Nuclear Information System (INIS)

    DMSA study is an established method for the assessment of renal sequelae after acute pyelonephritis related to febrile urinary tract infection (UTI). However, at the moment is not established if the DMSA study performed during the acute UTI has any prognostic value for outcome assessment. Objectives: to assess the usefulness of DMSA study performed during febrile UTI as predictor of patient outcome. Methods: One hundred-fifty-two children (74 boys) with mean age 20 months (range 1m-12 y) with first febrile UTI were studied by DMSA planar scintigraphy during the acute illness period (first 5 days). All patients had positive grown bacillus in urine (78% E. coli, 8% P. mirabilis), and all followed the same antibiotic treatment. After acute UTI all patients were explored by voiding cysto urethrography for diagnosis of vesicoureteral reflux (VUR). Fifty-seven patients who had an abnormal DMSA study, VUR, or recurrent UTI underwent a DMSA control study (mean 8m after UTI). Results: DMSA study during febrile UTI was normal in 112 children (74%). In 95 of these children, follow-up DMSA studies were not performed due to a good clinical outcome (no VUR, no recurrent UTI). In the remaining 17 patients, follow-up DMSA studies were normal as well. Forty children (26%), who presented focal or diffuse cortical lesions during acute UTI, underwent a DMSA control study. Twenty-six of them presented a normal control DMSA, and 14 (9% of all patients) presented cortical lesions, 10 associated with a high-grade VUR. Fifty-seven children were followed by control DMSA, and no significant correlation between initial and follow-up study was found (κ= 0.250, p<0.007). Conclusion: These results indicate that DMSA study performed during febrile UTI may not be useful as predictor of patient outcome. Voiding cysto urethrography and control DMSA study seem to be more useful to select patients at risk of development of chronic cortical lesions

  17. Static renal scintigraphy with 99mTc-DMSA or dynamic renal scintigraphy with 99mTc-EC at the assessment of diseases of the kidneys and the urinary tract in pediatrics

    International Nuclear Information System (INIS)

    In the field of pediatric nephrourology the nephropathies of children caused by obstruction and reflux of the urinary tract are very important. The pathogenesis of these diseases begins with an outflow impairment of urine because of a congenital ureteropelvic or ureterovesical obstruction, vesicouereteral reflux respectively. Etiologically a malformed ureter, or a neuropathic bladder with voiding disorders due to meningomyelocele are responsible for these problems. This outflow impairment of urine is followed by parenchymal damage of the involved kidneys, on the one hand caused by ascending dysplasia and nephrogenic arrest during the development of the urinary tract, and on the other hand caused by ascending urinary tract infections and water hammer effect with dilatative obstructive damage. Basically there are two ways of treatment for these little patients: first the conservative therapy with watchful waiting for maturation while giving medication and some further possibilities when treating a neuropathic bladder, and second surgery with invasive removal of the outflow impairment. To choose correctly between these possibilities of treatment clarifying convincing diagnostics are necessary (identification and evaluation of the outflow impairment and of the parenchymal damage, and evaluation of the kidney function separately for each side). Since the average age of these patients is very low the strain by diagnostics should also be as low as possible, especially concerning the radiation burden. The static renal scintigraphy with 99mTc-DMSA is considered to be the gold standard for identification and evaluation of parenchymal damage and scaring of kidneys. Now the dynamic renal scintigraphy with 99mTc-EC was found to reveal parenchymal damage as well as the static renal scintigraphy. In addition to this equivalence as far as the evaluation of parenchymal function is concerned, the dynamic renal scintigraphy with 99mTc-EC shows evidence to be superior to the static

  18. Insight into the structures and stabilities of Tc and Re DMSA complexes: A computational study

    International Nuclear Information System (INIS)

    Meso-2,3-dimercaptosuccinic acid (DMSA) is used in nuclear medicine as ligand for preparation of radiopharmaceuticals for diagnostic and therapy. DMSA has been the subject of numerous investigations during the past three decades and new and significant information of the chemistry and pharmacology of DMSA complexes have emerged. In comparison to other ligands, the structure of some DMSA complexes is unclear up today. The structures and applications of DMSA complexes are strictly dependent on the chemical conditions of their preparation, especially pH and the ratio of components. A computational study of M-DMSA (M = Tc, Re) complexes has been performed using density functional theory. Different isomers for M(V) and M(III) complexes were study. The pH influence over ligand structures was taken into account and the solvent effect was evaluated using an implicit solvation model. The fully optimized complex syn-endo Re(V)-DMSA shows a geometry similar to the X-ray data and was used to validate the methodology. Moreover, new alternative structures for the renal agent 99mTc(III)-DMSA were proposed and computationally studied. For two complex structures, a larger stability respect to that proposed in the literature was obtained. Furthermore, Tc(V)-DMSA complexes are more stable than the Tc(III)-DMSA proposed structures. In general, Re complexes are more stables than the corresponding Tc ones. (author)

  19. Prevalência de pielonefrite aguda e incidência de cicatriz renal em crianças menores de dois anos de idade com infecção do trato urinário avaliadas por cintilografia renal com 99mTc-DMSA: a experiência de um hospital universitário Prevalence of acute pyelonephritis and incidence of renal scarring in children under the age of two with urinary tract infection evaluated by 99mTc-DMSA renal scintigraphy: the experience of a university hospital

    Directory of Open Access Journals (Sweden)

    Eduardo Herz Berdichevski

    2013-02-01

    Full Text Available OBJETIVO: Calcular as frequências de pielonefrite aguda e cicatriz renal em pacientes menores de dois anos com cintilografia renal com 99mTc-DMSA com primeiro quadro de infecção do trato urinário em hospital universitário brasileiro, comparando com dados da literatura internacional. MATERIAIS E MÉTODOS: Foram revisados laudos cintilográficos de crianças menores de dois anos de idade que realizaram cintilografia renal com 99mTc-DMSA em um hospital universitário no Rio Grande do Sul, entre 2006 e 2009, para pesquisa de pielonefrite aguda/cicatriz renal. Revisaram-se a presença de refluxo vesicoureteral, o uso precoce de antibiótico, e a presença de comorbidades que constassem nos prontuários eletrônicos. Calculou-se a amostra com base num estudo de revisão sistemática e obteve-se um mínimo de 147 pacientes. Excluíram-se pacientes sem registro eletrônico. RESULTADOS: Cento e cinquenta e sete crianças preencheram critérios de inclusão do estudo, 48 tiveram pielonefrite aguda e 8 destas apresentaram cicatriz renal. Nem a idade nem o gênero dos pacientes apresentaram associação significativa com pielonefrite aguda (p = 0,405 e p = 0,124, respectivamente. Não houve diferença estatística nas associações de refluxo vesicoureteral e pielonefrite aguda (p = 1,0 e outras comorbidades (p = 0,470 e em relação ao uso precoce de antibiótico com pielonefrite aguda (p = 0,130 e cicatriz renal (p = 0,720. CONCLUSÃO: As frequências de pielonefrite aguda e cicatriz renal obtidas concordam com os resultados da maioria dos estudos publicados.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 99mTc-DMSA renal scintigraphy in a

  20. Design of a formulation for the preparation of 99m Tc-(V)-Dmsa and 186 Re-(V)-Dmsa

    International Nuclear Information System (INIS)

    Among the radiopharmaceuticals used for neoplasia, we can find the dimercaptosuccinic acid (Dmsa) labelled with 99m Tc and 186/188 Re. Initially, the 99m Tc-(III)-Dmsa was employed as a renal image agent. Nevertheless, when it is prepared into a basic solution, the 99m Tc-(V)-Dmsa complex is produced in high yield being cumulated by cells with a great metabolic activity. This property makes it a useful radiopharmaceutical for the detection of medullary thyroid carcinoma (MTC), soft-tissue tumors and other head and neck tumors. On the other hand, the renewed interest in β - emitting radionuclides, suggests that the 186 Re-(V)-Dmsa complex could be used as antineoplastic agent in therapy. However, the techniques reported for the preparation of these compounds lack of stability studies and they are still in process of investigation, compromising to continue on the development of the radiopharmaceuticals by introducing new possibilities for better products already known, obtaining in this way, the approximation to the ideal radiopharmaceutical. The objective of this work is to design a freeze dried kit formulation for the instant preparation of 99m Tc-(V)-Dmsa and 186 Re-(V)-Dmsa complexes useful in the diagnostic and therapy of soft-tissue tumors and other head and neck tumors. We obtained a freeze dried stable formulation for the preparation of 99m Tc-(V)-Dmsa kit with a radiochemical purity higher than 90 %, which fulfills with the quality control of radiopharmaceuticals. Furthermore, we developed analytical techniques for the determination of the different chemical compounds into the lyophilized kit. On the other hand, we obtained the optimum conditions for preparation of 186 Re-(V)-Dmsa complex in high radiochemical yields (>90%). (Author)

  1. Acute pyelonephritis in pediatric age: comparative study between power Doppler ultrasound scan and DMSA

    International Nuclear Information System (INIS)

    To evaluate the usefulness of power Doppler (PD) Ultrasound Scan in the study of acute pyelonephritis (APN). To compare ultrasound scan results with those obtained with renal gammagraphy (DMSA). To relate the findings to the clinical criteria and to determine the presence of vesicoureteral reflux (VUR) in the serial micturition cystography (SMC). Prospective study of 92 patients (ages between 1 month and 10 years) with suspected clinical PNA. All children were initially subjected to PD ultrasound scan and DMSA. Those under 3 years old were also subjected to SMC for the study of VUR. PNA in the PD ultrasound scan was manifested by decrease in vascularisation and in the DMSA by decrease in caption in the affected zones. 87 renal units (RU) with PNA foci were detected. Conformity between the PD ultrasound scan and DMSA was 157 RU (92%): 52 positives, 22 negatives with PNA and 83 normal RU. The sensitivities of PD and DMSA were 65.5% and 69.0%. 51 SMC were performed, with VUR being detected in 18 (13 bilateral and 5 unilateral), in which the sensitivities of PD and DMSA were 65.5% and 69.0%. 51 SMC were performed, with VUR being detected in 18 (13 bilateral and 5 unilateral), in which the sensitivities of PD and DMSA were 80% and 85%, respectively. Mode B ultrasound scan and PD can replace DMSA in the initial study of PPNA. It is non-invasive, simple, economical and just as reliable as DMSA in expert hands. it can also postpone by up to 6 months the need to perform DMSA for detection of permanent renal damage. (Author) 22 refs

  2. Comparison of 99Tcm-DMSA renal cortical scintigraphy and ultrasonography in diagnosing acute pyelonephritis in children%99Tcm-DMSA肾皮质显像和肾超声检查在小儿急性肾盂肾炎中的对比研究

    Institute of Scientific and Technical Information of China (English)

    李益卫; 钱蔷英; 赵瑞芳; 季志英; 吕孝妹; 吴哈; 程献影; 顾凡磊; 赵晓菲

    2010-01-01

    目的 比较肾超声检查和99Tcm-二巯基丁二酸(DMSA)肾皮质显像在诊断小儿急性肾盂肾炎(APN)中的作用.方法 对临床拟诊为APN的165例患儿均行肾超声检查及99Tcm-DMSA肾皮质显像.其中男79例,女86例,年龄1.5个月11岁,平均20个月.以肾皮质显像为诊断参考标准,确定肾超声检测APN的灵敏度及特异性.结果 165例患儿330个肾,其中99Tcm-DMSA肾皮质显像发现99个肾存在APN阳性表现,而肾超声仅发现31个肾表现阳性.在余231个99Tcm-DMSA肾皮质显像无异常的肾中,超声检查发现4个肾有异常表现.肾超声探测APN的灵敏度为31.3%(31/99),特异性为98.3%(227/231).结论 肾超声对小儿APN的诊断特异性较高,但灵敏度较低.对于肾超声检查阴性的APN,临床仍需采用99Tcm-DMSA肾皮质显像以帮助确诊.%Objective To compare the diagnostic value of renal ultrasound scan (RUS) and 99Tcmdimercaptosuccinic acid (DMSA) renal scintigraphy in children with acute pyelonephritis (APN). Methods In all, 165 children with initial clinical diagnosis of APN, aged from 1.5 months to 11 yrs ( median 20 months), were included in the study, all of which were examined with RUS and DMSA renal scientigraphy. The diagnosis with DMSA renal scientigraphy results was taken as the standard reference to evaluate the diagnostic sensitivity and specificity of RUS. Results Of 99 out of all 330 kidneys that were found abnormal on DMSA renal scientigraphy, 31 were abnormal on RUS. Of the rest normal kidneys on DMSA scans renal scientigraphy, 4 were abnormal on RUS. Thus diagnostic sensitivity of RUS for APN was 31.3%(31/99) and specificity was 98.3% (227/231). Conclusions Although RUS provides with high diagnostic specificity for children with APN, its low sensitivity may underestimate the clinical evaluation of APN.More often than not, 99Tcm-DMSA renal scientigraphy is a clinical necesscity for the definite RUS diagnosis.

  3. The comparative detection of renal scarring by intravenous pyelography versus dimercaptosuccinic acid renal scan

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Takanori; Itoi, Tatsunori; Nagata, Toyoharu; Ohfuji, Tetsuro; Kitada, Shinichiro; Osada, Yukio (Miyazaki Medical Coll., Kiyotake (Japan))

    1993-06-01

    Intravenous pyelography (IVP) and dimercaptosuccinic acid (DMSA) renal scan were performed in 82 kidneys of 52 patients with vesicoureteral reflux (VUR). Thirty-three kidneys (40%) were found to be scarred on IVP whereas 61 kidneys (74%) were found to be scarred on DMSA renal scan. In one of the 82 refluxing kidneys, IVP demonstrated a scar not detectable on DMSA study. The concordance rate was 40 of 82 kidneys (49%). When both studies were positive, there was an excellent correlation on a site by site basis. The incidence of positive DMSA increased with high grade VUR and decreased with low grade reflux. When IVP identifies renal scarring, there is usually a more significant area of scars demonstrated on DMSA renal scan. Our findings indicate that DMSA renal scan is more sensitive than IVP regarding the early detection of renal scarring in patients with VUR. (author).

  4. Prevalência de pielonefrite aguda e incidência de cicatriz renal em crianças menores de dois anos de idade com infecção do trato urinário avaliadas por cintilografia renal com 99mTc-DMSA: a experiência de um hospital universitário

    Directory of Open Access Journals (Sweden)

    Eduardo Herz Berdichevski

    2013-02-01

    Full Text Available OBJETIVO: Calcular as frequências de pielonefrite aguda e cicatriz renal em pacientes menores de dois anos com cintilografia renal com 99mTc-DMSA com primeiro quadro de infecção do trato urinário em hospital universitário brasileiro, comparando com dados da literatura internacional. MATERIAIS E MÉTODOS: Foram revisados laudos cintilográficos de crianças menores de dois anos de idade que realizaram cintilografia renal com 99mTc-DMSA em um hospital universitário no Rio Grande do Sul, entre 2006 e 2009, para pesquisa de pielonefrite aguda/cicatriz renal. Revisaram-se a presença de refluxo vesicoureteral, o uso precoce de antibiótico, e a presença de comorbidades que constassem nos prontuários eletrônicos. Calculou-se a amostra com base num estudo de revisão sistemática e obteve-se um mínimo de 147 pacientes. Excluíram-se pacientes sem registro eletrônico. RESULTADOS: Cento e cinquenta e sete crianças preencheram critérios de inclusão do estudo, 48 tiveram pielonefrite aguda e 8 destas apresentaram cicatriz renal. Nem a idade nem o gênero dos pacientes apresentaram associação significativa com pielonefrite aguda (p = 0,405 e p = 0,124, respectivamente. Não houve diferença estatística nas associações de refluxo vesicoureteral e pielonefrite aguda (p = 1,0 e outras comorbidades (p = 0,470 e em relação ao uso precoce de antibiótico com pielonefrite aguda (p = 0,130 e cicatriz renal (p = 0,720. CONCLUSÃO: As frequências de pielonefrite aguda e cicatriz renal obtidas concordam com os resultados da maioria dos estudos publicados.

  5. Importance of DMSA scintigraphy in children with the first urinary infection

    International Nuclear Information System (INIS)

    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

  6. Acute pyelonephritis in pediatric age: comparative study between power Doppler ultrasound scan and DMSA; Pielonefritis aguda en la edad pediatrica: estudio comparative entre la ecografiapower-Doppler y el DMSA

    Energy Technology Data Exchange (ETDEWEB)

    Muro, M. D.; Sanguesa, C.; Otero, M. C.; Piqueras, A. I.; Lloret, M. T. [Hospital Infantil Universitario La Fe. Valencia (Spain)

    2002-07-01

    To evaluate the usefulness of power Doppler (PD) Ultrasound Scan in the study of acute pyelonephritis (APN). To compare ultrasound scan results with those obtained with renal gammagraphy (DMSA). To relate the findings to the clinical criteria and to determine the presence of vesicoureteral reflux (VUR) in the serial micturition cystography (SMC). Prospective study of 92 patients (ages between 1 month and 10 years) with suspected clinical PNA. All children were initially subjected to PD ultrasound scan and DMSA. Those under 3 years old were also subjected to SMC for the study of VUR. PNA in the PD ultrasound scan was manifested by decrease in vascularisation and in the DMSA by decrease in caption in the affected zones. 87 renal units (RU) with PNA foci were detected. Conformity between the PD ultrasound scan and DMSA was 157 RU (92%): 52 positives, 22 negatives with PNA and 83 normal RU. The sensitivities of PD and DMSA were 65.5% and 69.0%. 51 SMC were performed, with VUR being detected in 18 (13 bilateral and 5 unilateral), in which the sensitivities of PD and DMSA were 65.5% and 69.0%. 51 SMC were performed, with VUR being detected in 18 (13 bilateral and 5 unilateral), in which the sensitivities of PD and DMSA were 80% and 85%, respectively. Mode B ultrasound scan and PD can replace DMSA in the initial study of PPNA. It is non-invasive, simple, economical and just as reliable as DMSA in expert hands. it can also postpone by up to 6 months the need to perform DMSA for detection of permanent renal damage. (Author) 22 refs.

  7. The DMSA scan in paediatric urinary tract infection

    International Nuclear Information System (INIS)

    The objective of the present paper was to review the use of the dimercaptosuccinic acid (DMSA) scan in urinary tract infection at British Columbia's Children's Hospital to determine the frequency of cortical defects and the association between vesico-ureteric reflux and the presence of cortical defects in children with urinary tract infection. A total of 129 consecutive children with a urinary tract infection referred for a DMSA scan in a 2-year period (January 1992-January 1994) were retrospectively studied. The results were analysed in terms of kidneys, and the incidence of cortical defects was determined. Eighty-eight patients (68%) had a radiographic micturating cysto-urethrogram within 6 months of the DMSA scan, and in this group the relationship of defects with vesico-ureteric reflux was determined. Overall, 81/258 (31%) of kidneys had a cortical defect on a DMSA scan. Of those who had a micturating cysto-urethrogram, 53/176 (30%) kidneys had vesico-ureteric reflux, and of those that had reflux, 21/53 (40%) had a cortical defect on a DMSA scan. In the group of children without reflux, 38/123 (31%) had a cortical defect. Renal cortical scan defects are common findings in paediatric urinary infection, and frequently occur in the absence of vesico-ureteric reflux. These defects represent either established scars or acute pyelonephritis that can proceed to scarring. The micturating cysto-urethro-gram alone is insufficient as a screening modality to identify those kidneys at risk of renal scarring. Copyright (1998) Blackwell Science Pty Ltd

  8. Technetium-99m DMSA preparation: Trivial issues causing severe problems

    International Nuclear Information System (INIS)

    Urinary tract infection (UTI) in children involving renal parenchyma, upper collecting system or bladder is one of the major causes for consideration in the diagnosis and management of paediatric nuclear medicine. Acute pyelonephritis is one of the prime causes of morbidity associated with urinary tract infection in children which can lead to progressive renal damage. Technetium-99m dimercaptosuccinic acid (DMSA) is used extensively for the assessment of UTI in paediatrics. The radiopharmaceutical preparation could be influenced by several factors, most of them are trivial, but invariably have severe impact on the quality of the scintiphotographs. This communication is mainly to highlight some of the issues related to 99mTc-DMSA preparation and the possible precautionary measures that need to be taken to obviate unwarranted problems. (author)

  9. Development of 99mTc-DMSA for kidney imaging

    International Nuclear Information System (INIS)

    In nuclear medicine studies, 99mTc-Dimercaptosuccinic acid (99mTc-DMSA) has been shown to be an excellent radiopharmaceutical agent for detecting focal abnormalities of the renal cortex in patients. The agent, however, oxidizes readily and must be used within 30 minutes of preparation. The instability of the radiopharmaceutical renders the kit less economical to use. Several factors affecting the labeling yield such as the kit formulation, stannous and stabilizer content were investigated. The radiochemical determination of the radiolabelled product was analyzed using I TLC-SG system developed in methyl ethyl ketone and the radiolabelled 99mTc-DMSA biological distributions were carried out in female rats. Stability study of the radiolabelled 99mTc-DMSA was carried out using ascorbic acid as stabilizer. Comparative study was also carried out on both the prepared kit and those obtained commercially. The DMSA kit was successfully developed and the result obtained was found to be comparable to that of the commercially available kit. (Author)

  10. 99mTc-DMSA uptake-percentage test and scintigram as a method for evaluation of kidney parenchyme defects in children with vesico-ureteral reflux

    International Nuclear Information System (INIS)

    99mTc-Dimercaptosuccinic acid (DMSA) has been evaluated as an excellent tracer for detection of renal parenchymal defects and especially for pyelonephritic scarring in children. In this contribution some comparisons have been made between DMSA and intravenous urogram (IVU) findings of kidney parenchyme in children with relux nephropathy. 6 refs.; 4 tabs

  11. Assessment of 99mTc-DMSA renoscintigraphy and uptake compared with creatinine clearance in rats with drug-induced nephrotoxicity, 1

    International Nuclear Information System (INIS)

    For evaluation of technetium-99m dimercaptosuccinic acid (99mTc-DMSA) renal uptake as an absolute renal function, 99mTc-DMSA uptake was compared with endogenous creatinine clearance (Ccr) in gentamicin-induced nephrotoxicity. Gentamicin (40 mg/kg/day) was given subcutaneously to male Wistar rats for periods of 3, 6, 9 and 12 days. On the next day, the renoscintigraphy was performed 2 hours following intravenous injection of 99mTc-DMSA and Ccr was measured. On the 7th day, 99mTc-DMSA uptake was significantly lower in the treated rats than that in control (32.27±0.92 vs 39.84±2.24%; p99mTc-DMSA uptake was measured and the histological examination was done. On the 4th day, 99mTc-DMSA uptake was significantly lower than that on the 1st day (32.32±3.00 vs 38.91±1.95%; p99mTc-DMSA uptake reduces earlier than Ccr in gentamicin-induced nephrotoxicity and 99mTc-DMSA uptake is a reliable indicator in the evaluation of a renal function in drug-induced nephrotoxicity. (author)

  12. 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.

  13. Variability in the interpretation of DMSA scintigraphy after urine infection

    International Nuclear Information System (INIS)

    Full text: This study investigated the extent of and potential reasons for interpretation disagreement of 99mTc-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

  14. 99mTc-DMSA scintigraphy in acute urinary tract infection in children

    International Nuclear Information System (INIS)

    24 children with symptomatic urinary tract infection (UTI) underwent systematically ultrasound studies (US) and 99mTc-DMSA renal scans. Among the 15 patients considered as acute pyelonephritis (APN) on clinical grounds, the scan was abnormal in 12 cases, in contrast with only 1 abnormal scan in the clinical subgroup of the lower UTI. Among the 10 abnormal scans that were repeated later on, 6 did completely normalize. US showed only once a parenchymal appearance suggestive for APN. Our findings suggest that the DMSA scan has to be considered at present as the most sensitive imaging technique for the detection of APN. (orig.)

  15. Prognostic value of the acute DMSA scan in hospitalized children with urinary tract infection

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    Hashemian H

    2008-12-01

    Full Text Available "nBackground: Urinary Tract Infection (UTI is one of the major etiological factors of permanent kidney impairment, resulting in renal scarring and severe and pernicious side effects, such as arterial hypertension and renal failure. The purpose of this study was to clarify the impression of renal parenchyma involvement by first UTI (on the basis of acute DMSA scan and vesicoureteral reflux (VUR-on the basis of VCUG/ RNC on the renal scar formation (on the basis of late DMSA scan. "nMethods: Children diagnosed with their first UTI at the Children's Hospital Medical Center, Tehran, Iran, were evaluated. For each patient, we recorded age, sex, results of VCUG/RNCs and acute DMSA scan, as well as those of a late DMSA scan performed 4-6 months later. The results of acute and late DMSA scans were compared along with the results of VCUG/RNCs. "nResults: This study included a total of 103 children, of whom 16 (15.5% were boys and 87 (84.5% were girls. The mean age was 27.2±27.7 months. The frequency of renal scars in kidneys with mild (28.6%, 8.7% and moderate (33.3%, 18.2% pyelonephritis with or without VUR was not significantly different, while the frequency of renal scars in kidneys with severe pyelonephritis (84.6%, 23.1% in the presence of VUR was significantly higher than non-refluxing kidneys with severe pyelonephritis (p=0.005. Furthermore, the frequency of renal scars in refluxing kidneys increased significantly with the severity of pyelonephritis (normal 8.3%, mild 28.6%, moderate 33.3%, and severe 84.6%; p=0.001. This pattern was not significant in non-refluxing kidneys (0%, 10.3%, 18.2%, and 23.1%, respectively; p=0.062. "nConclusion: The present study indicates that the incidence of renal scarring increases with pyelonephritis severity in patients with VUR. Furthermore, we can estimate the risk of renal scar formation from the results of acute DMSA scan and VCUG/RNC.

  16. Recurrent urinary tract infections in young children: role of DMSA scintigraphy in detecting vesicoureteric reflux

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    Awais, Muhammad; Rehman, Abdul; Nadeem, Naila [Aga Khan University Hospital, Department of Radiology, Karachi (Pakistan); Zaman, Maseeh Uz [Aga Khan University Hospital, Nuclear Medicine, Department of Radiology, Karachi (Pakistan)

    2014-07-04

    Performing micturiting cystourethrography (MCUG) in young children with recurrent urinary tract infections is controversial with discrepancy among the major guidelines. Previous studies have shown that a normal dimercaptosuccinic acid (DMSA) scintigraphy may avoid the need of performing MCUG for detecting vesicoureteric reflux in children with first febrile urinary tract infection. However, the role of DMSA for ruling out vesicoureteric reflux in children with recurrent urinary tract infections has not been studied. Approval from institutional ethical review committee was sought and the requirement of informed consent was waived. A total of 50 children under the age of 10 years with recurrent urinary tract infections underwent MCUG scan within 3 months of DMSA scan from January 2011 to September 2012 at our institution. Diagnosis of recurrent urinary tract infections and grading of vesicoureteric reflux was according to previously established standards. Abnormalities on DMSA scan - scarring, hydronephrosis and reduced differential renal function - were compared with presence of vesicoureteric reflux on MCUG. High-grade vesicoureteric reflux was noted on MCUG in 22 (44%) cases. The findings on DMSA included hydronephrosis and scarring in 25 (50%) and 25 (50%) cases, respectively. Abnormalities on DMSA scan for detecting the presence of high-grade vesicoureteric reflux on MCUG examination had sensitivity, specificity, positive and negative predictive values of 95.45%, 35.71%, 53.85% and 90.91%, respectively. The positive and negative likelihood ratios were 1.48 and 0.13 respectively. DMSA scan had high overall sensitivity and negative predictive value with a low negative likelihood ratio for ruling out high-grade vesicoureteric reflux on MCUG, which may obviate the need of invasive MCUG along with its associated drawbacks. (orig.)

  17. Recurrent urinary tract infections in young children: role of DMSA scintigraphy in detecting vesicoureteric reflux

    International Nuclear Information System (INIS)

    Performing micturiting cystourethrography (MCUG) in young children with recurrent urinary tract infections is controversial with discrepancy among the major guidelines. Previous studies have shown that a normal dimercaptosuccinic acid (DMSA) scintigraphy may avoid the need of performing MCUG for detecting vesicoureteric reflux in children with first febrile urinary tract infection. However, the role of DMSA for ruling out vesicoureteric reflux in children with recurrent urinary tract infections has not been studied. Approval from institutional ethical review committee was sought and the requirement of informed consent was waived. A total of 50 children under the age of 10 years with recurrent urinary tract infections underwent MCUG scan within 3 months of DMSA scan from January 2011 to September 2012 at our institution. Diagnosis of recurrent urinary tract infections and grading of vesicoureteric reflux was according to previously established standards. Abnormalities on DMSA scan - scarring, hydronephrosis and reduced differential renal function - were compared with presence of vesicoureteric reflux on MCUG. High-grade vesicoureteric reflux was noted on MCUG in 22 (44%) cases. The findings on DMSA included hydronephrosis and scarring in 25 (50%) and 25 (50%) cases, respectively. Abnormalities on DMSA scan for detecting the presence of high-grade vesicoureteric reflux on MCUG examination had sensitivity, specificity, positive and negative predictive values of 95.45%, 35.71%, 53.85% and 90.91%, respectively. The positive and negative likelihood ratios were 1.48 and 0.13 respectively. DMSA scan had high overall sensitivity and negative predictive value with a low negative likelihood ratio for ruling out high-grade vesicoureteric reflux on MCUG, which may obviate the need of invasive MCUG along with its associated drawbacks. (orig.)

  18. Variability in DMSA reporting following urinary tract infection in children: pinhole, planar, and pinhole with planar

    International Nuclear Information System (INIS)

    Purpose: To determine whether the provision of DMSA images obtained by pinhole collimation reduces inter-observer variability of reporting compared with planar DMSA images alone. Methods: One hundred consecutive DMSA images were independently interpreted three times (pinhole alone, planar alone, pinhole and planar) by four participating nuclear medicine specialists from different departments and in random order. The presence or absence of renal parenchymal abnormality was classified using the modified four level grading system of Goldraich with mean values for the 6 comparisons reported. Results: The proportion of DMSA images interpreted as abnormal was 31% for planar, 34% for pinhole and 33% for planar with pinhole. Agreement was 89% for planar alone, 89% for pinhole alone and 90% for planar with pinhole, with kappa values 0.74, 0.75 and 0.80 respectively for the normal-abnormal scan classification of individual children. These results did not vary appreciably whether interpretation of patients, kidneys or kidney zones was compared. Reasons for disagreement in reporting included different interpretations of 'abnormalities' as normal anatomical variations (splenic impression, fetal lobulation, duplex collecting systems, column of Bertin) or true parenchymal abnormalities, different adjustments in thresholds for reporting abnormality when images were technically suboptimal, different weighting given to pinhole and planar images when both were provided, and error. Conclusion: Four experienced nuclear medicine physicians showed substantial agreement in the interpretation of planar alone, pinhole alone and planar with pinhole DMSA images, but the provision of both sets of images, planar and pinhole, did not reduce variability. (authors)

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

    International Nuclear Information System (INIS)

    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 Tc99m dimercaptosuccinic acid (Tc99m-DMSA), with two other routine investigations; the intravenous urographic (IVU), and ultrasonography (US), for diagnosis of renal parenchymal abnormality in children. The Tc99m-DMSA renal scan was utilized as the gold standard test for renal involvement. All patients had Tc99m-DMSA renal scan, and US, and only 22 patients had contrast IVU. The Tc99m-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, Tc99m-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 Tc99m-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)

  20. Automatic classification of DMSA scans using an artificial neural network

    International Nuclear Information System (INIS)

    DMSA imaging is carried out in nuclear medicine to assess the level of functional renal tissue in patients. This study investigated the use of an artificial neural network to perform diagnostic classification of these scans. Using the radiological report as the gold standard, the network was trained to classify DMSA scans as positive or negative for defects using a representative sample of 257 previously reported images. The trained network was then independently tested using a further 193 scans and achieved a binary classification accuracy of 95.9%. The performance of the network was compared with three qualified expert observers who were asked to grade each scan in the 193 image testing set on a six point defect scale, from ‘definitely normal’ to ‘definitely abnormal’. A receiver operating characteristic analysis comparison between a consensus operator, generated from the scores of the three expert observers, and the network revealed a statistically significant increase (α < 0.05) in performance between the network and operators. A further result from this work was that when suitably optimized, a negative predictive value of 100% for renal defects was achieved by the network, while still managing to identify 93% of the negative cases in the dataset. These results are encouraging for application of such a network as a screening tool or quality assurance assistant in clinical practice. (paper)

  1. Evaluation of regenerative capacity after kidney ischemic/reperfustion injury using 99mTc-DMSA

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    Kwak, W. J.; Kim, J. W.; Park, K. M.; Lee, S. W.; Ahn, B. C.; Lee, J. T.; Yoo, J. S. [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2007-07-01

    Acute renal failure can be caused by a reduced renal blood flow induced because of ischemic injury. The damaged kidney can be completely restored in structure and function. {sup 99m}Tc-DMSA binds to cortical tubules in kidney and its uptake has been suggested to indicate function of cortical mass. Herein, the generative capacity of kidney after bilateral or unilateral ischemia/reperfusion (I/R) injury was evaluated non-invasively by scintigraphic imaging. Three different animal models were used. One or both kidneys of mice were subjected ischemic for 30 min for unilateral or bilateral I/R model, respectively. In third model, one kidney was excised and the other kidney was subjected ischemic for 30 min to give nephrectomy model. At 1 hr, 1 d, 3 d, 1 w, 2 w, 3 w after reperfusion, {sup 99m}Tc-DMSA (27.7 MBq) was injected via tail vein. After 3 hr, the mice were scanned for 30 min with pinhole equipped gamma camera. The ratio of ROI counts of kidney to total counts was calculated. In unilateral I/R mouse, the {sup 99m}Tc-DMSA uptake of injured kidney was decreased continuously up to 3 w (13.9 to 7.7%), while uptake in normal kidney is slowly increased. In case of nephrectomy model, {sup 99m}Tc-DMSA uptake of injured kidney was rapidly restored within 1 w after I/R operation (8.5 to 30%). Bilateral model showed reduced {sup 99m}Tc-DMSA uptake at 1 d, but total uptake in both I/R kidney was also increase up to 30% after 1 w and the uptake was maintained up to 3 w. In unilateral model, the {sup 99m}Tc-DMSA uptake of injured kidney kept decreasing up to 3 w while normal kidney showed increased {sup 99m}Tc-DMSA uptake. The restoration of I/R kidney was not observed within 3 w. However, in case of animal models which have only I/R kidneys such as bilateral and nephrectomy models, the {sup 99m}Tc-DMSA uptake was restored within 1 w and the excised kidney size was also normal in contrast to much smaller I/R kidney of unilateral model.

  2. Evaluation of regenerative capacity after kidney ischemic/reperfustion injury using 99mTc-DMSA

    International Nuclear Information System (INIS)

    Acute renal failure can be caused by a reduced renal blood flow induced because of ischemic injury. The damaged kidney can be completely restored in structure and function. 99mTc-DMSA binds to cortical tubules in kidney and its uptake has been suggested to indicate function of cortical mass. Herein, the generative capacity of kidney after bilateral or unilateral ischemia/reperfusion (I/R) injury was evaluated non-invasively by scintigraphic imaging. Three different animal models were used. One or both kidneys of mice were subjected ischemic for 30 min for unilateral or bilateral I/R model, respectively. In third model, one kidney was excised and the other kidney was subjected ischemic for 30 min to give nephrectomy model. At 1 hr, 1 d, 3 d, 1 w, 2 w, 3 w after reperfusion, 99mTc-DMSA (27.7 MBq) was injected via tail vein. After 3 hr, the mice were scanned for 30 min with pinhole equipped gamma camera. The ratio of ROI counts of kidney to total counts was calculated. In unilateral I/R mouse, the 99mTc-DMSA uptake of injured kidney was decreased continuously up to 3 w (13.9 to 7.7%), while uptake in normal kidney is slowly increased. In case of nephrectomy model, 99mTc-DMSA uptake of injured kidney was rapidly restored within 1 w after I/R operation (8.5 to 30%). Bilateral model showed reduced 99mTc-DMSA uptake at 1 d, but total uptake in both I/R kidney was also increase up to 30% after 1 w and the uptake was maintained up to 3 w. In unilateral model, the 99mTc-DMSA uptake of injured kidney kept decreasing up to 3 w while normal kidney showed increased 99mTc-DMSA uptake. The restoration of I/R kidney was not observed within 3 w. However, in case of animal models which have only I/R kidneys such as bilateral and nephrectomy models, the 99mTc-DMSA uptake was restored within 1 w and the excised kidney size was also normal in contrast to much smaller I/R kidney of unilateral model

  3. Early 99mtc Dimercaptosuccinic Acid (Dmsa Scan In Children With Acute Pyelonephritis Tehran University Of Medical Sciences (2000-2001

    Directory of Open Access Journals (Sweden)

    Ataei N

    2003-07-01

    Full Text Available Early diagnosis, treatment, investigation and follow up of children with urinary tract infection (UTI are needed to minimize renal scarring. The aims of this study were 1 to evaluate the ability of DMSA scintigraphy, ultrasound and biological parameters in detecting renal parenchymal involvement in children with acute pyelonephritis (APN 2 to assess the relation between renal parenchymal changes and creatinine clearance 3 to determine the incidence of renal scarring after APN."nMaterials and Methods: We prospectively studied 54 children (median age 4.02± 3.41 range 1 month to 12 years with first time symptomaticUTI. All patients had DMSA scan and ultrasonography within 5 days of admission. Erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, white blood cell (WBC, was measured at the time of infection, and voiding cystourethrography was performed in all children within 10 days. When scintigraphy showed renal parenchymal changes, repeat DMSA scan was done at least 3 months after initial infection."nResults: Changes on the DMSA scan were found in 93/108 (85.5 percent renal units in 54 children during acute pyelonephritis. Among 42 children who had underwent repeat scintigraphy , renal scars were found in 9 of 16 (56.25 percent renal units in 8 infants under 1 year ,23 of 32 (71.87 percent in 16 children aged 1-5 years, and 33 of 36(91 percent in 18 patients older than 5 years. Ultrasonography showed renal changes in 20 of 108 (18.5 percent kidneys. Reflux was seen in 21 of 108 (19.44 percent renal units. The sensitivity of ESR, CRP, WBC, and ultrasonography was 78.5 percent , 64.5 percent , 69.9 percent , 18.5 percent respectively, and the specificity of them was 40 percent, 33.3 percent, 13.3 percent,"n80 percent respectively. There was a positive correlation between renal parenchymal involvement and creatinine clearance level (p<0.001."nWe found no difference between groups with or without scars with respect to levels of ESR, CRP, and

  4. Urine interleukin-6 and interleukin-8 in children with acute pyelonephritis, relation to DMSA scintigraphy in the acute phase and at 1-year follow-up

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    Tullus, K. [Dept. of Pedriatics, St. Goeran`s Children`s Hospital, Stockholm (Sweden); Fituri, O. [Dept. of Pedriatics, St. Goeran`s Children`s Hospital, Stockholm (Sweden); Linne, T. [Dept. of Pedriatics, St. Goeran`s Children`s Hospital, Stockholm (Sweden); Escobar-Billing, R. [Dept. of Pedriatics Radiology, St. Goeran`s Children`s Hospital, Stockholm (Sweden); Wikstad, I. [Dept. of Pedriatics Radiology, St. Goeran`s Children`s Hospital, Stockholm (Sweden); Karlsson, A. [Dept. of Hospital Physics, St. Goeran`s Hospital, Stockholm (Sweden); Burman, L.G. [Dept. of Bacteriology, Swedish Inst. of Infectious Disease Control, Stockholm (Sweden); Wretlind, B. [Dept. of Bacteriology, Huddinge Hospital, Huddinge (Sweden); Brauner, A. [Dept. of Bacteriology, Karolinska Hospital, Stockholm (Sweden)

    1994-11-01

    The relationship between urine interleukin-6 (IL-6) and interleukin-8 (IL-8)/creatinine quotients and {sup 99m}Tc-dimercaptosuccinic acid (DMSA) scintigraphy, performed within 10 days of acute first-time pyelonephritis and after 1 year, was studied in 41 children. The urine IL-6 and IL-8/creatinine quotients were also related to the urine N-acetyl-{beta}-D-glucosaminidase (NAG) and albumin/creatinine quotients. Presence of DMSA uptake defects, reflecting local inflammation, in children in the acute phase of pyelonephritis, were associated with elevated urine IL-6/creatinine quotients (median 27 pg/{mu}mol); in children without DMSA changes there was no increase in quotients (median non-detectable) (P<0.05). Persistent DMSA changes at the 1-year follow-up, probably reflecting renal scarring, were only seen in children with increased urine IL-6/creatinine quotients in the acute phase (P<0.01). No correlation was found between urine IL-8 and DMSA uptake defects. Vesicoureteral reflux (VUR) at 6-8 weeks did not correlate with the urine cytokine levels in the acute phase. The urine excretion of NAG and albumin, reflecting renal dysfunction, was associated with values of both urine IL-6 and IL-8/creatinine quotients, but not with DMSA defects or VUR. Thus, the initial urine IL-6/creatinine quotients might be used as an indicator of risk for persistent renal damage in acute pyelonephritis. (orig.)

  5. Triple Detector SPECT Imaging with 99mTc-DMSA in Adult Patients with Urinary Tract Infection

    International Nuclear Information System (INIS)

    Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head 99mTc-DMSA SPECT imaging in urinary tract infection. We prospectively performed 99mTc-DMSA planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), 99mTc-DMSA SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of 99mTc-DMSA SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radiological studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on 99mTc-DMSA SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on 99mTc-DMSA SPECT imaging. Follow-up 99mTc-DMSA SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) 99mTc-DMSA SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. 99mTc-DMSA SPECT

  6. Triple Detector SPECT Imaging with {sup 99m}Tc-DMSA in Adult Patients with Urinary Tract Infection

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jin Sook; Bea, Woon Gyu; Moon, Dae Hyuk; Lee, Myung Hae; Kim, Soon Bae; Park, Su Kil; Park, Jung Sik; Hong, Chang Gi; Cho, Kyung Sik [Asan Medical Center, University of Ulsan, Seoul (Korea, Republic of)

    1992-07-15

    Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head {sup 99m}Tc-DMSA SPECT imaging in urinary tract infection. We prospectively performed {sup 99m}Tc-DMSA planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), {sup 99m}Tc-DMSA SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of {sup 99m}Tc-DMSA SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radiological studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on {sup 99m}Tc-DMSA SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on {sup 99m}Tc-DMSA SPECT imaging. Follow-up {sup 99m}Tc-DMSA SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) {sup 99m}Tc-DMSA SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal

  7. Reappraisal of Tc-99m DMSA scintigraphy for follow up in children with vesicoureteral reflux

    Energy Technology Data Exchange (ETDEWEB)

    Tsukamoto, Eriko; Morita, Koichi; Katoh, Chietsugu; Nakada, Kunihiro; Nonomura, Katsuya; Kakizaki, Hidehiro; Koyanagi, Tomohiko; Tamaki, Nagara [Hokkaido Univ., Sapporo (Japan). School of Medicine; Itoh, Kazuo

    1999-12-01

    We reviewed Tc-99m DMSA scintigraphy in children with vesicoureteral reflux (VUR) in order to assess whether repeated Tc-99m DMSA scans are necessary for the follow up of these patients. Ninety-seven children who were followed up for more than one year (1-7.4 years, average 2.8 years) after the first DMSA scan were included in the study. Fifty-one patients had been diagnosed as primary VUR and 46 as secondary VUR. Age at the first examination ranged from 0 to 14 years (average 5.1 years). Planar images were taken 2 hours after injection. The % renal uptake per injected dose (% RU) was calculated from posterior images. Kidneys in 11 patients (11.3%) changed morphologically during the follow up. Of these, new photon deficient areas (PD) were detected in only 4 patients (4.1%). All of these 4 patients had neurogenic bladder and were managed with self-catheterization. Of the remaining 7 patients, cortical thinning progressed in 5 patients (5.2%) and PDs resolved in 3 patients (3.1%). In one of these 7 patients, PD resolved in one kidney and cortical thinning progressed in the contralateral kidney. Of 97 patients reviewed, % RU decreased more than 20% during the follow up in 6 patients (6.2%). All were diagnosed as secondary VUR due to neurogenic bladder. % RU decreased only in the contracted kidneys at the initial scan. Two of them underwent renal transplantation because of severe renal failure. In conclusion, new PD rarely developed and % RU decreased in only a few patients during the follow up of children with VUR. Repeated Tc-99m DMSA scintigraphy therefore seems to have little benefit in the follow up of children with VUR. It should be performed in selected patients with high risk of urinary tract infection or renal failure. (author)

  8. Reappraisal of Tc-99m DMSA scintigraphy for follow up in children with vesicoureteral reflux

    International Nuclear Information System (INIS)

    We reviewed Tc-99m DMSA scintigraphy in children with vesicoureteral reflux (VUR) in order to assess whether repeated Tc-99m DMSA scans are necessary for the follow up of these patients. Ninety-seven children who were followed up for more than one year (1-7.4 years, average 2.8 years) after the first DMSA scan were included in the study. Fifty-one patients had been diagnosed as primary VUR and 46 as secondary VUR. Age at the first examination ranged from 0 to 14 years (average 5.1 years). Planar images were taken 2 hours after injection. The % renal uptake per injected dose (% RU) was calculated from posterior images. Kidneys in 11 patients (11.3%) changed morphologically during the follow up. Of these, new photon deficient areas (PD) were detected in only 4 patients (4.1%). All of these 4 patients had neurogenic bladder and were managed with self-catheterization. Of the remaining 7 patients, cortical thinning progressed in 5 patients (5.2%) and PDs resolved in 3 patients (3.1%). In one of these 7 patients, PD resolved in one kidney and cortical thinning progressed in the contralateral kidney. Of 97 patients reviewed, % RU decreased more than 20% during the follow up in 6 patients (6.2%). All were diagnosed as secondary VUR due to neurogenic bladder. % RU decreased only in the contracted kidneys at the initial scan. Two of them underwent renal transplantation because of severe renal failure. In conclusion, new PD rarely developed and % RU decreased in only a few patients during the follow up of children with VUR. Repeated Tc-99m DMSA scintigraphy therefore seems to have little benefit in the follow up of children with VUR. It should be performed in selected patients with high risk of urinary tract infection or renal failure. (author)

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

    International Nuclear Information System (INIS)

    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.)

  10. Calculation of relative glomerular filtration rate and correlation with delayed technetium-99m DMSA imaging

    International Nuclear Information System (INIS)

    The relative renal uptake of Tc-99m DMSA was compared with the relative glomerular filtration rate (GFR) in ten patients with serum creatinines ranging from 0.3 to 2.5 mg/dl. Relative GFR was based on the renal uptake of Tc-99m DTPA determined by two methods: 1) integrating the counts from 1 to 3 minutes postinjection and correcting for background. 2) Totalizing the individual renal counts in a single 15-second frame from 2:45 minutes to 3:00 minutes postinjection and correcting for background. The two methods of determining relative DTPA uptake showed excellent correlation, r = 0.98. Relative DMSA uptake determined at 24 hours post-injection using computer-assisted regions of interest showed excellent correlation with the relative GFR determined by either the integral or single-frame method, r = 0.98. The addition of background subtraction for the DMSA images at 24 hours did not improve the correlation

  11. Role of 99mTc-DMSA in the diagnosis of acute Pyelonephritis in children with urinary tract infection. Based on 114 cases

    International Nuclear Information System (INIS)

    Objective: To evaluate the use fullness of the renal scintigraphy with 99mTc-DMSA in the diagnosis of acute pyelonephritis in children with urinary tract infection (UTI), in comparison with intravenous urography (IVU), renal ultrasonography and voiding cystourethrogram. Material and Methods: One hundred and fourteen children with suspected UTI in the first episode. The isotopic technique consisted of administration 2-4 mCi ( 74-148 MBq) 99mTc-DMSA i.v. obtaining posterior and left and right posterior obliques views with pinhole collimator; and posterior and anterior views with parallel hole collimator, after 2-4 hours. Results: The overall sensitivity and specificity for the renal scintigraphy with 99mTc-DMSA was 90 % and 95 % respectively. In renal ultrasonography was 52 % and 86 % respectively. In voiding cystourethrogram was 30 % and 90 % respectively. And in IVU was 30 % and 91 % respectively. Conclusion: We consider renal scintigraphy with 99mTc-DMSA, the first method in the evaluation of UTI, with better sensitivity and specificity than renal ultrasonography, voiding cystourethrogram and IVU

  12. Analysis of Ultrasonographic Findings in Children with Urinary Tract Infection : Comparison with Voiding Cystourethrography and 99mTc-DMSA Scan

    International Nuclear Information System (INIS)

    To evaluate whether the presence of hydronephrosis or cortical irregularity on ultrasonogram (US) in children with urinary tract infection (UTI) predicts the vesicoureteral reflux on voiding cystourethrography(VCUG) or or associated renal scar on DMSA scan, and to assess the clinical value of US. We analyzed 90 kidneys of 45 children with UTI, and US, VCUG and DMSA scan were performed in all cases. We evaluated the presence of hydroneprhosis and cortical irregularity on US, vesicoureteral reflux on VCUG and cortical defect on DMSA scan. We analyzed the sensitivity, specificity and positive and negative predictive values of US findings for detection of vesicoureteral reflux and cortical defect. Hydronephrosis on US showed 28% sensitivity for diagnosis of vesicoureteral reflux on VCUG, and was not significantly related with the grade of reflux.Cortical irregularity on US showed 31% sensitivity and 89% positive predictive value for cortical defect on DMSA scan. Hydronephrosis and cortical irregularity on US showed low sensitivities for diagnosis of refluxon VCUG and cortical defect on DMSA scan, however, ultrasonographic features of renal parenchyma were considered to be useful for prediction of renal scar

  13. Analysis of Ultrasonographic Findings in Children with Urinary Tract Infection : Comparison with Voiding Cystourethrography and 99mTc-DMSA Scan

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Yong; Suh, Chang Hae [Inha University Hospital, Incheon (Korea, Republic of)

    1996-12-15

    To evaluate whether the presence of hydronephrosis or cortical irregularity on ultrasonogram (US) in children with urinary tract infection (UTI) predicts the vesicoureteral reflux on voiding cystourethrography(VCUG) or or associated renal scar on DMSA scan, and to assess the clinical value of US. We analyzed 90 kidneys of 45 children with UTI, and US, VCUG and DMSA scan were performed in all cases. We evaluated the presence of hydroneprhosis and cortical irregularity on US, vesicoureteral reflux on VCUG and cortical defect on DMSA scan. We analyzed the sensitivity, specificity and positive and negative predictive values of US findings for detection of vesicoureteral reflux and cortical defect. Hydronephrosis on US showed 28% sensitivity for diagnosis of vesicoureteral reflux on VCUG, and was not significantly related with the grade of reflux.Cortical irregularity on US showed 31% sensitivity and 89% positive predictive value for cortical defect on DMSA scan. Hydronephrosis and cortical irregularity on US showed low sensitivities for diagnosis of refluxon VCUG and cortical defect on DMSA scan, however, ultrasonographic features of renal parenchyma were considered to be useful for prediction of renal scar

  14. Potential utility of MRI in the evaluation of children at risk of renal scarring

    International Nuclear Information System (INIS)

    Background. Gadolinium-enhanced MRI has recently been employed in the diagnosis of acute pyelonephritis. Its potential utility in the diagnosis of renal scars in children is unknown. Objective. To evaluate the potential utility of MRI using fat-saturated T1-weighted (T1-W) and post-gadolinium, short-tau inversion-recovery (STIR) sequences in detecting renal scarring by comparison with technetium dimercaptosuccinic acid (99mTc-DMSA) renal scintigraphy in children at risk of renal scarring. Materials and methods. A group of 24 children with spina bifida and neurogenic bladder or anorectal anomaly was studied. No patient had a history of acute pyelonephritis. Documented urinary tract infection (UTI) was present in 10 children (42 %). The remaining 14 (58 %) children had a history of asymptomatic bacteriuria. None had clinical signs or symptoms of acute UTI at the time of the study. 99mTc-DMSA and MRI were performed to detect renal scarring. 99mTc-DMSA scans were supplemented with pinhole imaging. MRI of the kidneys employed a fat-saturated T1-W sequence and a post-gadolinium STIR sequence employing a short echo time. Results. Of the kidneys studied, 33 % (n = 16) had evidence of a renal parenchymal defect suggestive of scarring on 99mTc-DMSA. The concordance in the detection of a scarred kidney by post-gadolinium STIR sequence and 99mTc-DMSA is 94 %; that by fat-saturated T1-W sequence and 99mTc-DMSA is 82 %; that by both sequences (positive result on either sequence) and 99mTc-DMSA is 100 %. Using 99mTc-DMSA as the gold standard, MRI had a sensitivity of 100 % and a specificity of 78 % in the diagnosis of a scarred kidney. The concordance in the detection of a scarred zone by post-gadolinium STIR sequence and 99mTc-DMSA is 68 %; that by fat-saturated T1-W sequence and DMSA is 44 %; that by both sequences (positive result on either sequence) and 99mTc-DMSA is 84 %. MRI had a sensitivity of 84 % and a specificity of 86 % in the diagnosis of a scarred zone, using 99mTc-DMSA

  15. Evaluation of renal function in children with vesicoureteral reflux

    International Nuclear Information System (INIS)

    Renal uptake rate was calculated by 99mTc-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 β2-microglobulin (β2-MG), α1-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 β2-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.)

  16. Influences of renal stone surgeries on renal function

    International Nuclear Information System (INIS)

    From 1984 to 1990, 99mTc-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)

  17. Comparison of renal ultrasonography and dimercaptosuccinic acid renal scintigraphy in febrile urinary tract infection.

    Science.gov (United States)

    Ayazi, Parviz; Mahyar, Abolfazl; Noroozian, Elham; Esmailzadehha, Neda; Barikani, Ameneh

    2015-12-01

    Accurate and early diagnosis and appropriate treatment of patient with urinary tract infection (UTI) are essential for the prevention or restriction of permanent damage to the kidneys in children. The aim of this study was to compare renal ultrasonography (US) and dimercaptosuccinic acid (DMSA) renal scan in the diagnosis of patients with febrile urinary tract infection. This study involved the medical records of children with febrile urinary tract infection who were admitted to the children's hospital in Qazvin, Iran. Pyelonephritis was diagnosed on the basis of clinical symptoms, laboratory tests and abnormal DMSA renal scans. The criteria for abnormality of renal US were an increase or a decrease in diffuse or focal parenchymal echogenicity, loss of corticomedullary differentiation, kidney position irregularities, parenchymal reduction and increased kidney size. Of the 100 study patients, 23% had an abnormal US and 46% had an abnormal DMSA renal scan. Of the latter patients, 15 had concurrent abnormal US (P value ≤ 0.03, concordance rate: 18%). Renal US had a sensitivity of 32%, specificity of 85%, positive predictive value of 65% and negative predictive value of 60%. Of the 77 patients with normal US, 31 (40.2%) had an abnormal DMSA renal scan. Despite the benefits and accessibility of renal US, its value in the diagnosis of pyelonephritis is limited. PMID:26700082

  18. Formulation, radiopharmaceutical kinetics and dosimetry of the {sup 188}Re(V)-DMSA complex; Formulacion, radiofarmacocinetica y dosimetria del complejo {sup 188}Re(V)-DMSA

    Energy Technology Data Exchange (ETDEWEB)

    Garcia S, L.; Ferro F, G. [Departamento de Materiales Radiactivos. Instituto Nacional de Investigaciones Nucleares, C.P. 52045 Salazar, Estado de Mexico (Mexico); Murphy, C.A. de; Pedraza L, M. [Departamento de Medicina Nuclear, Instituto Nacional de la Nutricion, Salvador Zubiran, Mexico D.F. (Mexico); Azorin N, J. [Departamento de Fisica, Universidad Autonoma Metropolitana Iztapalapa, Mexico D.F. (Mexico)

    1999-07-01

    It was developed through experimental design (ANOVA), a formulation to prepare the {sup 188} Re(V)-Dmsa complex. Likewise, there were realized studies of radiopharmaceutical kinetics and internal dosimetry in animals, its normal and with induced tumors, considering an open bi compartmental model using the MIRD methodology. The {sup 188} Re(V)-Dmsa complex was obtained with a radiochemical purity greater than 95% incubating 30 min at 90 Centigrade under the following formulation: [SnCl{sub 2}] = 1.4 mg/ml, [ascorbic acid] = 0.5 mg/ml, p H = 2.0 - 3.0. The stability test of the formulation, shows that after 48 h of its preparation, does not produce radiolytic degradation neither chemical decomposition. The radiopharmaceutical kinetics data show an average residence time 7.2h, velocity constant {alpha} = 0.6508h{sup -1} and {beta} = 0.1046 h{sup -1} with an apparent distribution volume 6.9 l. The main elimination via was renal and it was observed osseous caption with an accumulated activity 522.049 {+-} 62 MBq h (residence time 14.1094 {+-} 1.69h). In according with the dosimetric calculations, by each 37 MBq injected, the equivalent dose at the tumor was 9.67{+-} 0.33 Sv/g, for an effective dose 0.292 {+-} 0.0017 mSv/MBq. The images obtained in the gamma camera of the mice with induced tumors, show that do not have significant accumulation in the metabolic organs. The caption in bone and in tumors induced of the {sup 188} Re(V)-Dmsa complex, show its potential for be used as a palliative agent for pain in patients with osseous metastasis and in the treatment of tumors of soft tissue. (Author)

  19. Influence of splenectomy on the biodistribution of technetium-99m dimercaptosuccinic acid (99mTc-DMSA) in rats

    International Nuclear Information System (INIS)

    This study aimed to evaluate if the splenectomy alters the biodistribution of 99mTc-DMSA and renal function in Wistar rats. The animals were separated in the groups: splenectomy (n = 6) and control (n = 6). After splenectomy (15 days), the administration of 0.1 ml of 99mTc-DMSA IV (0.48 MBq) was carried out. Thirty minutes later, kidney, heart, lung, thyroid, stomach, bladder and femur and samples of blood were isolated. The organs were weighed, counted and the percentage of radioactivity /g (%ATI/g) determined. Serum urea and creatinine, hematocrit, leukocytes and platelets were measured. Statistics by t test (p<0.05) was done. There was a significant reduction in %ATI/g in kidney and blood (p<0.05) of splenectomized animals, a significant increase (p<0.05) of urea (88.8 ± 18.6 mg/dL) and creatinine (0.56 ± 0.08 mg/dL), compared to the controls (51.5±1.6, 0.37±0.02 mg/dL, respectively), as well as increase in platelets and leucocytes, and hematocrit reduction. The analysis of the results indicates that in rats, splenectomy seems to alter the renal function and the uptake of 99mTc-DMSA. (author)

  20. Influence of splenectomy on the biodistribution of technetium-99m dimercaptosuccinic acid (99mTc-DMSA) in rats

    Energy Technology Data Exchange (ETDEWEB)

    Acucena, Maria Kadja Meneses Torres; Pereira, Kercia Regina Santos Gomes; Villarim Neto, Arthur; Rego, Amalia Cinthia Meneses [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Centro de Ciencias da Saude; Bernardo-Filho, Mario [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Dept. de Biofisica e Biometria; Azevedo, Italo Medeiros; Araujo Filho, Irami; Medeiros, Aldo Cunha [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Dept. de Cirurgia]. E-mail: aldo@ufrnet.br

    2008-12-15

    This study aimed to evaluate if the splenectomy alters the biodistribution of 99mTc-DMSA and renal function in Wistar rats. The animals were separated in the groups: splenectomy (n = 6) and control (n = 6). After splenectomy (15 days), the administration of 0.1 ml of 99mTc-DMSA IV (0.48 MBq) was carried out. Thirty minutes later, kidney, heart, lung, thyroid, stomach, bladder and femur and samples of blood were isolated. The organs were weighed, counted and the percentage of radioactivity /g (%ATI/g) determined. Serum urea and creatinine, hematocrit, leukocytes and platelets were measured. Statistics by t test (p<0.05) was done. There was a significant reduction in %ATI/g in kidney and blood (p<0.05) of splenectomized animals, a significant increase (p<0.05) of urea (88.8 {+-} 18.6 mg/dL) and creatinine (0.56 {+-} 0.08 mg/dL), compared to the controls (51.5{+-}1.6, 0.37{+-}0.02 mg/dL, respectively), as well as increase in platelets and leucocytes, and hematocrit reduction. The analysis of the results indicates that in rats, splenectomy seems to alter the renal function and the uptake of 99mTc-DMSA. (author)

  1. Preparation of an ultra high pure technetium-99m pentavalent dimercaptosuccinic acid (Tc99m(V) DMSA) and evaluation of kinetics

    International Nuclear Information System (INIS)

    Full text: Tc-99m (V) DMSA as a clinically useful tumour-seeking agent is widely reported and its preparation was first described by simply adding NaHCO3 to commercially available renal agent kit, DMSA (m), and raising the pH to 8.5. Later methods used oxygen bubbling to improve the purity of Tc-99m (V) DMSA. However, the percentage purity of the product was not consistent, varying between 83 and 94% (Kobayashi H, Eur J Nucl Med 1995:22,559-562). The present study was undertaken with a view to improve the purity of the preparation and evaluate the kinetics. Stannous ions play a central role in Tc-99m labelled compounds in general, particularly so with the preparation of Tc-99m(V)DMSA from the trivalent precursor. To resolve the issue of whether the excess stannous ions must be oxidised to ensure no further reduction of the pentavalent product back to its trivalent form, we prepared two different DMSA kits in-house, with SnCl2 concentrations at 200 and 400 μg and the composition of the other ingredients similar to Amersham kit. NaHCO3 (3.5%,0.4mL) was added to each kit to adjust the pH to 8.5. To the kit containing 400 μg of SnCl2, oxygen was bubbled through for 5 min. The radiochemical purity was measured using plastic backed TLC (Merck Silica Gel 60F) with the solvent system of n-Butanol: Acetic acid: water (3:2:3 v/v). The percentage purity of Tc-99m (V) DMSA (n=4) was 53.9 ± 3.6% after the addition of NaHCO3 which improved to 71.6 ±2.9% immediately after oxygen bubbling and peaked at 99±1.2% within 20 min. This was stable for 8 hrs at least. The results indicated that the fall in the levels of Tc-99m (m) DMSA was accompanied by a concomitant increase in the levels of Tc- 99m (V) DMSA which peaked at 98-100% after 20 min. Conversely, a purity level of 100 % was achieved in less than 10 min, when the kit containing 200 μg of SnCl2 was subjected to similar treatment as above. Kinetic studies show that it is desirable to use the product 20-30 min after oxygen

  2. Evaluation of a DMSA kit for instant preparation of 99mTc(V)-DMSA for tumour and metastasis scintigraphy

    International Nuclear Information System (INIS)

    A kit has been developed to instantly prepare 99mTc(V)-DMSA. The freeze-dried kit consisting of DMSA, stannous chloride and ascorbic acid in appropriate proportions, produces quality 99mTc(V)-DMSA when mixed with 0.2 mL of 3.5% NaHCO3 solution and 2-4 mL of [99mTc] pertechnetate. The radiopharmaceutical characterized by chromatography with ITLC-SG in 0.9% saline and horizontal paper electrophoresis in 50 mM vernol buffer, pH 8.6, at a potential gradient of 15 V/cm showed a different mobility with respect to 99mTc(III)-DMSA, a known agent for kidney imaging. The new agent exhibited less plasma protein binding as compared to that of 99mTc(III)-DMSA. Biodistribution of the pentavalent DMSA in mouse demonstrated greater uptake in bone and muscle and lower uptake in liver and kidney with respect to trivalent DMSA. The soft tissue tumour specificity and its suitability for tumour scintigraphy was apparent from the scintigrams of mammary carcinoma in a C3H Jax mouse and medullary carcinoma in a patient. Brain metastatic lesions were also visible in a breast carcinoma patient after administering him with the agent. (author)

  3. Formulation, radiopharmaceutical kinetics and dosimetry of the 188Re(V)-DMSA complex

    International Nuclear Information System (INIS)

    It was developed through experimental design (ANOVA), a formulation to prepare the 188 Re(V)-Dmsa complex. Likewise, there were realized studies of radiopharmaceutical kinetics and internal dosimetry in animals, its normal and with induced tumors, considering an open bi compartmental model using the MIRD methodology. The 188 Re(V)-Dmsa complex was obtained with a radiochemical purity greater than 95% incubating 30 min at 90 Centigrade under the following formulation: [SnCl2] = 1.4 mg/ml, [ascorbic acid] = 0.5 mg/ml, p H = 2.0 - 3.0. The stability test of the formulation, shows that after 48 h of its preparation, does not produce radiolytic degradation neither chemical decomposition. The radiopharmaceutical kinetics data show an average residence time 7.2h, velocity constant α = 0.6508h-1 and β = 0.1046 h-1 with an apparent distribution volume 6.9 l. The main elimination via was renal and it was observed osseous caption with an accumulated activity 522.049 ± 62 MBq h (residence time 14.1094 ± 1.69h). In according with the dosimetric calculations, by each 37 MBq injected, the equivalent dose at the tumor was 9.67± 0.33 Sv/g, for an effective dose 0.292 ± 0.0017 mSv/MBq. The images obtained in the gamma camera of the mice with induced tumors, show that do not have significant accumulation in the metabolic organs. The caption in bone and in tumors induced of the 188 Re(V)-Dmsa complex, show its potential for be used as a palliative agent for pain in patients with osseous metastasis and in the treatment of tumors of soft tissue. (Author)

  4. Evaluation of renal function in children with vesicoureteral reflux; Changes in renal uptake rate using [sup 99m]Tc-dimercaptosuccinic acid scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hioki, Takuichi (Mie Univ., Tsu (Japan). School of Medicine)

    1993-09-01

    Renal uptake rate was calculated by [sup 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 [beta][sub 2]-microglobulin ([beta][sub 2]-MG), [alpha][sub 1]-microglobulin and N-acetyl-[beta]-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 [beta][sub 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.).

  5. Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

    Directory of Open Access Journals (Sweden)

    Ajdinović Boris

    2008-01-01

    Full Text Available Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU less than 40% was found in three, and poor kidney function (RKU less than 10% in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

  6. A comparative study of {sup 188}Re(V)-meso-DMSA and {sup 188}Re(V)-rac-DMSA: preparation and in vivo evaluation in nude mice xenografted with a neuroendocrine tumor

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jun-Young [Department of Biomedical Laboratory Science, College of Health Science, Yonsei University, Wonju 220-710 (Korea, Republic of); Department of Nuclear Medicine, Yonsei University Health System, Seoul 120-752 (Korea, Republic of); Lee, Tae-Sup; Choi, Tae-Hyun; Cheon, Gi-Jeong; Choi, Chang-Woon [Laboratory of Nuclear Medicine, Korea Institute of Radiological and Medical Science, Seoul 139-706 (Korea, Republic of); Awh, Ok-Doo [Department of Nuclear Medicine, Yonsei University Health System, Seoul 120-752 (Korea, Republic of)], E-mail: immunoch@yonsei.ac.kr

    2007-11-15

    Dimercaptosuccinic acid (DMSA) exists in meso and racemic (rac) forms. Unlike a meso isomer, rac-2,3-DMSA is very soluble in water, strongly acidic solutions and organic solvents. Despite these differences, rac-2,3-DMSA has not been studied as a radiopharmaceutical. In this study, {sup 188}Re complexes with diastereomeric DMSA were prepared to compare the properties of {sup 188}Re(V)-rac-DMSA with those of {sup 188}Re(V)-meso-DMSA in in vitro and in vivo models. Methods: rac-2,3-DMSA was synthesized and radiolabeled with {sup 188}Re. The biodistribution and gamma camera imaging of {sup 188}Re(V)-meso-DMSA and {sup 188}Re(V)-rac-DMSA were performed in nude mice subcutaneously implanted with PC-12 cell lines. Results and conclusions: Both {sup 188}Re(V)-meso-DMSA and {sup 188}Re(V)-rac-DMSA showed excellent radiochemical purity and stability at room temperature. Compared with {sup 188}Re(V)-meso-DMSA, {sup 188}Re(V)-rac-DMSA needed a higher concentration of rac-DMSA and metabisulfite for maximum yields. {sup 188}Re(V)-meso-DMSA showed high labeling efficiency at pH 2, whereas {sup 188}Re(V)-rac-DMSA showed maximum yields at pH 5. The tumor uptake of {sup 188}Re(V)-rac-DMSA was 3.5 times higher than that of {sup 188}Re(V)-meso-DMSA at 1 h (P<.01). Gamma camera images showed that {sup 188}Re(V)-rac-DMSA was more selectively localized than {sup 188}Re(V)-meso-DMSA at the tumor region in a xenograft model. These results demonstrate that {sup 188}Re(V)-rac-DMSA may have better potential than {sup 188}Re(V)-meso-DMSA as a therapeutic agent against neuroendocrine tumors.

  7. A comparative study of 188Re(V)-meso-DMSA and 188Re(V)-rac-DMSA: preparation and in vivo evaluation in nude mice xenografted with a neuroendocrine tumor

    International Nuclear Information System (INIS)

    Dimercaptosuccinic acid (DMSA) exists in meso and racemic (rac) forms. Unlike a meso isomer, rac-2,3-DMSA is very soluble in water, strongly acidic solutions and organic solvents. Despite these differences, rac-2,3-DMSA has not been studied as a radiopharmaceutical. In this study, 188Re complexes with diastereomeric DMSA were prepared to compare the properties of 188Re(V)-rac-DMSA with those of 188Re(V)-meso-DMSA in in vitro and in vivo models. Methods: rac-2,3-DMSA was synthesized and radiolabeled with 188Re. The biodistribution and gamma camera imaging of 188Re(V)-meso-DMSA and 188Re(V)-rac-DMSA were performed in nude mice subcutaneously implanted with PC-12 cell lines. Results and conclusions: Both 188Re(V)-meso-DMSA and 188Re(V)-rac-DMSA showed excellent radiochemical purity and stability at room temperature. Compared with 188Re(V)-meso-DMSA, 188Re(V)-rac-DMSA needed a higher concentration of rac-DMSA and metabisulfite for maximum yields. 188Re(V)-meso-DMSA showed high labeling efficiency at pH 2, whereas 188Re(V)-rac-DMSA showed maximum yields at pH 5. The tumor uptake of 188Re(V)-rac-DMSA was 3.5 times higher than that of 188Re(V)-meso-DMSA at 1 h (P188Re(V)-rac-DMSA was more selectively localized than 188Re(V)-meso-DMSA at the tumor region in a xenograft model. These results demonstrate that 188Re(V)-rac-DMSA may have better potential than 188Re(V)-meso-DMSA as a therapeutic agent against neuroendocrine tumors

  8. Influence of splenectomy on the biodistribution of technetium-99m dimercaptosuccinic acid (99mTc-DMSA in rats

    Directory of Open Access Journals (Sweden)

    Maria Kadja Meneses Torres Açucena

    2008-12-01

    Full Text Available This study aimed to evaluate if the splenectomy alters the biodistribution of 99mTc-DMSA and renal function in Wistar rats. The animals were separated in the groups: splenectomy (n = 6 and control (n = 6. After splenectomy (15 days, the administration of 0.1ml of 99mTc-DMSA IV (0.48 MBq was carried out. Thirty minutes later, kidney, heart, lung, thyroid, stomach, bladder and femur and samples of blood were isolated. The organs were weighed, counted and the percentage of radioactivity /g (%ATI/g determined. Serum urea and creatinine, hematocrit, leukocytes and platelets were measured. Statistics by t test (pEstudo com objetivo de avaliar se a esplenectomia altera a biodistribuição do 99mTc-DMSA e alguns parâmetros bioquímicos e hematológicos em ratos Wistar. Os animais forma divididos em 2 grupos: esplenectomizados (n=6 e controle(n=6. Após 15 dias, administração de 0,1 ml de 99mTc-DMSA via plexo orbital (0,48 MBq foi realizada. Rim, coração, pulmão, tireóide, estômago, bexiga e fêmur e amostras de sangue foram separadas. Após pesagem e contagem da radioatividade foi determinado o percentual de radioatividade/g (% ATI/g. Dosadas uréia e creatinina sérica, hematócrito, plaquetas e leucócitos. Estatística pelo teste t, significância 0,05 foi realizada. Foi observada redução significante no %ATI/g no rim e sangue (p<0,05 dos animais esplenectomizados, aumento significante (p<0.05 da uréia (88,8±18,6 mg/dL e creatinina (0,56±0,08, comparado aos controles (51,5±1,6; 0,37±0,02mg/dL, respectivamente assim como aumento de leucócitos e plaquetas e redução de hematócrito. Conclui-se que em ratos, a esplenectomia alterou a captação de 99mTc-DMSA pelo rim, e a função renal.

  9. Renal Impairment in 79 Pediatric Patients (158 Renal Units) With Repeated Urinary Tract Infection in Relation to Vesicoureteric Reflux

    International Nuclear Information System (INIS)

    Seventy nine patients with repeated urinary tract infection were evaluated for detection of vesico-ureteric reflux (VUR) by direct (DRC) and indirect (IRC) radionuclide cystography as well as assessment of renal scarring using 99mTc-DMSA. Positive VUR was evident in 38 patients (59 renal units), 50%, patients had history of recurrent urinary tract infection. Patients kidneys were divided into 2 groups: group A with normal if kidneys (74 renal units), but still they have high grade VUR in 20 renal units (20.6%.Group B with scarred kidneys (84 renal Units) with high grade VUR in 36 renal units (42.9%) with significant difference between both groups (P99mTc-DMSA with VUR assessment are essential in pediatric patients with urinary tract infection for detection of high grade VUR which may contribute to renal scarring and damage

  10. Rhenium(V) complexes with meso and racemic DMSA. Pt. 1

    International Nuclear Information System (INIS)

    The so-called pentavalent 186/188Re-meso-DMSA (dimercaptosuccinic acid) represents a potential therapeutical anologue to the pentavalent 99mTc-meso-DMSA. In order to clear up the orientation of the carboxylic acid substituents of the meso-Re(V)DMSA complex, the individual isomers were isolated and characterized. (BBR)

  11. 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; Strandgaard, S

    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...... up by the tubular cells from the peritubular capillaries since the uptake was unaffected by the acute decrease in GFR....

  12. Evaluation of extent of UTI related renal parenchymal damage in pediatric patient population

    International Nuclear Information System (INIS)

    Introduction: Urinary tract infection (UTI) is important cause of morbidity in childhood. UTI may lead to involvement of renal parenchyma ranging from recoverable acute inflammation, renal scarring of Reflux nephropathy, hypertension and ultimately end stage renal disease. Hence, extent of renal parenchymal involvement bears prognostic significance in pediatric population. Laboratory and clinical parameters have inherent limitations in detecting and localizing renal parenchymal involvement in the settings of UTI. Objectives: The present study has been designed with the aim to determine the frequency and degree of renal parenchymal involvement in pediatric patients having urinary tract infection. MATERIALS AND METHODS: From May to December 2003, 33 consecutive children (65 Kidneys, 32-paired, I-solitary) aged one month to 12 years (mean age 3 years, 20M, 13F) with positive past history and culture documented urinary tract infection were enrolled in the study. They were subjected to Renal cortical scan using Tc-99m DMSA (20-100 MBq) on Dual detectors gamma camera (e.cam) fitted with LEHR collimator in anterior, posterior and posterior oblique projections. DMSA renal scans were interpreted as per Clarke's interpretation criteria. Renal ultrasound (RUS) and cystourethrogram (MCUG) were available in all the cases. Results: As per Clarke's classification, there were 19 children with no evidence of renal cortical involvement (Type-1). Renal parenchymal involvement found to be unilateral (Type-4 to Type-6) and bilateral (Type-7 and 8) in 8 and 6 children respectively. DMSA scan was abnormal in 20 of 65 kidneys (31%). MCUG was positive for presence of VUR in 34 kidneys (Group A) and negative for VUR in remaining 31 units (Group B). In Gp A, 18 of 34 kidneys (53%) showed renal parenchymal involvement on DMSA Scan. In Gp A, presence or absence of renal parenchymal damage on DMSA scan did not show any statistically significant difference in age, sex and grade of VUR. Whereas

  13. A two-year report on scintigraphies by DMSA-99mTc in emergency diagnosis of acute pyelonephritis in infants

    International Nuclear Information System (INIS)

    During 2 years, 232 DMSA scintigraphies were achieved in case of clinic suspicion of acute pyelonephritis (APN); the infants addressed for renal infectious scars were not taken into account. The 148 girls and 84 boys, 1 month to 14 years old (average age, 4 years and 3 months) have benefited by at least one planar image of 600 seconds achieved with a parallel collimator, 6 hours after injection with 50 μCi/kg of DMSA. Two hundred infants (86% presented infectious episodes, while in 32 (14%) it was a recurrence. Thirty two infants presented an associated uro-nephrologic malformation. In association with the scintigraphy, the boys benefited by a blood and urinary examination and a renal echography; the cystography was achieved long after the infectious episode as well as the non-systematic UIV. The scintigraphies indicated absence of APN signs in 124 patients (53%), a scar aspect in 12 patients (5%) and an aspect evoking acute lesions in 83 patients (38%), unilaterally, most often, with superior or inferior polar localized hypo-fixation (70 cases), a global hypo-fixation with a heterogenous kidney (11 cases), a cortical polar, possibly, hilar cutting (7 cases). However, in 18 patients (4%) the scintigraphy allowed not to conclude formally (one or several moderate, uni- or bilateral, hypo-fixations). In comparison with the initial data, the clinic and biologic follow-up over more than 6 months confirms the contribution of DMSA scintigraphy in the APN diagnosis

  14. Comparison of the Relative Renal Function Calculated with 99mTc-Diethylenetriaminepentaacetic Acid and 99mTc-Dimercaptosuccinic Acid in Children.

    Science.gov (United States)

    Çelik, Tanju; Yalçin, Hülya; Günay, Emel Ceylan; Özen, Aynur; Özer, Cahit

    2014-09-01

    The aim was to compare the relative renal functions measured with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) and technetium-99m diethylenetriaminepentaacetic acid (99mTc-DTPA) in children with renal diseases. Relative renal function of 128 children who applied to three hospitals from 2009 to 2011 were analyzed retrospectively. The mean value measured with 99mTc-DTPA and 99mTc-DMSA were 51.58 ± 14.95 and 51.96 ± 14.99 for the right kidney, 47.87 ± 15.27 and 47.94 ± 15.17 for the left kidney, respectively. A significant positive correlation was found between the relative renal functions (r = 0.963, P renal function, 99mTc-DTPA can be another choice for the calculation of relative renal function without a complementary DMSA scan particularly in pediatric patients who require renogram curve and GFR calculations. PMID:25538484

  15. Comparative study of unilateral renal tubule function using 131I-o-hippuran and sup(99m)Tc-dimercaptosuccinic acid with regard to renal depth and excretion relations

    International Nuclear Information System (INIS)

    Good agreement was found between sonographic and nuclear renal depth data. In patients with undisturbed postrenal urodynamics, the data of unilateral renal clearance obtained by DMSA and OIH are in good agreement after depth correction. With OIH, the activity measured for unilateral congestion kidneys was higher than with DMSA. However, both methods may overestimate unilateral congestion kidneys. The OIH method should be favoured in nuclear renal diagnostics. In patients with mobile kidneys, the lower function calculated for the ptotic kidney can be evaluated only after depth correction. To reduce the radiation exposure, renal depth data required for depth correction should be determined by sonographic methods. The peak/scatter method of renal depth determination cannot be employed in practice in the 131J hippurane test; in the sup(99m)Tc-DMSA test, sufficient agreement between peak/scatter quotient and renal depth is only obtained after background correction. The result does not warrant the tedious procedure. DMSA studies of the kidneys are appropriate in the following cases: 1. Emergency studies of unilateral renal function in cases of acute anuria due to postrenal stoppage. 2. Assessment of unilateral parenchymal function in patients with mobile kidneys if the ptotic kidney cannot be imaged by sonographic processes. 3. Search for extremely displaced renal tissue. 4. Unilateral renal function studies in patients with unilateral kidney diseases if the postrenal situation and the global renal function can be assessed by other methods. (orig./MG)

  16. Value of renal cortical scintigraphy in children with acute pyelonephritis

    International Nuclear Information System (INIS)

    Purpose: Acute pyelonephritis is a major cause of morbidity in children with urinary tract infection and can result in irreversible renal scarring leading to hypertension and end-stage renal disease. Tc-99m-dimercaptosuccinic acid (DMSA) scintigraphy is the imaging modality of choice for the detection of acute pyelonephhfis and renal scarfing. This study evaluated the importance of renal cortical scintigraphy to identify children at risk from renal damage due to acute pyelonephritis. Methods: Forty-nine children (ages 9 months to 11 years) with urinary tract infection having positive urine culture were studied. A DMSA scan was performed within 72 hours of receiving antibiotic during acute infection. Single or multiple areas of varying degrees of diminished cortical uptake or diffusely decreased uptake in an enlarged kidney was considered for the diagnosis of acute pyelonephrifis. Follow-up scintigraphy was done at 6 months of initial scan in children with acute pyelonephritis documented by DMSA scan. Renal scarring was considered if the affected kidney shows cortical thinning or focal cortical defect with loss of volume or become small kidney. Children with known renal tract abnormalities were excluded from the study. RESULTS: Twenty-seven children (55%) wine considered acute pyelonephritis by DMSA scintigraphy and the abnormality was bilateral in 17(63%) cases and unilateral in 10(37%) cases. Among these 44 abnormal kidneys, scintigraphy showed solitary defect in 29 kidneys, multiple defects in 6 kidneys and diffuse decreased uptake in 9 kidneys. Of them, twenty children were available for follow-up evaluation and scintigraphy demonstrated complete recovery in 21 of 34 (62%) kidneys and renal scarfing in 13 of 34 (38%) kidneys. Renal scarring was found in 5 of 7 kidneys (71%) with diffuse decreased uptake, 2 of 5 kidneys (40%) with multiple cortical defect and 6 of 22 (27%) with single focal detect. Conclusion: The scintigraphic pattern of acute pyelonephritis

  17. A comparative study of 99Tcm (V)-DMSA imaging with histopathological examination in ovarian neoplasms

    International Nuclear Information System (INIS)

    Objective: To assess the clinical value of 99Tcm(V)-Dmsa imaging in detecting the ovarian and the pelvic cavity neoplasms. Methods: 99Tcm(V)-DMSA imaging was performed on 24 patients with diagnosed ovarian neoplasms which were pathologically confirmed after operation. Results: 14 of the 15 patients with malignant ovarian tumors had positive 99Tcm(V)-DMSA scintigraphy. However, 7 of 9 cases with benign ovarian tumors had negative 99Tcm(V)-DMSA scintigraphy. The sensitivity, specificity, positive predictive value, negative predictive value, false positive rate, false negative rate, and accuracy of 99Tcm(V)-DMSA imaging for detecting malignant ovarian tumors were 93.33%, 77.78%, 87.50%, 87.50%, 14.29%, 6.67% and 87.50%, respectively. Conclusions: 99Tcm(V)-DMSA imaging is of important value in detecting malignant and benign ovarian and pelvic tumors

  18. Impact of arterial occlusion during partial nephrectomy on residual renal function. An evaluation with 99mtechnetium-dimercaptosuccinic acid scintigraphy

    International Nuclear Information System (INIS)

    Partial nephrectomy (PNx) has been performed with temporary renal arterial occlusion and in situ renal hypothermia (conventional PNx). However, the impact of temporary renal arterial occlusion on residual renal function has not been well assessed. To address this question, we performed renal scintigraphy with 99mtechnetium-dimercaptosuccinic acid (DMSA) for the quantitative measurement of postoperative residual renal function after conventional PNx and partial nephrectomy without arterial occlusion (non-clamping PNx). Thirty-four patients underwent postoperative DMSA scintigraphy after PNx for renal cell carcinoma. No obvious difference in preoperative renal function between the diseased kidney and the contralateral kidney was found in any of the patients. Of these patients, 24 underwent conventional PNx, and 10 underwent non-clamping PNx. Residual renal function was evaluated using the relative DMSA uptake of the operated kidney. The relative DMSA uptake of the operated kidney was 39.9±7.3% (25.1-58.8) after conventional PNx compared to 34.8±8.9% (13.5-45.5) after non-clamping PNx. This difference was not statistically significant (P=0.15). Total ischemic time during conventional PNx had no adverse influence on the residual renal function. In the analysis of the other determinant factors influencing residual renal function, tumor size was the only significant factor that inversely correlated with the relative DMSA uptake. Our results showed that arterial clamping during PNx has no negative impact on the functional residual capacity as long as in situ renal hypothermia is adequately performed. (author)

  19. Renal imaging in paediatrics

    International Nuclear Information System (INIS)

    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.)

  20. 99mTc-DMSA scintigraphy in children with vesico-ureteral reflux and previous urinary tract infections

    International Nuclear Information System (INIS)

    401 children were studied the correlation between 99mTcDMSA-scintigraphy and intravenous urogram in with vesicoureteric reflux and previous urinary tract infections (time interval from infection more than 4 weeks). Scintigraphy, together with differential uptake percentage, is an exellent method for the detection and followup of regional functional kidney abnormalities. It should however be associated with other imaging techniques. Comparing scintigraphy with intravenous urography, there is, in most cases, a good agreement of the presence of lesions with both methods. The divergences are related to the characteristics of both techniques, the scintigraphy detecting functional alterations, while intravenous urography describing the morphological changes, like kidney scars or parenchymal thinning. Although the differential diagnosis between scar and thinning was not possible by scintigraphy, the scintigram showed regional changes which were not present or recognized on the intravenous urogram. In 20% of children scintigraphic changes were observed in radiologically normal kidneys with vesicoureral reflux (past or present) and 10% of children with scars or thin areas of renal parenchyma had normal DMSA scintigram and normal uptake %. (orig./MG)

  1. Rhenium(V) complexes with meso-DMSA. Pt. 3

    International Nuclear Information System (INIS)

    The crystal structure of the complex under investigation shows hydrogen bonds between the acetone molecules and the carboxylic acid groups on the one side and between the carboxylic acid groups of two molecules on the ohter. The distances of the O--H contacts are slightly longer (2.605-2.691 A) than described for the Et4N[ReO(DMSA)2] complex. (orig.)

  2. Potential utility of MRI in the evaluation of children at risk of renal scarring

    Energy Technology Data Exchange (ETDEWEB)

    Chan Yuleung; Chan Kamwing; Roebuck, D.J.; Chu, W.C.W.; Metreweli, C. [Dept. of Diagnostic Radiology and Organ Imaging, Chinese Univ. of Hong Kong, Shatin (China); Yeung Chungkwong; Lee Kimhung [Dept. of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong (China)

    1999-11-01

    Background. Gadolinium-enhanced MRI has recently been employed in the diagnosis of acute pyelonephritis. Its potential utility in the diagnosis of renal scars in children is unknown. Objective. To evaluate the potential utility of MRI using fat-saturated T1-weighted (T1-W) and post-gadolinium, short-tau inversion-recovery (STIR) sequences in detecting renal scarring by comparison with technetium dimercaptosuccinic acid ({sup 99} {sup m}Tc-DMSA) renal scintigraphy in children at risk of renal scarring. Materials and methods. A group of 24 children with spina bifida and neurogenic bladder or anorectal anomaly was studied. No patient had a history of acute pyelonephritis. Documented urinary tract infection (UTI) was present in 10 children (42 %). The remaining 14 (58 %) children had a history of asymptomatic bacteriuria. None had clinical signs or symptoms of acute UTI at the time of the study. {sup 99} {sup m}Tc-DMSA and MRI were performed to detect renal scarring. {sup 99} {sup m}Tc-DMSA scans were supplemented with pinhole imaging. MRI of the kidneys employed a fat-saturated T1-W sequence and a post-gadolinium STIR sequence employing a short echo time. Results. Of the kidneys studied, 33 % (n = 16) had evidence of a renal parenchymal defect suggestive of scarring on {sup 99} {sup m}Tc-DMSA. The concordance in the detection of a scarred kidney by post-gadolinium STIR sequence and {sup 99} {sup m}Tc-DMSA is 94 %; that by fat-saturated T1-W sequence and {sup 99} {sup m}Tc-DMSA is 82 %; that by both sequences (positive result on either sequence) and {sup 99} {sup m}Tc-DMSA is 100 %. Using {sup 99} {sup m}Tc-DMSA as the gold standard, MRI had a sensitivity of 100 % and a specificity of 78 % in the diagnosis of a scarred kidney. The concordance in the detection of a scarred zone by post-gadolinium STIR sequence and {sup 99} {sup m}Tc-DMSA is 68 %; that by fat-saturated T1-W sequence and DMSA is 44 %; that by both sequences (positive result on either sequence) and {sup 99

  3. Evaluation and optimization of a DMSA kit for instant preparation of 99mTc(V)-DMSA

    International Nuclear Information System (INIS)

    The methods to prepare instant kit of 99mTc(V)-DMSA were evaluated and optimized. Various conditions and procedures were taken to prepare and label the kit. The physico-chemical properties and biodistribution of the labelling compound were tested in order to select the optimal condition. Each kit contains 0.55 mg DMSA and 0.1 mg SnCl2. An aliquot of 1.0-10 mL 99mTcO4- was mixed with the kit for labelling, and a radiochemical purity of ≥95% was then reached. The biodistribution ratios of tumor/liver and tumor/blood are 2.5 and 2.2 respectively in tumor bearing mice

  4. Resolution of cortical lesions on serial renal scans in children with acute pyelonephritis

    International Nuclear Information System (INIS)

    The ideal time for distinguishing a renal scar from acute inflammatory lesions by renal DMSA scintigraphy remains controversial. To determine the time needed for resolution of lesions after acute pyelonephritis. A total of 105 children with acute pyelonephritis underwent renal sonography, voiding cystourethrography and baseline DMSA scintigraphy. Two subsequent scans were performed during the 6th and 12th months in patients with abnormal findings on the previous scan. The baseline DMSA scintigraphy revealed cortical lesions in 37 patients. At 6 months, 13 patients (38.2%) were found to have cortical lesions. At 12 months, 6 patients (17.6%) were found to have persistent renal cortical lesions. The resolution rates for lesions detected on the first scan were 61.8% and 82.4% on the 6- and 12-month scans, respectively. Vesicoureteric reflux, and bilaterality or multifocality were not relevant for resolution of lesions. Female gender seemed to be associated with a higher persistence rate. The renal cortical defects present at 6 months have a high rate of resolution later during follow-up. DMSA scintigraphy performed 12 months after the infection provides more reliable data regarding persistence of renal cortical lesions. (orig.)

  5. Renal scintigraphy in children with first febrile urinary tract infection

    International Nuclear Information System (INIS)

    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)

  6. Renal dysplasia: US findings

    International Nuclear Information System (INIS)

    Renal dysplasia is a congenital anomaly with abnormal development of nephrotic and ductal structure and untreatable disease with absent renal function. To determine whether any consistent sonographic patterns exists,the sonograms of 27 pediatric patients with mastocytosis despotically kidney were reviewed. The diagnosis was proved by pathology in 16 cases and other radiologic imaging in 11 cases. In the classical multicystic despotically kidney(pelvoinfundibular atresia type, 10 cases), there were typical findings, such as absent communication between peripherally located variable sized cysts and presence of the largest cyst away from the renal hilum. One case was associated contralateral renal hydronephrosis. There cases were hydro nephrotic type which had medial location of the largest cyst with non communicating peripheral cysts. Segmental dysplasia with double collecting system and ureterocele (5 cases) and dysplasia due to parasite urethral valve (2 cases) showed hydronephrosis without identifiable peripheral cysts. Among the hypoplastic dysplastic kidney (7 cases) including ectopic kidneys (3cases), corticomedullary differentiation were hard to be identified in 2 cases. In conclusion, diagnosis of the renal dysplasia can be obtained by US only or US with other functional studies such as radionuclide scan(99mTc-DMSA or renogram) and IVP. US detection of renal dysplasia is easy, and US findings provide valuable information in the subsequent management

  7. Renal dysplasia: US findings

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Doo Hoe; Oh, Ki Keun; Jung, Woo Hee; Yoon, Choon Sik; Ahn, Chang Soo; Kim, Myung Joon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1993-12-15

    Renal dysplasia is a congenital anomaly with abnormal development of nephrotic and ductal structure and untreatable disease with absent renal function. To determine whether any consistent sonographic patterns exists,the sonograms of 27 pediatric patients with mastocytosis despotically kidney were reviewed. The diagnosis was proved by pathology in 16 cases and other radiologic imaging in 11 cases. In the classical multicystic despotically kidney(pelvoinfundibular atresia type, 10 cases), there were typical findings, such as absent communication between peripherally located variable sized cysts and presence of the largest cyst away from the renal hilum. One case was associated contralateral renal hydronephrosis. There cases were hydro nephrotic type which had medial location of the largest cyst with non communicating peripheral cysts. Segmental dysplasia with double collecting system and ureterocele (5 cases) and dysplasia due to parasite urethral valve (2 cases) showed hydronephrosis without identifiable peripheral cysts. Among the hypoplastic dysplastic kidney (7 cases) including ectopic kidneys (3cases), corticomedullary differentiation were hard to be identified in 2 cases. In conclusion, diagnosis of the renal dysplasia can be obtained by US only or US with other functional studies such as radionuclide scan(99mTc-DMSA or renogram) and IVP. US detection of renal dysplasia is easy, and US findings provide valuable information in the subsequent management

  8. Nuclear medicine in acute and chronic renal failure

    International Nuclear Information System (INIS)

    The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131I OIH, 67gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease

  9. Biological behavior of {sup 99m}Tc(v)DMSA in mice

    Energy Technology Data Exchange (ETDEWEB)

    Correia, Marilia B.L.; Silva, Orion M.C. da; Magnata, Simey S.S.L.P. [Universidade Federal de Pernambuco, Recife, PE (Brazil). Dept. de Energia Nuclear. Centro de Tecnologia e Geociencias]. E-mail: marilialiborio@ig.com.br; Barros, Andre L.S.; Catanho, Maria Teresa J. de A. [Universidade Federal de Pernambuco, Recife, PE (Brazil). Dept. de Biofisica e Radiobiologia]. E-mail: mariajansem@terra.com.br; Lima, Fabiana F. de [Centro Regional de Ciencias Nucleares CRCN/NE-CNEN, Recife, PE (Brazil)]. E-mail: fflima@cnen.gov.br

    2007-07-01

    The {sup 99m}Tc(v)DMSA is a tumor-seeking agent which has been reported in bone metastasis and others tumors scintigraphies. The bone affinity and tumor uptake has been researched to elucidate its mechanism and biological behavior. The aim of this study was to obtain {sup 99m}Tc(v)DMSA from a conventional DMSA kit, to evaluate its biodistribution in an animal model, and to verify the efficiency of this method based on literature data. DMSA kit (produced by IPEN) were used to prepare {sup 99m}Tc(v)DMSA by reconstituting the lyophilized kit with 0.2mL of 3.5% NaHCO{sub 3} and addition of {sup 99m}TcO{sup 4}{sup -}. The biodistribution assays were made with mice (130, 115 and 70 days old), males and females. To each assay, the control group (n=5) received intravenous {sup 99m}Tc-DMSA and the experimental group (n=5) received {sup 99m}Tc(v)DMSA. After 30 min or 1 h, the animals were sacrificed, the organs excised and the activity measured by a gamma counter. The uptake percentage per gram (% uptake/g), tissue/blood ratio (kidney/blood - K/BL) and kidney/bone ratio (K/BO) were evaluated. In all assays there were different significant biodistribution (p{<=}0.05) between control and experimental groups, the results showed the less kidney uptake of {sup 99m}Tc(v)DMSA while increase bone affinity as young as be the animal. The {sup 99m}Tc(v)DMSA arising from DMSA kit by modified binding method was compatible with literature data. (author)

  10. Antireflux surgery does not change ongoing renal functional deterioration.

    Science.gov (United States)

    Arslansoyu Çamlar, Seçil; Çağlar, Sevinç; Soylu, Alper; Türkmen, Mehmet Atilla; Kavukçu, Salih

    2016-04-01

    Aim Treatment modalities of vesicoureteral reflux (VUR) consist of antimicrobial prophylaxis and antireflux surgery. In this study, we aimed to determine if antireflux surgery changes the course of renal functional deterioration in children with VUR and urinary tract infections (UTI). Methods Medical files of patients with VUR diagnosed during evaluation for UTI were evaluated retrospectively for gender, age, follow-up period, and renal ultrasonography (US) and serial 99mTc-dimercaptosuccinic acid (99mTc-DMSA) scintigraphy findings. Estimated glomerular filtration rate and urinary protein levels were determined at the initial and last visits, and before the operation in children who had antireflux surgery. The patients were divided into two groups as solely medically treated (Group 1) and both medically and surgically treated (Group 2). Group 2 was further divided as those with stable renal function (Group 2a) and with progressive renal injury (Group 2b). Results There were 140 patients (77 female; mean age 51.6 ± 51.9 months). Group 1 and Group 2 included 82 and 58 patients, respectively. In Group 2, the number of patients with the abnormal US, DMSA scintigraphy, and renal function was higher than in Group 1. Recurrent UTI rate was similar, but progressive scarring was more prominent in the antireflux surgery group. In Group 2, 31 patients had a stable renal function (Group 2a) while 27 had progressive deterioration of renal functions (Group 2b). These subgroups were not different with respect to the rate of high-grade VUR, the presence of a renal scar in DMSA, and UTI recurrence. However, the bilateral renal scar was more common in Group 2b. Conclusion Antireflux surgery does not change the course of ongoing renal injury and renal functional deterioration. PMID:26786885

  11. Equivalence of the blockage of ureter and the action of the urethane in 99mTc-DMSA biodistribution in rats

    International Nuclear Information System (INIS)

    The indication of the United States Pharmacopoeia (USP) for biological control of 99mTc-DMSA is the experiment in rats with ureter occlusion. Urethane has a vessel constriction action in the urinary system and keeps the eliminatory mechanism functioning through glomerular filtration. The objective of this work is to show that the use of urethane in animals without blockage of ureteres has total credibility, even if the expressed value of the renal retention does not correspond to 40% injected dose (I.D.) related in the literature. The experiments were performed in 2 groups of 12 rats each, the first using urethane and the second, urethane and blockage of ureter. Four lots of DMSA were labeled with 10 mCi/3 mL of 99mTc solution, and 300 μCi/0.1 mL was injected intravenously in each animal. After one hour, they were sacrificed and kidneys, bladder, liver, spleen and carcass were taken out for determination of the retained radiation in function of the injected dose. The USP establishes two parameters for the metabolism of 99mTc-DMSA: renal retention equal or higher than 40% and kidneys/liver plus spleen relation equal or higher than 6. In animals whose ureteres were obstructed, it was clearly observed that the urine was not transferred from kidneys to bladder 0.05 ± 0.35% I.D., while the first group presented 0.50 ± 6.50 % I.D. The kidneys/liver plus spleen relation were above 6 for both. Considering the deviation, all results were in the USP limit of acceptability, and for routine evaluation, urethane can be used without surgical intervention. (author)

  12. Biodistribution of Ru-97-labeled DTPA, DMSA and transferrin

    International Nuclear Information System (INIS)

    Ruthenium-97 is being produced at the Brookhaven Linac Isotope Producer (BLIP). The favorable physical properties of Ru-97 and chemical reactivity of ruthenium offer a potential for using this isotope to label compounds useful for delayed scanning. Diethylenetriamine pentaacetic acid (DTPA), 2,3-Dimercaptosuccinic acid (DMSA), and Transferrin (TF) were labeled with Ru-97-chloride. Ru-97-DTPA and In-111-DTPA, injected intravenously, showed similar organ distribution, kinetics, and more than 80% excretion by 0.5 h. Ru-97-DTPA and In-111-DTPA injected into the cisterna magna of dogs showed similar kinetics in brain, blood, and urinary bladder. The energy deposited by 1 mCi In-111-DTPA is twice that from 1 mCi Ru-97-DTPA. High quality camera images of the CSF space in the dog were obtained with both isotopes. Ru-97-DMSA was prepared with and without the addition of SnCl2.2H2O. Tin-free DMSA was rapidly excreted via the kidneys, whereas for maximum cortical deposition, the tin-containing preparation was superior. This compound is suitable for delayed imaging of both normal and impaired kidneys. Tissue distribution studies were performed in abscess-bearing rats with Ru-97-transferrin. Although blood levels were higher than with Ga-67-citrate, the abscess had twice as much Ru-97-TF as Ga-67-citrate and the Ru-97 muscle activity was one-third that of Ga-67. Imaging of abscess-bearing rabbits with Ru-97-TF visualized the abscesses as early as 1/2 hr after injection. Since the initial images visualize the abscess so clearly and since the TF portion of the compound binds to the abscess, Tc-99m-TF is being studied for the same purpose. Ru-97-labeled compounds are a promising replacement for In-111 and possibly also for Ga-67 compounds with the advantages of lower radiation dose and high quality image

  13. Renal Power Doppler Ultrasonographic Evaluation of Children With Acute Pyelonephritis

    Directory of Open Access Journals (Sweden)

    Ali Pahlusi

    2011-10-01

    Full Text Available Urinary tract infections are common in children. The available gold standard method for diagnosis, Tc-99m dimercaptosuccinic acid scan is expensive and exposes patients to considerable amount of radiation. This study was performed to compare and assess the efficacy of Power Doppler Ultrasound versus Tc-99m DMSA scan for diagnosis of acute pyelonephritis. A quasi experimental study was conducted on 34 children with mean age of 2.82.7 years who were hospitalized with their first episode of febrile urinary tract infection. All children were evaluated in the first 3 days of admission by Doppler Ultrasound and Tc-99m DMSA scan. Patients with congenital structural anomalies were excluded. Each kidney was divided into three zones. The comparison between efficacy of Doppler Ultrasound and DMSA scan was carried out based on number of patients and on classified renal units. Based on the number of patients enrolled; the sensitivity, specificity, positive and negative predictive values and accuracy of Doppler Ultrasound were 89%, 53%, 70%, 80% and 74%, respectively but based on the renal units, it was 66%, 81%, 46%, 91% and 79% , respectively. Although Doppler Ultrasound has the potential for identifying acute pyelonephritis in children, but it is still soon to replace DMSA scan.

  14. Evaluation of interobserver variability of parenchymal phase of Tc-99m mercaptoacetyltriglycine and Tc-99m dimercaptosuccinic acid renal scintigraphy

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the variability in the interpretation of parenchymal abnormalities and to assess the differences in interpretation of routine renal scintigraphic findings on posterior view of technetium-99m dimercaptosuccinic acid (pvDMSA) scans and parenchymal phase of technetium-99m mercaptoacetyltriglycine (ppMAG3) scans by using standard criterions to make standardization and semiquantitative evaluation and to have more accurately correlation. Two experienced nuclear medicine physicians independently interpreted pvDMSA scans of 204 and ppMAG3 scans of 102 pediatric patients, retrospectively. Comparisons were made by visual inspection of pvDMSA scans, and ppMAG3 scans by using a grading system modified from Itoh et al. According to this, anatomical damage of the renal parenchyma was classified into six types: Grade 0-V. In the calculation of the agreement rates, Kendall correlation (tau-b) analysis was used. According to our findings, excellent agreement was found for DMSA grade readings (DMSA-GR) (tau-b = 0.827) and good agreement for MAG3 grade readings (MAG3-GR) (tau-b = 0.790) between two observers. Most of clear parenchymal lesions detected on pvDMSA scans and ppMAG3 scans identified by observers equally. Studies with negative or minimal lesions reduced correlation degrees for both DMSA-GR and MAG3-GR. Our grading system can be used for standardization of the reports. We conclude that standardization of criteria and terminology in the interpretations may result in higher interobserver consistency, also improve low interobserver reproducibility and objectivity of renal scintigraphy reports

  15. Riñón multicístico: Evaluación del riñón contralateral Multicystic Kidney: an evaluation of the contralateral kidney

    OpenAIRE

    María del Pilar Hevia J.; María Pía Rosati M; Elizabeth Lagos R; Juan Pablo Barroso S.

    2002-01-01

    El riñón multicístico (RMC) se asocia a malformación del riñón contralateral en porcentajes variables. Con el propósito de determinar la prevalencia y tipo de malformaciones asociadas, y la evolución de la función renal, se estudiaron de manera retrospectiva 34 niños con diagnóstico de RMC entre 1 día y 13 meses de edad con ecotomografía renal, cintigrama renal Tc99 DMSA y uretrocistografía miccional. Se encontró malformación del riñón contralateral en 11/34 pacientes (32%) siendo las más fre...

  16. Predictive efficacy of radioisotope voiding cystography for renal outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seok Ki; Lee, Dong Soo; Kim, Kwang Myeung; Choi, Whang; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2000-04-01

    As vesicoureteral reflux (VUR) could lead to renal functional deterioration when combined with urinary tract infection, we need to decide whether operative anti-reflux treatment should be performed at the time of diagnosis of VUR. Predictive value of radioisotope voiding cystography (RIVCG) for renal outcome was tested. In 35 children (18 males, 17 females), radiologic voiding cystoure-thrography (VCU), RIVCG and DMSA scan were performed. Change in renal function was evaluated using the follow-up DMSA scan, ultrasonography, and clinical information. Discriminant analysis was performed using individual or integrated variables such as reflux amount and extent at each phase of voiding on RIVCG, in addition to age, gender and cortical defect on DMSA scan at the time of diagnosis. Discriminant function was composed and its performance was examined. Reflux extent at the filling phase and reflux amount and extent at postvoiding phase had a significant prognostic value. Total reflux amount was a composite variable to predict prognosis. Discriminant function composed of reflux extent at the filling phase and reflux amount and extent at postvoiding phase showed better positive predictive value and specificity than conventional reflux grading. RIVCG could predict renal outcome by disclosing characteristic reflux pattern during various voiding phases.

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

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the usefulness of 99mTc 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. 99mTc 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

  18. Evaluation of Tc-99m (V) DMSA for imaging inflammatory lesions. An experimental study

    International Nuclear Information System (INIS)

    The present study evaluated 99mTc (V) DMSA as an agent for the visualization of inflammatory lesions in comparison to 99mTc (III) DMSA and 99mTc-HIG. All three radiopharmaceuticals were prepared with commercial kits. 99mTc (V) DMSA was prepared at neutral pH by the addition of first bicarbonate and then pertechnetate to the kit contents. The labeling efficiency was 99% as determined by ITLC. Abscesses were induced by i.m. injection of 50 μl turpentine into the right thighs of 36 Swiss albino mice. Six days later 3.7 MBq of each radiopharmaceutical was i.v. administered to 12 mice. The mice were sacrificed at 1, 3, 6 and 24 h later. Scintigrams were obtained with a gamma camera. The abscesses were better visualized on scintigrams with 99mTc (V) DMSA compared to 99mTc (III) DMSA, starting at 1 h. The animals were dissected and the organs were removed, weighed and the radioactivity determined with a gamma counter. The abscess to other tissue ratios were higher with 99mTc (V) DMSA than the other radiopharmaceuticals. The max. abscess/muscle ratios were 9.46±3.20 (24 h), 4.19±1.39 (6 h) and 5.98±1.17 (24 h) and max. abscess/blood ratios were 6.22±1.41, 4.09±0.84 and 0.914±0.351 all at 24 h for 99mTc (V) DMSA, 99mTc (III) DMSA and 99mTc-HIG, respectively. Experimental arthritis was produced in 6 New Zealand white rabbits by intra-articular injection of ovalbumin. Four days later 37 MBq of 99mTc (V) DMSA and 99mTc-HIG were each i.v. administered to 3 rabbits. Scintigrams obtained at 1, 3, 6, and 24 h clearly demonstrated arthritic joints. ROI's over arthritic joints were compared to contralateral normal joints (A/C). The max. A/C ratios were 2.10±0.31 (3 h) and 2.92±0.99 (24 h) for 99mTc (V) DMSA and 99mTc-HIG, respectively. Our results indicated the feasibility of imaging inflammatory lesions with 99mTc (V) DMSA. (author)

  19. Evaluation of reflux nephropathy, pyelonephritis and renal dysplasia

    International Nuclear Information System (INIS)

    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.)

  20. Preparation of [186Re]Re-DMSA and its bio-distribution studies

    International Nuclear Information System (INIS)

    99mTc(V)-DMSA is widely used for imaging medullary carcinoma and hence 186/188Re(V)-DMSA is suggested as a potential agent for treating medullary carcinoma. In the present paper, we report the work carried out for the preparation of [186Re]Re(V)-DMSA and it's bio-distribution studies in Wistar rats. The complex was prepared by reducing 186Re (100 μg, 0.54 μM, ∼150 MBq) in the presence of DMSA (2 mg, 11 μM) with stannous chloride (0.4 mg, 2.2 μM) in acidic medium at pH 2. The reaction was taken to completion by heating the complex in a boiling water bath for 30 min. Bio-distribution studies carried out revealed that pharmacological behaviour of 186Re(V)-DMSA is similar to that of 99mTc(V)-DMSA except that the kidney uptake is marginally higher. The kidney uptake reduced significantly when the pH of the complex was adjusted to 8 prior to injection. The in vitro stability studies of this complex suggest that the product formed is stable and could be used for clinical trials

  1. Urinary Beta 2 Microglobulin in Various Grades of Renal Scar in Pyelonephritis in Children

    OpenAIRE

    N Anvaripour; M Sharifian; Karimi, A.

    2006-01-01

    Background: For patients who have renal involvement during urinary infection or children with Vesico-ureteral Reflux (VUR), renal Dimercaptosuccinic Acid (DMSA) scan is performed which exposes children to significant radiation. β²MG is a low molecular weight protein freely filtered by the glomeruli and then actively reabsorbed normally up to 99.9% in the proximal tubules; its urinary measurement is a good index of proximal tubular function of these cells as a primary screening test. Meth...

  2. Development of methods of labeling pentavalent DMSA with 99mTc and 188Re

    International Nuclear Information System (INIS)

    Technetium-99 m is the most useful radionuclide in diagnostic imaging procedures in Nuclear Medicine, more than 80 percent of radiopharmaceuticals are 99mTc-labeled compounds. 99mTc-DMSA(V) has been used for imaging of soft tissue, head and neck tumors. It shows a particularly high specificity for medullary thyroid carcinoma and bone metastases in a variety of cancers. Biodistribution studies of 188Re-DMSA(V) have shown that its general pharmacokinetic properties are similar to that of 99mTc-DMSA(V), so this agent could be used for targeted radiotherapy of these tumors. The aim of this work is the development of methods of labeling DMSA(V) with 99mTc and 188Re. 99mTc-DMSA(V) can be prepared by two methods. One of them is the indirect one, through the use of a commercial kit of DMSA (III), by adjusting the pH from 2.5 to ∼ 8.5 with NaHCO3. This method was evaluated and optimized presenting high labeling yields. The other method is the direct one, through the preparation of a lyophilised kit ready for labeling with 99mTc, being the method of interest of this work, due to the easy of its clinical use. The most adequate formulation of the kit was: 1.71 mg of DMSA, 0.53 mg of SnCl2.2H2O and 0.83 mg of ascorbic acid (pH 9). Labeling yields higher than 95% were achieved labeling this kit with 1 to 2 m L of 99mTc with activities up to 4736 MBq (128 mCi). The kit was stable up to 6 months and biodistribution studies confirmed the quality of the DMSA (V) labeled with 99mTc using this kit. The reduction potential of Re is lower than the one for Tc, so the labeling conditions of 188Re-DMSA(V) are different from the ones used for 99mTc- DMSA(V). 188Re-DMSA(V) is prepared in acid solution, that makes it possible to use the DMSA (III) commercial kit developed for labeling with 99mTc, prepared in pH 2.5, for labeling with 188Re. Labeling yields higher than 95% were achieved with this methodology, with a rection time of 30 minutes at 100 deg C using no more than 1 m L of 188ReO4

  3. Pitfalls and Limitations of Radionuclide Renal Imaging in Adults.

    Science.gov (United States)

    Keramida, Georgia; James, Jacqueline M; Prescott, Mary C; Peters, Adrien Michael

    2015-09-01

    To understand pitfalls and limitations in adult renography, it is necessary to understand firstly the physiology of the kidney, especially the magnitude and control of renal blood flow, glomerular filtration rate and tubular fluid flow rate, and secondly the pharmacokinetics and renal handling of the three most often used tracers, Tc-99m-mercaptoacetyltriglycine (MAG3), Tc-99m-diethylene triamine pentaacetic acid (DTPA) and Tc-99m-dimercaptosuccinic acid (DMSA). The kidneys may be imaged dynamically with Tc-99m-MAG3 or Tc-99m-DTPA, with or without diuretic challenge, or by static imaging with Tc-99m-DMSA. Protocols are different according to whether the kidney is native or transplanted. Quantitative analysis of dynamic data includes measurement of renal vascularity (important for the transplanted kidney), absolute tracer clearance rates, differential renal function (DRF) and response to diuretic challenge. Static image reveals functional renal parenchymal damage, both focal and global, is useful in the clinical management of obstructive uropathy, renal stone disease and hypertension (under angiotensin converting enzyme inhibition), and is the preferred technique for determining DRF. Diagnosis based on morphological appearances is important in transplant management. Even though nuclear medicine is now in the era of hybrid imaging, renal imaging remains an important subspecialty in nuclear medicine and requires a sound basing in applied physiology, the classical supporting discipline of nuclear medicine. PMID:26278854

  4. Labeling procedures for the preparation of 188Re- DMSA(V)

    International Nuclear Information System (INIS)

    188Re has received a lot of attention in the past decade, due to its favorable nuclear characteristics [t1/2 16.9 h, Eβmax 2.12 MeV and Eγ 155 keV (15%) suitable for imaging], including the fact that it is carrier-free and can be obtained cost-effectively through the generator 188W-188Re. Besides the therapeutic usefulness of 188Re, the emission of the 155 keV gamma photon is an added advantage since the biodistribution of 188Re-labeled agents can be evaluated in vivo with a gamma camera. Biodistribution studies of 188Re-DMSA(V) have shown that its general pharmacokinetic properties are similar to that of 99mTc-DMSA(V), so this agent could be used for targeted radiotherapy of the same tumors, i.e., medullary thyroid carcinoma, bone metastases, soft tissue, head and neck tumors. The aim of this work is to evaluate two labeling procedures for the preparation of 188Re- DMSA(V). 188Re-DMSA(V) was prepared by two methods. The first method was prepared using a commercial kit of DMSA(III) for labeling with 99mTc, at high temperature (100 deg C). The second method was prepared in a vial containing 2.5 mg of DMSA, 1.00 mg of SnCl2.2H2O and 30 mg of sodium oxalate, in a total volume of 1.1 mL. The pH was adjusted to 5 with 37% HCl. After labeling the solution was stirred and incubated for 15 min at room temperature. The radiochemical purity was determined using TLC-SG developed with two different solvent systems. Preliminary results for both methods of labeling 188Re-DMSA(V) showed that the labeling yield was >90%. (author)

  5. Effects of transient post ESWL obstruction on renal function

    International Nuclear Information System (INIS)

    Introduction and Objectives: This study examined the effects of transient post SWL obstruction on renal function after its application for treatment of renal stones in one non-obstructed kidney, using two different lithotripters. Method: This study included one hundred consecutive patients with unilateral renal stones were treated by SWL monotherapy in our center. The patients had normal laboratory profile in terms of renal function, liver function, blood picture, bleeding and clotting time, prothrombin concentration, and no or controlled urinary tract infection. Also, the urinary tract was radiologically normal with no obstruction. 99mTechnetium mercaptoacetyl triglycine (99mTc-MAG3) and 99mTechnetium dimercaptosuccinic acid (99mTc-DMSA) renographic studies together with Doppler sonography were performed for all cases few days before, one week after and three months after SWL. Renal uptake, Tmax, split renal function, ERPF and detection of renal scarring can be obtained from renographic studies as well as resistive index which can be calculated using Doppler sonography. Patients were stratified into 2 groups; Group I). Patients with non obstructed kidneys after SWL (N = 84), Group II) Patients with obstructed kidneys one week after SWL. (N = 16). Results: In group I, we found slight but statistically significant improvement of renal function. In group II, a significant deterioration of ipsilateral renal function was observed one week after SWL. This was due to transient obstruction by stein strasse. This improved after 3 months, but still below the pre SWL baseline function. DMSA scan revealed no changes after 3 months in both groups. Furthermore, there were no significant changes of the resistive index in both groups. Conclusion: Post SWL obstruction although transient has a major effect on the renal function on the treated side and must be managed urgently. On the other hand, SWL of renal stones in normal kidneys, with no post treatment obstruction, has no

  6. Synthesis of {sup 188}Re-DMSA complex using carrier-free {sup 188}Re

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Kazuyuki; Izumo, Mishiroku [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Islam, M.S.

    1997-03-01

    The synthesis of rhenium-DMSA labelled compound using carrier-free {sup 188}Re from the {sup 188}W/{sup 188}Re generator has been carried out. Stannous chloride was used as the reducing agent for reduction of rhenium and ascorbic acid was used as an antioxidant in the reaction media. The dependence of the yield of Re-DMSA complex upon the concentration of reducing agent, pH, reaction time, anti-oxidant, carrier and temperature was investigated. Under optimum conditions, the yield of Re-DMSA complexes were more than 98% for the carrier-free as well as carrier-added {sup 188}Re. The stability of the Re-DMSA complexes at different pH and time were also investigated. It was found that the Re-DMSA complex was very stable and did not undergo any changes or decomposition with the changes of pH from its initial values even after 48 hours of pH change for carrier-free as well as carrier-added complexes. (author)

  7. Childhood acute pyelonephritis: comparison of power Doppler sonography and Tc-DMSA scintigraphy

    International Nuclear Information System (INIS)

    Tc 99m DMSA scintigraphy is regarded as the gold standard for the detection and localization of acute pyelonephritis (APN) in children. Power Doppler sonography (PD US) is a radiation-free and cost-effective technique that could be useful in the diagnosis of APN in children. To compare the predictive value of PD US with DMSA scintigraphy in the diagnosis of APN in children. A total of 74 neonates and children with clinical findings consistent with possible upper urinary tract infection were evaluated with PD US and DMSA scintigraphy. Children with anatomic (grey-scale) abnormalities were excluded. A total of 147 kidneys were examined within the first 48 h after the onset of symptoms. Each kidney was divided into three zones (upper, middle, and lower third). APN was diagnosed by PD US in 46 kidneys. Sensitivity and specificity for detecting APN using DMSA scintigraphy as the reference standard were 73.8% and 85.7%, respectively. There was good agreement between PD US and DMSA scintigraphy in the localization of lesions. In clinically suspected APN, PD US has acceptable specificity and sensitivity, if performed within the first 48 h and could be helpful in neonates and children under 3 months of age in whom the use of scintigraphy is generally discouraged. (orig.)

  8. Renal hyperconcentration of /sup 99m/Tc-HEDP in experimental acute tubular necrosis

    International Nuclear Information System (INIS)

    The effect of transient renal ischemia on renal concentration and distribution of /sup 99m/Tc-HEDP, /sup 99m/Tc-DMSA, and /sup 99m/Tc-DTPA was compared in rabbits with acute tubular necrosis. Scintigrams were obtained after injection in normal rabbits or ones with unilateral or bilateral ischemia. /sup 99m/Tc-HEDP concentration in ischemic tissue was 8 to 18 times normal 1 to 4 hrs after injection, and the resulting images delineated the morphological changes in the ischemic kidneys more accurately than those obtained with DMSA or DTPA. Calcium concentration in the ischemic kidneys increased sixfold. /sup 99m/Tc-HEDP may be useful in evaluation of renal failure secondary to tubular injury

  9. The changes in renal function after a single dose of intravenous furosemide in patients with compensated liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Mejirisky Yoram

    2006-11-01

    Full Text Available Abstract Background Patients with compensated Child-A cirrhosis have sub clinical hypovolemia and diuretic treatment could result in renal impairment. Aim To evaluate the changes in renal functional mass as reflected by DMSA uptake after single injection of intravenous furosemide in patients with compensated liver cirrhosis. Methods Eighteen cirrhotic patients were divided in two groups; eight patients (group 1, age 56 ± 9.6 yrs, Gender 5M/3F, 3 alcoholic and 5 non alcoholic were given low intravenous 40 mg furosemide and ten other patients (group 2, age 54 ± 9.9, Gender 6M/4F, 4 alcoholic and 6 non alcoholic were given high 120 mg furosemide respectively. Renoscintigraphy with 100MBq Of Tc 99 DMSA was given intravenously before and 90 minutes after furosemide administration and SPECT imaging was determined 3 hours later. All patients were kept under low sodium diet (80mEq/d and all diuretics were withdrawn for 3 days. 8-hours UNa exertion, Calculated and measured Creatinine clearance (CCT were performed for all patients. Results Intravenous furosemide increased the mean renal DMSA uptake in 55% of patients with compensated cirrhosis and these changes persist up to three hours after injection. This increase was at the same extent in either low or high doses of furosemide. (From 12.8% ± 3.8 to 15.2% ± 2.2, p 40%, as compared to normal calculated creatinine clearance (CCT 101 ± 26, and measured CCT of 87 ± 30 cc/min (P Conclusion A single furosemide injection increases renal functional mass as reflected by DMSA in 55% of patients with compensated cirrhosis and identify 45% of patients with reduced uptake and who could develop renal impairment under diuretics. Whether or not albumin infusion exerts beneficial effect in those patients with reduced DMSA uptake remains to be determined.

  10. Estimation and relevance of depth correction in paediatric renal studies

    International Nuclear Information System (INIS)

    Measurement of absolute renal function by gamma camera techniques requires knowledge of kidney depth to correct for soft tissue attenuation, there is debate about the need to take depth into account when only relative renal function is estimated. The aim of this study was to derive a formula for renal depth in children and to assess the importance of depth correction when relative renal function is assessed with dimercaptosuccinic acid (DMSA) on the gamma camera. In this study, kidney depths were derived from measurements on abdominal computerised tomography (CT) images in 57 children in the supine position with two normally located kidneys. Using best-subset regression analysis, one formula for both left and right kidney depth (KD, cm) was developed based on the easily measured parameters of height (H, cm) and body weight (W, kg). The inclusion of extra variables was found to significantly improve the model compared with a model using weight alone (P<0.005). A second group of 19 children who underwent technetium-99m DMSA scans, had differential function estimated from both anterior and posterior views and the geometric mean method. The mean difference in differential renal function calculated by the geometric mean method versus the posterior image was only 1.2%. In conclusion, we present a new formula for the estimation of paediatric kidney depth for the absolute quantitation of kidney uptake. Further, for normally located kidneys it appears unnecessary to use the geometric mean method or to correct for individual renal depth when calculating differential function. (orig.)

  11. Retention of 99mTc-DMSA(III) and 99mTc-nanocolloid in different syringes affects imaging quality.

    Science.gov (United States)

    Bauwens, Matthias; Pooters, Ivo; van der Pol, Jochen; Mottaghy, Felix M; van Kroonenburgh, Marinus

    2014-04-01

    (99m)Tc-dimercaptosuccinic acid [DMSA(III)] and colloidal human serum albumin ((99m)Tc-nanocolloid) are widely used radiopharmaceuticals. Recently, in our institution we encountered image quality problems in DMSA scans after changing the brand of syringes we were using, which triggered us to look into the adsorption properties of syringes from different brands for (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid. We also describe a clinical case in which adsorption of (99m)Tc-DMSA(III) caused inferior imaging quality. DMSA and nanocolloid were labeled with (99m)Tc following manufacturer guidelines. After synthesis, syringes with (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid were stored for 15, 30, 60, and 120 min. We evaluated Luer Lock syringes manufactured by different brands such as Artsana, Henke-Sass-Wolf, B. Braun Medical N.V., CODAN Medizinische Geräte GmbH & Co KG, Becton Dickinson and Company, and Terumo Europe. Adsorption of (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid was acceptably low for all syringes (brands with (99m)Tc-DMSA(III) adsorption rates of 36 and 30%, respectively, and for one brand with a (99m)Tc-nanocolloid adsorption rate of 27%. Adsorption of (99m)Tc-DMSA(III) and (99m)Tc-nanocolloid reaches critical levels in syringes produced by two brands, potentially causing poor image quality--for example, in DMSA scans using pediatric radiopharmaceutical doses. It is advised to check the compatibility of any radiopharmaceutical with syringes as an integral part of the quality assurance program. PMID:24569706

  12. The changes in renal function after a single dose of intravenous furosemide in patients with compensated liver cirrhosis

    OpenAIRE

    Mejirisky Yoram; kayal Mohib; Assy Nimer; Gorenberg Miguel; Hussein Osamah; Schlesinger Sorina

    2006-01-01

    Abstract Background Patients with compensated Child-A cirrhosis have sub clinical hypovolemia and diuretic treatment could result in renal impairment. Aim To evaluate the changes in renal functional mass as reflected by DMSA uptake after single injection of intravenous furosemide in patients with compensated liver cirrhosis. Methods Eighteen cirrhotic patients were divided in two groups; eight patients (group 1, age 56 ± 9.6 yrs, Gender 5M/3F, 3 alcoholic and 5 non alcoholic) were given low i...

  13. Selection of micronutrients used along with DMSA in the treatment of moderately lead intoxicated mice

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Yingjun [China Medical University, Department of Physiology, School of Basic Medicine, Shenyang, Liaoning (China); Yu, Fei; Zhi, Xuping; An, Li; Yang, Jun [China Medical University, Department of Nutrition and Food Hygiene, School of Public Health, Shenyang, Liaoning (China); Jin, Yaping; Lu, Chunwei; Li, Gexin [China Medical University, Department of Environmental and Occupational Health, School of Public Health, Shenyang, Liaoning (China)

    2008-01-15

    The objective of this study was to explore the optimum combination of micronutrients used with 2,3-dimercaptosuccinic acid (DMSA) in the treatment of moderately lead-intoxicated mice. Experiment was carried out based on the orthogonal design L{sub 8}(2{sup 7}) setting six factors with two different levels of each, and eight groups of mice were needed. Mice were exposed to lead by drinking water contaminated with 0.1% lead acetate for four consecutive weeks, and then supplemented by gavage with different combinations of micronutrients with and without DMSA as designed in the orthogonal table. Lead levels in blood, liver, kidney, brain and bone and activities of blood {delta}-aminolevulinic acid dehydratase (ALAD) were analyzed after cessation of supplementation. The results suggested that DMSA was the only factor which could decrease significantly lead levels in blood, liver, kidney and bone; calcium and ascorbic acid were the notable factors decreasing lead levels in blood, liver, kidney, bone and brain; zinc and calcium were the notable factors reversing the lead-inhibited activities of blood ALAD; taurine was the notable factor decreasing lead levels in kidney and brain; and thiamine was the notable factor decreasing lead levels in brain. The lowest lead level in blood, liver, kidney and bone was shown in the mice supplemented with combination of calcium and ascorbic acid along with DMSA. In conclusion, the optimum combination of micronutrients used with DMSA suggested in present study was calcium and ascorbic acid, which seemed to potentiate the chelating efficacy of DMSA in the treatment of moderately lead intoxicated mice. (orig.)

  14. Study of 188Re(V)-DMSA for treatment of cancer: radiolabeling and biodistribution

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the radiolabeling and biodistribution of 188Re(V)-DMSA as a therapeutic cancer radiopharmaceutical. We made a DMSA kit(NaHCO3 1.5 mg, meso-2,3-dimercaptosuccinic acid 1.0 mg, L(+)-ascorbic acid 0.7 mg, SnCl2·2H2O 0.34 mg, pH 2.9) for labeling with 188Re. In this kit, 188ReO4 5 mCi/2 ml added and boiled at 100 .deg. C for 3 hr in water bath. The final pH adjusted to 7.5 with 7% NaHCO3 solution. We checked the labelling efficacy with TLC-SG(n-butanol : acetic acid : H2O= 3 : 2: 3) and examined the stability both in room temperature and in serum at 37 .deg. C. Biodistribution (1, 3, 13, 24, 48 hr) of 188Re(V)-DMSA compound was evaluated in Sarcoma 180 tumor-bearing mice. Each labeling efficiency and stability at room temperature for 48 hours was over 98% and 95%, respectively. The stability in serum were 82% (6 hr) and 85% (48 hr). Tumor uptake of 188Re(V)-DMSA in Sarcoma 180-bearing mice were 0.66±0.15% (1 hr), 0.51±0.10% (3 hr), 0.19±0.05%(24 hr) and 0.13±0.02%(48 hr). These result are consistent with those of 99mTc(V)-DMSA which were reported previously. In conclusion, 188Re(V)-DMSA may be a useful therapeutic radiopharmaceutical for treating some cancers and metastatic bone lesion

  15. Renal damage in vesicoureteral reflux associated to duplex systems

    International Nuclear Information System (INIS)

    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

  16. The Hydrophobic Region of the DmsA Twin-Arginine Leader Peptide Determines Specificity with Chaperone DmsD

    OpenAIRE

    Winstone, Tara M. L.; Tran, Vy A.; Turner, Raymond J.

    2013-01-01

    The system specific chaperone DmsD plays a role in the maturation of the catalytic subunit of dimethyl sulfoxide (DMSO) reductase, DmsA. Pre-DmsA contains a 45-amino acid twin-arginine leader peptide that is important for targeting and translocation of folded and cofactor-loaded DmsA by the twin-arginine translocase. DmsD has previously been shown to interact with the complete twin-arginine leader peptide of DmsA. In this study, isothermal titration calorimetry was used to investigate the the...

  17. Optimization of labelling procedure of {sup 188}rE-DMSA(v)

    Energy Technology Data Exchange (ETDEWEB)

    Dantas, Danielle M.; Brambilla, Tania P.; Reis, Nicoli F.; Osso Junior, Joao A., E-mail: jaosso@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    Radionuclide therapy (RNT) is emerging as an important tool of nuclear medicine. Apart from the well established {sup 131}I, several other promising radionuclides have been identified, among them {sup 188}Re, {sup 90}Y and {sup 177}Lu. {sup 188}Re has received a lot of attention in the past decade, due to its favourable nuclear characteristics [t{sub 1/2} 16.9 h, E{sub b}eta{sub m}ax 2.12 MeV and E{sub g}amma 155 keV (15%) suitable for imaging, including the fact that it is carrier-free and can be obtained cost-effectively through the generator {sup 188}W-{sup 188}Re. Biodistribution studies of {sup 188}Re-DMSA(V) have shown that its general pharmacokinetic properties are similar to that of {sup 99m}Tc-DMSA(V), so this agent could be used for targeted radiotherapy of medullary thyroid carcinoma, bone metastases, soft tissue and others tumors. The aim of this work is to evaluate two labeling procedures for the preparation of {sup 188}Re-DMSA(V). The first method was prepared using a commercial kit of DMSA(III) for labeling with {sup 99m}Tc at high temperature (100 deg C). The second method was prepared in a vial containing 2.5 mg of DMSA, 1.00 mg of SnCl{sub 2}.2H{sub 2}O and 10 mg of sodium oxalate, 10 mg of cyclodextrin, in a total volume of 2.0 mL. The pH was adjusted to 3 with 37% HCl. After labeling the solution was stirred and incubated for 30 min at room temperature. The radiochemical purity was determined using TLC-SG developed with two different solvent systems: Acetone and glycine. Preliminary results for both methods of labeling {sup 188}Re-DMSA(V) showed that the labeling yield was >95%. Further experiments are also necessary to optimize the labeling methodology of {sup 188}Re-DMSA(V).author)

  18. Labeling procedures for the preparation of {sup 188}Re- DMSA(V)

    Energy Technology Data Exchange (ETDEWEB)

    Brambilla, Tania P.; Osso Junior, Joao A., E-mail: taniabrambilla@yahoo.com.b, E-mail: jaosso@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2009-07-01

    {sup 188}Re has received a lot of attention in the past decade, due to its favorable nuclear characteristics [t{sub 1/2} 16.9 h, E{sub beta}{sub max} 2.12 MeV and E{sub gamma} 155 keV (15%) suitable for imaging], including the fact that it is carrier-free and can be obtained cost-effectively through the generator {sup 188}W-{sup 188}Re. Besides the therapeutic usefulness of {sup 188}Re, the emission of the 155 keV gamma photon is an added advantage since the biodistribution of {sup 188}Re-labeled agents can be evaluated in vivo with a gamma camera. Biodistribution studies of {sup 188}Re-DMSA(V) have shown that its general pharmacokinetic properties are similar to that of {sup 99}mTc-DMSA(V), so this agent could be used for targeted radiotherapy of the same tumors, i.e., medullary thyroid carcinoma, bone metastases, soft tissue, head and neck tumors. The aim of this work is to evaluate two labeling procedures for the preparation of {sup 188}Re- DMSA(V). {sup 188}Re-DMSA(V) was prepared by two methods. The first method was prepared using a commercial kit of DMSA(III) for labeling with {sup 99m}Tc, at high temperature (100 deg C). The second method was prepared in a vial containing 2.5 mg of DMSA, 1.00 mg of SnCl{sub 2}.2H2{sub O} and 30 mg of sodium oxalate, in a total volume of 1.1 mL. The pH was adjusted to 5 with 37% HCl. After labeling the solution was stirred and incubated for 15 min at room temperature. The radiochemical purity was determined using TLC-SG developed with two different solvent systems. Preliminary results for both methods of labeling {sup 188}Re-DMSA(V) showed that the labeling yield was >90%. (author)

  19. 99mTc-DTPA dynamic SPECT and CT volumetry for measuring split renal function in live kidney donors

    International Nuclear Information System (INIS)

    Split renal function (SRF) estimated from the posterior view of 99mTc-diethylenetriaminepentaacetic acid planar scintigraphy (DTPA/P) is not sufficiently accurate even after correction for kidney depth by computed tomography (CT). To obtain more accurate SRF using 99mTc-DTPA dynamic single photon emission computed tomography (SPECT) method was carried out for the initial 5 min after bolus injection of 99mTc-DTPA (DTPA/SPECT). Also SRF was evaluated from the renal volume measured by CT. We compared the results with 99mTc-dimercaptosuccinic acid SPECT (DMSA/SPECT). In 60 consecutive live kidney donors, 30 DTPA/P, 30 DTPA/SPECT, 60 99mTc-DMSA/SPECT, and 60 CT studies were performed. In the DTPA/P studies, SRF was calculated from the posterior image recorded during 2-3-min postinjection with attenuation correction for kidney depth measured by CT. In the DTPA/SPECT studies, SPECT images were acquired continuously for 5 min with a dual-headed gamma camera. In 99mTc-DMSA scintigraphy, DMSA/SPECT images were acquired 3-h postinjection. The SRF on both SPECT studies was calculated from the total counts of each kidney. In the DTPA/SPECT study, SRF was evaluated on the three images summed for 1 min: 1-2 min (DTPA/SPECT1-2), 2-3 min (DTPA/SPECT2-3), and 1-3 min (DTPA/SPECT1-3). In the CT examination, to assess the global renal volume, the axial images in the excretory phase were chosen. Renal contours were identified on each image, and the areas (cm2) of these regions were summed and multiplied by the slice thickness (10 mm) to yield global renal volume (ml). Right renal function from DTPA/P, DTPA/SPECT, and CT were compared with that from DMSA/SPECT as a reference. Correlation coefficients of the right renal function between DMSA/SPECT and DTPA/P, DTPA/SPECT2-3, and CT were 0.663, 0.849 and 0.907, respectively (P<0.0001). The differences between DMSA/SPECT and DTPA/P, DTPA/SPECT2-3 and CT were 2.42±3.878, 0.867±1.672, and -0.421±1.077% (mean±standard deviation (SD

  20. The identity confirmation of 99gTc-DMSA complexes by using NMR and HPLC-MS/MS methods

    International Nuclear Information System (INIS)

    The analyses of 99gTc-DMSA complexes prepared under alkali and acidic reactions were reported. Modern analytical, separation and spectral methods such as NMR (1H-NMR, 13C-NMR, APT, COSY and HSQC) and Q-TOF HPLC-MS/MS system with ESI were employed to determine the identity and characterization of the products. The structure of 99gTc(V)DMSA was clearly confirmed and its fragmentation path in negative and positive ionisation mode was suggested. The effect of ascorbic acid and new alternative labelling with the use of NH499gTcOCl4 was examined. Surprisingly, 99gTc(III)DMSA complex was not formed under acidic reaction conditions. 99gTc(V)DMSA complex was the main reaction product under both experimental conditions. This result suggests the key role of 99g/99mTc concentration during the process of radiopharmaceuticals preparation. (author)

  1. 99mTc(V)-DMSA. A useful radio isotopic material for the diagnosis of pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Shinichi; Yamamura, Koji; Chang, Chia-Cheng; Kojima, Yasuhiro; Yamamoto, Isao; Ikegami, Tadashi [Yokohama City Univ., Kanagawa (Japan). School of Medicine

    2000-06-01

    We compared images of pituitary adenoma, parasellar tumors, and non-pituitary adenoma using the tumor-seeking agent technetium-99m-labeled pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) and evaluated the relationship between 99mTc(V)-DMSA uptake and pituitary hormone level. Fifteen patients with pituitary adenoma were studied: 3 non-functioning adenoma, 6 prolactinoma, 4 GH secreting adenoma, and 2 ACTH secreting adenoma. As a control group, we studied 6 patients without adenoma who had undergone a pathological examination. Planar and SPECT images were obtained 2-hours after intravenous injection of approximately 740 MBq 99mTc(V)-DMSA. Uptake ratios between normal background and tumor lesion were calculated. Three non-functioning adenoma (100%), five prolactinoma (83%), three GH secreting adenoma (75%) and no ACTH secreting adenoma (0%) significantly concentrated 99mTc(V)-DMSA. One of the non-adenomatous tumors, a Rathke's cleft cyst concentrated 99mTc(V)-DMSA in the pituitary while the others did not. The 99mTc(V)-DMSA scintigraphy showed an overall sensitivity of 73% (11/15) in detecting pituitary adenomas. Uptake ratios were higher in hormone-secreting adenoma than non-secreting adenoma. We were able to detect residual tumors and distinguish pituitary adenoma from surgical non-tumoral lesion with 99mTc(V)-DMSA. These results suggest that 99mTc(V)-DMSA imaging is useful in detecting pituitary adenoma and noninvasively differentiating tumor types in parasellar lesion. (author)

  2. Predictors of DMSA chelatable lead, tibial lead, and blood lead in 802 Korean lead workers

    OpenAIRE

    Todd, A; Lee, B; Lee, G.; Ahn, K; Moshier, E; Schwartz, B.

    2001-01-01

    OBJECTIVES—To examine the interrelations among chelatable lead (by dimercaptosuccinic acid, DMSA), tibial lead, and blood lead concentrations in 802 Korean workers with occupational exposure to lead and 135 employed controls with only environmental exposure to lead.
METHODS—This was a cross sectional study wherein tibial lead, DMSA chelatable lead, and blood lead were measured. Linear regression was used to identify predictors of the three lead biomarkers, evaluating the influence of age, job...

  3. 99mTc(V)-DMSA. A useful radio isotopic material for the diagnosis of pituitary adenoma

    International Nuclear Information System (INIS)

    We compared images of pituitary adenoma, parasellar tumors, and non-pituitary adenoma using the tumor-seeking agent technetium-99m-labeled pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) and evaluated the relationship between 99mTc(V)-DMSA uptake and pituitary hormone level. Fifteen patients with pituitary adenoma were studied: 3 non-functioning adenoma, 6 prolactinoma, 4 GH secreting adenoma, and 2 ACTH secreting adenoma. As a control group, we studied 6 patients without adenoma who had undergone a pathological examination. Planar and SPECT images were obtained 2-hours after intravenous injection of approximately 740 MBq 99mTc(V)-DMSA. Uptake ratios between normal background and tumor lesion were calculated. Three non-functioning adenoma (100%), five prolactinoma (83%), three GH secreting adenoma (75%) and no ACTH secreting adenoma (0%) significantly concentrated 99mTc(V)-DMSA. One of the non-adenomatous tumors, a Rathke's cleft cyst concentrated 99mTc(V)-DMSA in the pituitary while the others did not. The 99mTc(V)-DMSA scintigraphy showed an overall sensitivity of 73% (11/15) in detecting pituitary adenomas. Uptake ratios were higher in hormone-secreting adenoma than non-secreting adenoma. We were able to detect residual tumors and distinguish pituitary adenoma from surgical non-tumoral lesion with 99mTc(V)-DMSA. These results suggest that 99mTc(V)-DMSA imaging is useful in detecting pituitary adenoma and noninvasively differentiating tumor types in parasellar lesion. (author)

  4. Renal function imaging with radioisotopes - state of the art

    International Nuclear Information System (INIS)

    In modern nuclear medicine, iodine-131-hippurate is more and more replaced by alternative radiopharmaceuticals like iodine-123-hippurate and technetium-99m-MAG3. Lower photon energy and higher count rates produce better image quality by using these new substances. Other disadvantages of iodine-131-hippurate are the unnecessary irradiation of the patient - because of the beta ray component - and the environment - because of its long half-life. Because of these facts, nowadays only the technetium compounds MAG3, DTPA and DMSA or iodine-123-hippurate should be used in renal scanning. Tc-DMSA only allows static images. The glomerular filtration marker Tc-DTPA has an unfavourably low clearance. For this, Tc-MAG3 and iodine-123-hippurate are the most appropriate tracers for renal function scintigraphy. While the image quality of both is equal, Tc-MAG3 has the advantage of better availability and handling. Summarizing our experience in a large number of kidney investigations, Tc-MAG3 has been proved to be the radiopharmacon with the most universal range of indications. Iodine-hippurate and Tc-DTPA can be completely replaced by Tc-MAG3 in the scintigraphic imaging of kidney perfusion, renal function, urinary tract obstruction, renal artery stenosis, and vesicoureteral reflux. (orig.)

  5. Renal scarrings (RS) after acute pyelonephritis (APN) in the children under the age of 5 years and its correlation with clinical risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Lee, B. S.; Moon, D. H.; Ahn, S. H.; Lee, W. W.; Yoon, S. Y.; Yoon, J. H.; Park, Y. S. [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2001-07-01

    In children with APN, risk factors for the subsequent RS are still controversial. We evaluated the changes in renal cortical defects on the Tc-99m DMSA scan and the relationship between RS and risk factors. Patients were 143 children (age < 5 yrs) with first APN documented by the presence of fever (< 38.5 .deg. C ), and abnormal DMSA scan from 1994 to 2000. We performed a follow-up DMSA scan at 6 months. RS was defined as persistent or partially reversible abnormalities on the follow-up scan. Nine were excluded due to recurrent infection, and 58 who were lost to follow-up. A total of 76 (m/f =38/38) were available for the study (mean age : 1.19 yr, range: 47 day - 5.0 yr). Of 152 kidneys, DMSA was abnormal in 90. Initial defect was completely recovered in 52, partially recovered in 30, and persistent in 8 (38 RS). Univariate analysis revealed that duration of fever, C-reactive protein, and vesicoureteral reflux (VUR) were associated with RS. Multivariate analysis showed that duration of fever and VUR were independent predictors of RS. However, in patients with unilateral defect, only duration of fever (p=0.027) and relative function (p=0.002) were independent predictors. The severity and extent of acute inflammatory response may determine RS. DMSA may be of value because it provides information on the extent of initial parenchymal damage.

  6. The clinical value of using anterior and posterior views in the calculation of geometric mean with a Tc-99m DMSA scan: is the evaluation of the geometric mean necessary in the paediatric patients?

    International Nuclear Information System (INIS)

    The geometric mean can be determined by using both the anterior and the posterior views in a Tc-99m DMSA renal scan. The aim of this study is to evaluate if there are significant differences in the quantification of the renal function percentage using only the posterior view and the geometric mean. 200 DMAS-scans (81 f, 119 m) aged to 57 year old were reviewed. The difference between the relative renal function obtained using the posterior view and that obtained using the geometric mean was calculated. For the purpose of evaluating the value of performing the geometric mean calculation in patients of different ages, patients were divided into four age groups (group I, 15 years). If counts were obtained from the posterior view only, significant change (5% difference) in relative renal function would be obtained in 2.2% (2 out of 91) of group I, in 1.4% (one out of 70) of group II patients, in 5.5% (one out of 18) of group III patients and in 14.3% (3 out of 21) of group IV patients. These data suggest that only the posterior view data sufficiently may represent relative renal function in pediatric groups (group I, II, III) in comparison to adult group (group IV). For normally located kidneys, it appears appropriate to use only the posterior view data rather than to use the geometric mean method, especially in pediatric age group

  7. Development of methods of labeling pentavalent DMSA with {sup 99m}Tc and {sup 188}Re; Desenvolvimento de metodos para marcacao de DMSA pentavalente com {sup 99m}Tc e {sup 188}Re

    Energy Technology Data Exchange (ETDEWEB)

    Brambilla, Tania de Paula, email: jtoniolo@ipen.br

    2009-07-01

    Technetium-99 m is the most useful radionuclide in diagnostic imaging procedures in Nuclear Medicine, more than 80 percent of radiopharmaceuticals are {sup 99m}Tc-labeled compounds. {sup 99m}Tc-DMSA(V) has been used for imaging of soft tissue, head and neck tumors. It shows a particularly high specificity for medullary thyroid carcinoma and bone metastases in a variety of cancers. Biodistribution studies of {sup 188}Re-DMSA(V) have shown that its general pharmacokinetic properties are similar to that of {sup 99m}Tc-DMSA(V), so this agent could be used for targeted radiotherapy of these tumors. The aim of this work is the development of methods of labeling DMSA(V) with {sup 99m}Tc and {sup 188}Re. {sup 99m}Tc-DMSA(V) can be prepared by two methods. One of them is the indirect one, through the use of a commercial kit of DMSA (III), by adjusting the pH from 2.5 to {approx} 8.5 with NaHCO{sub 3}. This method was evaluated and optimized presenting high labeling yields. The other method is the direct one, through the preparation of a lyophilised kit ready for labeling with {sup 99m}Tc, being the method of interest of this work, due to the easy of its clinical use. The most adequate formulation of the kit was: 1.71 mg of DMSA, 0.53 mg of SnCl{sub 2}.2H{sub 2}O and 0.83 mg of ascorbic acid (pH 9). Labeling yields higher than 95% were achieved labeling this kit with 1 to 2 m L of {sup 99m}Tc with activities up to 4736 MBq (128 mCi). The kit was stable up to 6 months and biodistribution studies confirmed the quality of the DMSA (V) labeled with {sup 99m}Tc using this kit. The reduction potential of Re is lower than the one for Tc, so the labeling conditions of {sup 188}Re-DMSA(V) are different from the ones used for {sup 99m}Tc- DMSA(V). {sup 188}Re-DMSA(V) is prepared in acid solution, that makes it possible to use the DMSA (III) commercial kit developed for labeling with {sup 99m}Tc, prepared in pH 2.5, for labeling with {sup 188}Re. Labeling yields higher than 95% were

  8. Relationship of cell proliferation (Ki-67) to 99mTc-(V)DMSA uptake in breast cancer

    International Nuclear Information System (INIS)

    The aim of the present study was to identify the relationships between the uptake of radiotracers – namely pentavalent dimercaptosuccinic acid [(V)DMSA] and sestamibi (MIBI) – and the following parameters in primary breast cancer: steroid receptor concentrations (i.e. estrogen receptor [ER] and progesterone receptor [PR]), Ki-67 expression, tumor size, tumor grade, age, and levels of expression of p53 and c-erbB-2. In addition, by multivariate regression analysis, we further isolated those factors with independent associations with (V)DMSA and/or MIBI uptake in primary breast cancer. Thirty-four patients with histologically confirmed breast carcinoma underwent preoperative scintimammography with technetium-99m (99mTc)-(V)DMSA and/or 99mTc-MIBI in consecutive sessions 10 and 60 min after administration of 925–1110 MBq of each radiotracer. The tumor-to-background ratio was calculated and correlated with the presence of ER, PR, Ki-67, tumor size, tumor grade, p53, and c-erbB-2. ER, PR, p53, and c-erbB-2 were determined immunohistochemically. The analysis included tumor-to-background ratio of (V)DMSA and MIBI uptake as dependent and all of the other parameters as independent variables. Correlation was positive between Ki-67 and (V)DMSA (r = 0.37 at 10 min, P = 0.038; r = 0.42 at 60 min, P = 0.018) and inverse between PR and (V)DMSA uptake (r = -0.46 at 10 min, P = 0.010; r = -0.51 at 60 min, P = 0.003). Multivariate regression analysis demonstrated a positive correlation between Ki-67 and (V)DMSA at 60 min (P = 0.045). Ki-67 was not significantly correlated with MIBI uptake, whereas tumor size was positively correlated with MIBI uptake at 60 min both in univariate (r = 0.45, P = 0.027) and multivariate analysis (P = 0.024). Negative correlations were observed between (V)DMSA uptake and ER, as well as between ER/PR and MIBI uptake, but these were not significant. Ki-67 appears to represent the major independent factor affecting (V)DMSA uptake in breast cancer

  9. Three new renal simulators for use in nuclear medicine

    Directory of Open Access Journals (Sweden)

    Dullius Marcos

    2014-03-01

    Full Text Available 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.

  10. Diagnostic chelation challenge with DMSA: a biomarker of long-term mercury exposure?

    OpenAIRE

    Frumkin, H; Manning, C C; Williams, P. L.; Sanders, A; Taylor, B.B.; Pierce, M; Elon, L; Hertzberg, V S

    2001-01-01

    Chelation challenge testing has been used to assess the body burden of various metals. The best-known example is EDTA challenge in lead-exposed individuals. This study assessed diagnostic chelation challenge with dimercaptosuccinic acid (DMSA) as a measure of mercury body burden among mercury-exposed workers. Former employees at a chloralkali plant, for whom detailed exposure histories were available (n = 119), and unexposed controls (n = 101) completed 24-hr urine collections before and afte...

  11. Magnetic nanoparticle film reconstruction modulated by immersion within DMSA aqueous solution

    OpenAIRE

    Qing Xiang; Cimei Borges Teixeira; Li Sun; Paulo Cesar Morais

    2016-01-01

    The process of reconstruction of pre-fabricated films comprising maghemite nanoparticles deposited onto flat glass substrates triggered by immersion into aqueous solutions of meso-2,3-dimercaptosuccinic acid (DMSA) at increasing concentration (0.025, 0.050, and 0.100 mol/L) is herein reported. The evolution of this process was assessed by measuring the time (t) dependence of the particle analysis histogram width (W) extracted from atomic force microscopy images. Furthermore, a physical pictur...

  12. The relationships between clinical variables and renal parenchymal disease in pediatric clinically suspected urinary tract infection

    Directory of Open Access Journals (Sweden)

    Jung Lim Byun

    2010-02-01

    Full Text Available Purpose : To evaluate the significance of clinical signs and laboratory findings as predictors of renal parenchymal lesions and vesicoureteral reflux (VUR in childhood urinary tract infection (UTI. Methods : From July 2005 to July 2008, 180 patients admitted with a first febrile UTI at the Pediatric Department of Konkuk University Hospital were included in this study. The following were the clinical variables: leukocytosis, elevated C-reactive protein (CRP, positive urine nitrite, positive urine culture, and fever duration both before and after treatment. We evaluated the relationships between clinical variables and dimercaptosuccinic acid (DMSA scan and voiding cystourethrography (VCUG results. Results : VCUG was performed in 148 patients; of them, 37 (25.0% had VUR: 18 (12.2% had low-grade (I-II VUR, and 19 (10.5% had high-grade (III-V VUR. Of the 95 patients who underwent DMSA scanning, 29 (30.5% had cortical defects, of which 21 (63.6% had VUR: 10 (30.3%, low-grade (I-II VUR; and 11 (33.3%, high-grade VUR. Of the 57 patients who were normal on DMSA scan, 8 (14.0% had low-grade VUR and 6 (10.5% had high-grade VUR. The sensitivity, specificity, and positive and negative predictive values of the DMSA scan in predicting high-grade VUR were 64.7%, 69.9%, 33.3%, and 89.5%, respectively. Leukocytosis, elevated CRP, and prolonged fever (?#243;6 hours after treatment were significantly correlated with the cortical defects on DMSA scans and high-grade VUR. Conclusion : Clinical signs, including prolonged fever after treatment, elevated CRP, and leukocytosis, are positive predictors of acute pyelonephritis and high-grade VUR.

  13. Comparison of clearance determination with sup 131 I-hippurate (split function ERPF) and sup 99m Tc-DMSA. Vergleich der seitengetrennten Nierenclearance mit der Leistungsbeurteilung mittels Technetium DMSA

    Energy Technology Data Exchange (ETDEWEB)

    Illing, H.; Weiss, M.L.; Deckart, H. (Klinikum Berlin-Buch, Klinik fuer Nuklearmedizin und Endokrinologie (Germany))

    1990-01-01

    The capacity of separated kidney function, estimated by means of {sup 131}I- or {sup 123}I-hippurate clearance, was compared with the capacity results from {sup 99m}TC-DMSA scintigraphy. There was found a good correlation (0.98) of the two methods. In patients with urine congestion the frequent high capacity in hippurate clearance in comparison to DMSA-scintigraphy on the affected kidney was evident. This results needs further investigations. In cases where it is necessary to evaluate the relative separated capacity of both sides, the hippurate clearance can be substituted by combination of DMSA-scintigraphy and isotope renogram. Considering surgical consequences, it is important to carry out both methods. (orig.).

  14. Analiza funkcije i morfologije bubrega pomocu Tc-99m-DTPA i Tc-99m-DMSA u djece s vezikoureteralnim refluksom

    International Nuclear Information System (INIS)

    The aim of this study was the evaluation of a new method, dynamic renal scintigraphy in zoom mode using Tc-99m-DTPA with deconvolution of renographic curves in evaluation of morphology and function of the kidney and upper urinary tract in children with various degrees of vesicoureteral reflux. For the first time we used our own method generating 6 functional images of the mean time in deconvolution of renographic curves which offers better detectability of pathologic changes in the kidney using dynamic scintigraphy. In the analysis of functional images of the mean time retention of activity was noticed within anatomic structures of a kidney, parenchyma, calyces as well as the renal pelvis. Time activity curves generated over focal retention in the parenchyma, found in the late functional images of the mean time, exhibited the return of activity in this region, i.e. intrarenal reflux. Intrarenal reflux is an important risk factor in development of reflux nephropathy and its detection is of utmost importance in evaluating possible reflucting kidney damage and indicating children with high risk of renal scarring. We found the method of functional images of mean time to be more sensitive in detecting parenchymal changes than static scintigraphy with Tc-99m-DMSA, which was till now used for evaluation of kidney morphology. Likewise, we found the method of functional images of the mean time superior in detecting changes in upper urinary tract in comparison with excretory urography. The analysis of deconvolution numerical data exhibited the prolongation of parenchymal, renal pelvis and total kidney transit time in higher reflux degrees. These data contribute to better functional evaluation of reflucted kidney and point out the ones with great risk of renal scarring. We can conclude that careful analysis of each of the 6 functional images of the mean time and deconvolution of renographic curves with Tc-99m-DTPA contribute to early detection of children with vesicoureteral

  15. 99mTc-DMSA complex preparation. The effect of pH and tin(II) chloride amount on reaction

    International Nuclear Information System (INIS)

    Labelling of meso-2,3-dimercaptosuccinic acid (DMSA) with technetium-99m was reinvestigated. Dependence of the 99mTc-DMSA complex formation on the molar ratio of DMSA:reducing agent (SnCl2 · 2H2O) and pH was studied. Five different types of 99mTc-DMSA complexes were determined. Especially three different complexes were established in the clinically used and prepared DMSA kit labelled with 99mTc under alkaline condition. This radiopharmaceutical is used as imaging agent of the primary medullary carcinoma in the thyroid gland and different metastasis types. The existence of all complexes was observed by paper chromatography, paper electrophoresis and high performance liquid chromatography. (author)

  16. Trauma renal Renal trauma

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    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

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

    International Nuclear Information System (INIS)

    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/mm3 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

  18. Comparison of clearance determination with 131I-hippurate (split function ERPF) and 99mTc-DMSA

    International Nuclear Information System (INIS)

    The capacity of separated kidney function, estimated by means of 131I- or 123I-hippurate clearance, was compared with the capacity results from 99mTC-DMSA scintigraphy. There was found a good correlation (0.98) of the two methods. In patients with urine congestion the frequent high capacity in hippurate clearance in comparison to DMSA-scintigraphy on the affected kidney was evident. This results needs further investigations. In cases where it is necessary to evaluate the relative separated capacity of both sides, the hippurate clearance can be substituted by combination of DMSA-scintigraphy and isotope renogram. Considering surgical consequences, it is important to carry out both methods. (orig.)

  19. Potential place of {sup 99m}Tc-DMSA scintigraphy in the management of children with urinary tract infection; Stellenwert der {sup 99m}Tc-DMSA-Szintigrafie bei der Behandlung von Kindern mit Harnwegsinfektionen

    Energy Technology Data Exchange (ETDEWEB)

    Piepsz, A. [Univ. Hospital St Pierre, Dept. Radioisotopes, Brussels (Belgium)

    2010-09-15

    Cortical {sup 99m}Tc DMSA scintigraphy is accepted as a highly sensitive technique for the detection of regional lesions. It reflects accurately the histological changes and the interobserver reproducibility in reporting is high. Potential technical pitfalls should be recognized, such as the normal variants and the difficulty to differentiate acute lesions from permanent ones, or acquired lesions from congenital ones. Although DMSA scintgraphy seems to play a minor role in the traditional approach of urinary tract infection, recent studies suggest that this examination might influence the treatment of the acute phase, the indication of chemoprophylaxis and of micturating cystography, as well as the duration of follow-up. (orig.)

  20. Identifying Vulnerable Atherosclerotic Plaque in Rabbits Using DMSA-USPIO Enhanced Magnetic Resonance Imaging to Investigate the Effect of Atorvastatin.

    Directory of Open Access Journals (Sweden)

    Chunmei Qi

    Full Text Available Rupture of an atherosclerotic plaque is the primary cause of acute cardiovascular and cerebrovascular syndromes. Early and non-invasive detection of vulnerable atherosclerotic plaques (VP would be significant in preventing some aspects of these syndromes. As a new contrast agent, dimercaptosuccinic acid (DMSA modified ultra-small super paramagnetic iron oxide (USPIO was synthesized and used to identify VP and rupture plaque by magnetic resonance imaging (MRI.Atherosclerosis was induced in male New Zealand White rabbits by feeding a high cholesterol diet (n = 30. Group A with atherosclerosis plaque (n = 10 were controls. VP was established in groups B (n = 10 and C (n = 10 using balloon-induced endothelial injury of the abdominal aorta. Adenovirus-carrying p53 genes were injected into the aortic segments rich in plaques after 8 weeks. Group C was treated with atorvastatin for 8 weeks. Sixteen weeks later, all rabbits underwent pharmacological triggering, and imaging were taken daily for 5 d after DMSA-USPIO infusion. At the first day and before being killed, serum MMP-9, sCD40L, and other lipid indicators were measured.DMSA-USPIO particles accumulated in VP and rupture plaques. Rupture plaques appeared as areas of hyper-intensity on DMSA-USPIO enhanced MRI, especially T2*-weighted sequences, with a signal strength peaking at 96 h. The group given atorvastatin showed few DMSA-USPIO particles and had lower levels of serum indicators. MMP-9 and sCD40L levels in group B were significantly higher than in the other 2 groups (P <0.05.After successfully establishing a VP model in rabbits, DMSA-USPIO was used to enhance MRI for clear identification of plaque inflammation and rupture. Rupture plaques were detectable in this way probably due to an activating inflammatory process. Atorvastatin reduced the inflammatory response and stabilizing VP possibly by decreasing MMP-9 and sCD40L levels.

  1. Synthesis and radiolabelling of DMSA-PLGA microspheres with 188rhenium replacing 99mtechnetium: an experimental radio therapeutic approach

    International Nuclear Information System (INIS)

    99mTc(V) Dimercaptosuccinic acid (DMSA), a well known tumor seeking agent, has been well documented. The attachment of a β-emitter /higher energy γ- emitter in lieu of Tc-99m .in its position. DMSA (labeled/unlabeled) loaded polymeric microspheric delivery system may be utilized theoretically as therapeutic agent for neurogenic/neuroendocrine tumors and some other types of tumors. The aim of our studies was to deliver the loaded drug to tumors and to irradiate the tumor tissue for the extended period. The bioabsorbable poly lactic-co-glycolic acid (75:25) microspheres ranging between 200 nm-2.00 μm were developed using double emulsion solvent evaporation method. The known amount of dimercaptosuccinic acid was loaded and tagged with freshly prepared Re-188 eluted from W-188 Generator. For microsphere characterization unlabelled and 99mTc(V) DMSA labeled microspheres were also prepared. Microspheres of different sizes were prepared. Size and morphology was studied by SEM. Drug (labeled/unlabeled DMSA) loading was dependent on the size of microspheres. In vitro drug loading and drug release was recorded. Thermal analysis demonstrated that the drug inside the microspheres was amorphous crystalline state, as melting endothermic peak of DMSA could not be detected in the drug loaded microspheres. The morphology based glioma cell kinetics using electron microscopy, demonstrated the in-vitro ability of radiolabelled DMSA to enter within the cell and block the cell growth; potentially by enhancing the radiation doses to cultured cells, when incubated with a microsphere-based drug delivery system.

  2. Potential place of 99mTc-DMSA scintigraphy in the management of children with urinary tract infection

    International Nuclear Information System (INIS)

    Cortical 99mTc DMSA scintigraphy is accepted as a highly sensitive technique for the detection of regional lesions. It reflects accurately the histological changes and the interobserver reproducibility in reporting is high. Potential technical pitfalls should be recognized, such as the normal variants and the difficulty to differentiate acute lesions from permanent ones, or acquired lesions from congenital ones. Although DMSA scintgraphy seems to play a minor role in the traditional approach of urinary tract infection, recent studies suggest that this examination might influence the treatment of the acute phase, the indication of chemoprophylaxis and of micturating cystography, as well as the duration of follow-up. (orig.)

  3. Technetium Tc 99m Dimercaptosuccinic Acid Renal Scintigraphy in Diagnosis of Urinary Tract Infections in Children with Negative Culture

    Directory of Open Access Journals (Sweden)

    Mehdi Fazel

    2006-02-01

    Full Text Available

    Introduction: The aim of this study was to evaluate the accuracy of Technetium Tc 99m dimercaptosuccinic acid (99mTc-DMSA renal scintigraphy in the diagnosis of urinary tract infection (UTI in children with suspected infection but with a negative urine culture.

    Materials and Methods: The records of all children with suspected or definite diagnosis of UTI presented during a 2-year period were reviewed in this study. Abnormal findings on renal scintigraphy, voiding cystourethrography (VCUG, and ultrasonography were evaluated and compared between the patients with the definite diagnosis of UTI and those with suspected UTI and negative urine cultures.

    Results: Of 210 patients, 86 had a definite diagnosis of UTI (group 1 and 124 had suspected UTI without a positive culture (group 2. Abnormal findings on DMSA scans were seen in 76 patients (88.4% in group 1 and 84 (67.7% in group 2. Vesicoureteral reflux was detected by VCUG in 50% and 32.3% of the patients in groups 1 and 2, respectively. In group 2, vesicoureteral reflux was seen in 40.5% of the patients with abnormal DMSA scan. Ultrasonography findings were abnormal in 51.3% and 39.8% of the patients with abnormal DMSA scan findings in groups 1 and 2, respectively.

    Conclusion: According to our findings, in children with a negative urine

  4. Clinical nuclear medicine applications in Turkey and specific renal studies

    International Nuclear Information System (INIS)

    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. (author)

  5. Clinical nuclear medicine applications in Turkey and specific renal studies

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    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

  7. Differentiation of pituitary adenomas from other sellar and parasellar tumors by {sup 99m}Tc(V)-DMSA scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamamura, Koji [Yokohama City Univ. (Japan). Medical Center; Suzuki, Shinichi; Yamamoto, Isao [Yokohama City Univ. (Japan). School of Medicine

    2003-04-01

    Pentavalent technetium-99m dimercaptosuccinic acid [{sup 99m}Tc(V)-DMSA] scintigraphy was evaluated for the differentiation of pituitary adenomas, especially non-functioning adenomas, from other sellar and parasellar lesions. Diffuse {sup 99m}Tc(V)-DMSA accumulation within the tumor was found in seven of seven non-functioning, three of four growth hormone-secreting, and seven of eight prolactin-secreting adenomas, but only partial accumulation in only two of 16 non-pituitary adenomas and normal pituitary glands. There were no significant relationship between tumor-to-background ratios and tumor size or serum hormone level. {sup 99m}Tc(V)-DMSA scintigraphy showed overall sensitivity of 81% (17/21 cases) for detecting pituitary adenomas, in particular 100% for non-functioning adenomas. {sup 99m}Tc(V)-DMSA may be useful for detecting pituitary adenomas, especially non-functioning adenomas, and for the differentiation of non-functioning pituitary adenomas from other sellar and parasellar lesions. (author)

  8. Differentiation of pituitary adenomas from other sellar and parasellar tumors by 99mTc(V)-DMSA scintigraphy

    International Nuclear Information System (INIS)

    Pentavalent technetium-99m dimercaptosuccinic acid [99mTc(V)-DMSA] scintigraphy was evaluated for the differentiation of pituitary adenomas, especially non-functioning adenomas, from other sellar and parasellar lesions. Diffuse 99mTc(V)-DMSA accumulation within the tumor was found in seven of seven non-functioning, three of four growth hormone-secreting, and seven of eight prolactin-secreting adenomas, but only partial accumulation in only two of 16 non-pituitary adenomas and normal pituitary glands. There were no significant relationship between tumor-to-background ratios and tumor size or serum hormone level. 99mTc(V)-DMSA scintigraphy showed overall sensitivity of 81% (17/21 cases) for detecting pituitary adenomas, in particular 100% for non-functioning adenomas. 99mTc(V)-DMSA may be useful for detecting pituitary adenomas, especially non-functioning adenomas, and for the differentiation of non-functioning pituitary adenomas from other sellar and parasellar lesions. (author)

  9. Emission tunable, cyto/hemocompatible, near-IR-emitting Ag2S quantum dots by aqueous decomposition of DMSA

    OpenAIRE

    Birer, Özgür; Hocaoğlu, İbrahim; Demir, Fatma; Kiraz, Alper; Grandfils, Christian; Acar, Havva Yağcı; Sevrin, Chantal

    2014-01-01

    Size tunable aqueous Ag2S quantum dots emitting in the near-infrared region were synthesized through decomposition of meso-2,3-dimercaptosuccinic acid (DMSA) in water. The resulting NIR QDs are highly cyto- and hemocompatible, have quantum yields as high as 6.5% and are effective optical imaging agents based on in vitro evaluation.

  10. Effects of meso-2,3-dimercaptosuccinic acid (DMSA) on the teratogenicity of sodium arsenate in mice

    Energy Technology Data Exchange (ETDEWEB)

    Bosque, M.A.; Domingo, J.L.; Llobet, J.M. (Univ. of Barcelona, Reus (Spain)); Corbella, J. (Univ. of Barcelona (Spain))

    1991-11-01

    Although the effects of arsenic on mammalian development are now well established, very few data on the protective activity of different chelators against embryotoxicity and teratogenicity of arsenic are available. Chelating agents may interact with teratogen metals to augment or ameliorate their actions. Researchers demonstrated that a single dose of 2,3-dimercaptopropanol (BAL) was capable of affording a degree of protection to arsenate exposed fetal mice. Subcutaneous treatment with 50 mg/kg of BAL 4 hr after arsenate reduced the frequency or severity of malformations compared with the effects of arsenate alone. However, BAL has several drawbacks. In recent years dimercaptosuccinic acid (DMSA) is receiving growing attention in the USA and Western Europe. Results of a number of different investigations in rodents have led to the conclusion that DMSA is much less toxic than BAL. Moreover, DMSA has been reported to be effective in inducing arsenic excretion. In the present study, the protective effects of DMSA in alleviating the embryotoxic and teratogenic effects of sodium arsenate were evaluated in mice.

  11. Renal function imaging with radioisotopes - state of the art. Nuklearmedizinische Nierenfunktionsdiagnostik - aktueller Stand

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, K.; Piepenburg, R. (Mainz Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin)

    1991-10-01

    In modern nuclear medicine, iodine-131-hippurate is more and more replaced by alternative radiopharmaceuticals like iodine-123-hippurate and technetium-99m-MAG3. Lower photon energy and higher count rates produce better image quality by using these new substances. Other disadvantages of iodine-131-hippurate are the unnecessary irradiation of the patient - because of the beta ray component - and the environment - because of its long half-life. Because of these facts, nowadays only the technetium compounds MAG3, DTPA and DMSA or iodine-123-hippurate should be used in renal scanning. Tc-DMSA only allows static images. The glomerular filtration marker Tc-DTPA has an unfavourably low clearance. For this, Tc-MAG3 and iodine-123-hippurate are the most appropriate tracers for renal function scintigraphy. While the image quality of both is equal, Tc-MAG3 has the advantage of better availability and handling. Summarizing our experience in a large number of kidney investigations, Tc-MAG3 has been proved to be the radiopharmacon with the most universal range of indications. Iodine-hippurate and Tc-DTPA can be completely replaced by Tc-MAG3 in the scintigraphic imaging of kidney perfusion, renal function, urinary tract obstruction, renal artery stenosis, and vesicoureteral reflux. (orig.).

  12. Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function

    Directory of Open Access Journals (Sweden)

    Nevena Manevska

    2015-12-01

    Full Text Available BACKGROUND: Radionuclide techniques, as direct radionuclide cystography and 99mTc-DMSA scintigraphy, have been used in evaluation of vesicoureteral reflux (VUR and reflux nephropathy (RN in children. Dynamic 99mTc-DTPA scintigraphy is reserved for evaluation of differential renal function and obstruction in children, where hydronephrosis is detected by ultrasonography (US pre- or postnatally. CASE REPORT: Six year old boy was prenatally diagnosed with bilateral hydronephrosis. Postnatal, severe bilateral VUR was detected by voiding urethrocytography. US and 99mTc-DTPA scintigraphy performed in the first month of life showed small left kidney that participated with 2% in the global renal function. Bilateral cutaneous ureterostomy has been performed in order to obtain good renal drainage and promote optimal renal growth. Twelve months later, classic antireflux procedure was done. Control 99mTc-DTPA scintigraphy, 5 ys after antireflux surgery, revealed persisting radioactivity during the diuretic phase, in the left kidney that indicated antireflux procedure failure with VUR reappearance. CONCLUSION: 99mTc-DTPA scintigraphy is the first method of choice for long-term monitoring of individual kidney function in children with VUR and other congenital urinary tract anomalies. Additionally, it can be used as indirect radionuclide cystography when rising of radioactivity in the kidney region, during the diuretic phase can indicate presence of VUR.

  13. Evaluation of environmental safety concentrations of DMSA Coated Fe2O3-NPs using different assay systems in nematode Caenorhabditis elegans.

    Directory of Open Access Journals (Sweden)

    Qiuli Wu

    Full Text Available Dimercaptosuccinic acid (DMSA coating improves the uptake efficiency presumably by engendering the Fe(2O(3-NPs. In the present study, we investigated the possible environmental safety concentrations of Fe(2O(3-NPs using different assay systems in nematode Caenorhabditis elegans with lethality, development, reproduction, locomotion behavior, pharyngeal pumping, defecation, intestinal autofluorescence and reactive oxygen species (ROS production as the endpoints. After exposure from L4-larvae for 24-hr, DMSA coated Fe(2O(3-NPs at concentrations more than 50 mg/L exhibited adverse effects on nematodes. After exposure from L1-larvae to adult, DMSA coated Fe(2O(3-NPs at concentrations more than 500 μg/L had adverse effects on nematodes. After exposure from L1-larvae to day-8 adult, DMSA coated Fe(2O(3-NPs at concentrations more than 100 μg/L resulted in the adverse effects on nematodes. Accompanied with the alterations of locomotion behaviors, ROS production was pronouncedly induced by exposure to DMSA coated Fe(2O(3-NPs in the examined three assay systems, and the close associations of ROS production with lethality, growth, reproduction, locomotion behavior, pharyngeal pumping, defecation, or intestinal autofluorescence in nematodes exposed to DMSA coated Fe(2O(3-NPs were confirmed by the linear regression analysis. Moreover, mutations of sod-2 and sod-3 genes, encoding Mn-SODs, showed more susceptible properties than wild-type when they were used for assessing the DMSA coated Fe(2O(3-NPs-induced toxicity, and the safety concentrations for DMSA coated Fe(2O(3-NPs should be defined as concentrations lower than 10 μg/L in sod-2 and sod-3 mutant nematodes.

  14. Renal angiomyolipoma

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Sørensen, Flemming Brandt

    1988-01-01

    Renal angiomyolipoma is a rare lesion composed of smooth muscle cells, adipose tissue and abnormal vessels. It is currently classified as a benign, non-epithelial renal tumor. It has a high incidence in patients suffering from tuberous sclerosis but is more frequently found as an isolated renal...

  15. Daño renal congénito asociado a reflujo vesicoureteral CONGENITAL RENAL DAMAGE ASSOCIATED WIHT VESICOURETERAL REFLUX

    Directory of Open Access Journals (Sweden)

    Sandalio Durán Álvarez

    2005-03-01

    Full Text Available Se realizó uretrocistografía miccional a 71 niños (48 varones en los que el estudio ultrasonográfico materno-fetal había detectado una dilatación pélvica renal y esta alteración se confirmó en el ultrasonido renal posnatal. Se encontró reflujo vesicoureteral (RVU en 16 (22,5 % y unidades renales refluentes (URR en 23 (16 %. El estudio gammagráfico estático (Tc 99 m-DMSA demostró alteración de la función renal diferencial en 6 pacientes, 1 con RVU de grado II y 5 con RVU de grados IV y V. El grado de afectación funcional varió de ligero hasta esencialmente afuncional. En uno de estos pacientes había el antecedente de una infección urinaria en el período neonatal y en los 5 restantes no existía historia de infección urinaria. Estos datos apoyan el criterio de que en el RVU, sobre todo en los grados IV y V, el riñón puede afectarse antes del nacimiento.Miction uretrocystography was performed in 71 children (48 boys, among whom the maternofetal ultrasonographic study had detected a pelvic renal dilation that was confirmed in the postnatal renal ultrasound. Vesicoureteral reflux (VUR was found in 16 (22.5 % and renal reflowing units (RRU in 23 (16 %. The static gammagraphic study (Tc 99m-DMSA showed alteration of the differential renal function in 6 patients, 1 with degree II VUR and 5 with degree IV and V VUR. The degree of functional affectation varied from mild to essentially nonfunctional. One of these patients had history of urinary infection in the neonatal period, whereas the other five did not. These data support the criterion that in VUR, mainly in IV and V degrees, the kidney may be affected before birth.

  16. Risk factors of renal scars in children with acute pyelonephritis

    Directory of Open Access Journals (Sweden)

    Fahimeh Ehsanipour

    2012-02-01

    Full Text Available OBJECTIVE: The aim of this study was to determine the association between previously documented risk factors such as recurrent pyelonephritis with the incidence of renal scarring after acute pyelonephritis in children. MATERIAL AND METHODS: Children with acute pyelonephritis who were admitted to the Department of Pediatrics of a teaching hospital during 2007-2009 were enrolled in this study. DMSA scans were obtained 4-6 months after the last episode of pyelonephritis in all patients. RESULTS: A total of 80 children with acute pyelonephritis were enrolled in this study. Most of them were girls (77.5%, with a median age of 12 months. Nearly half of the children (n = 44; 55% had one or more renal scars. The distribution of gender, CRP level and leukocytosis did not differ significantly regardingthe absence or presence of renal scars (p > 0.05. Most of the scars occurred in children who had presented with bilateral pyelonephritis (69.4% vs. 18.2%, p = 0.001. Most of the patients with renal scars had a positive history of vesicoureteral reflux (VUR (75% vs.13.6%, p = 0.001. The significant roles of recurrent pyelonephritis and presence of VUR were further confirmed by multivariate analysis. CONCLUSIONS: According to our findings, presence of VUR and recurrent pyelonephritis are independently associated with a higher incidence of renal scarring.

  17. Uptake of the 188Re(V)-DMSA complex by cervical carcinoma cells in nude mice: pharmacokinetics and dosimetry

    International Nuclear Information System (INIS)

    The uptake of the rhenium-188 (188Re(V)-DMSA) complex of dimercaptosuccinic acid by cervical carcinoma cells in nude mice was evaluated. The pharmacokinetics and dosimetry calculations in normal rats were also evaluated. The images obtained in mice did not show significant accumulation in metabolic organs and the biodistribution studies showed that 3.52±0.76% of the injected activity per gram (n=4) was taken up by the tumor. This percentage produces a cumulated activity of 35.63±8.40 MBq h and an equivalent dose per injected activity of 260±8.91 mSv/MBq. Pharmacokinetics and dosimetry of the 188Re(V)-DMSA complex indicate that this radiopharmaceutical could be evaluated in patients with soft tissue tumors, since the risk of radiation damage to the kidney or red bone marrow could not be an obstacle for its application in therapeutic nuclear medicine

  18. Paediatric 99mTc-DMSA imaging: reducing distress and rate of sedation using a psychological approach

    International Nuclear Information System (INIS)

    Aim: To evaluate the effect of a psychological approach on distress and sedation rates in children undergoing dimer captosuccinic acid-labelled with technetium-99 (99mTc) DMSA imaging. Materials and methods: Baseline data, on a retrospective consecutive sample of children examined using DMSA over a 6-month period (n = 81), were collected via medical note search and postal questionnaire. A further consecutive sample of 40 children was recruited prospectively to the intervention, which consisted of distraction during medical procedures and environmental manipulation. In addition half of the intervention group were provided with a photo-booklet depicting a coping child model, together with a letter offering advice to parents on how to prepare their child for the procedure. Results: Sedation rates were lower (p = 0.003) and service satisfaction ratings higher (p = 0.002) in the Intervention group as compared with the Baseline group. Within the intervention condition, children who received the photo-booklet displayed less distress before the procedure (p = 0.01) than those who did not. Also families who received the photo-booklet were more likely to attend the appointment (p = 0.024). Conclusion: In this study, the use of a psychological approach was associated with lower rates of distress and sedation in children undergoing 99mTc-DMSA imaging, without compromising image quality

  19. RENAL CRYOABLATION

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2014-08-01

    Full Text Available Renal cryoablation is an alternative minimally-invasive method of treatment for localized renal cell carcinoma. The main advantages of this methodology include visualization of the tumor and the forming of "ice ball" in real time, fewer complications compared with other methods of treatment of renal cell carcinoma, as well as the possibility of conducting cryotherapy in patients with concomitant pathology. Compared with other ablative technologies cryoablation has a low rate of repeat sessions and good intermediate oncological results. The studies of long-term oncological and functional results of renal cryoablation are presently under way.

  20. Renal liposarcoma

    Directory of Open Access Journals (Sweden)

    Diogo A.L. Bader

    2004-06-01

    Full Text Available INTRODUCTION: Liposarcoma is a malignant mesenchymal tumor frequently located in retroperitoneum, and rarely presenting an isolated lesion in kidney. CASE REPORT: Female, Caucasian, 49-year old patient, with family history of renal polycystic disease, was selected for organ donation. During preoperative examinations a renal pleomorphic liposarcoma was detected. She was treated with radical nephrectomy and remains asymptomatic, without evidences of recurrence in control ecographic examinations after a 4-year follow-up. COMMENTS: Renal liposarcoma is a rare tumor. We report one case incidentally diagnosed during a routine pre-transplantation assessment in renal donor.

  1. Role of Tc-99M(V) DMSA for imaging of ocular melanoma developing in graves' patients treated with radioiodine

    International Nuclear Information System (INIS)

    The melanoma originates from the melanocytes, which are embryologically derived from neural crest. The melanoma of choroids in adults is a very common type primary ocular malignancy, where the tyrosine, an immediate precursor common for both melanin and thyroid hormone synthesis is involved. The neurogenic origins of melanoma and medullary thyroid carcinoma have also been shown to have certain common metabolites, receptors and the receptor binding proteins. Several radiolabelled derivatives either in the form of melanin metabolites or melanin binding agents including receptors/ receptor-binding proteins like somatostatin, calcitonin and other monoclonal antibodies, protein receptors (S-100, myelin basic protein, Leu-7, glial fibrillary acidic protein, HMB-45) etc. have been tried to evaluate/diagnose melanoma, staging or post therapeutic effects. However their cost of production, tedious synthetic and radiolabelling processes and the availability of certain cyclotron produced isotopes were not favorable or patient friendly. Moreover post-therapeutic assessments in melanoma patients were not encouraging. Because of the chelating properties of Tc-99m (V) Dimercaptosuccinic acid with Calcium ion, uptake by neurogenic tumors including ocular retinoblastoma, medullary thyroid carcinoma, pituitary adenoma etc has been demonstrated. Since MTC and Melanoma have the common neural crest origin and producing some common metabolites, receptors/receptor proteins and at the same time Tc-99m (V) DMSA was used in pre and post therapeutic assessment of Medullary thyroid carcinoma extensively. We therefore decided to use Tc-99m (v) DMSA for the assessment of melanoma developed in thyrotoxicosis patients who underwent radioiodine therapy more than 15 years back. The DMSA kits were prepared locally and labeled with Tecnetium-99m at pentavalent state. After the quality control each patients were injected a dose of 10mCi of Tc-99m labeled DMSA.The whole body images were taken after two

  2. Renal DMSA scintigraphy (RS) and direct radionuclide cystogram (DRC) in children with recurrent urinary tract infections (UTI): retrospective study

    International Nuclear Information System (INIS)

    Material and Methods: We analysed the results of RS and DRC in 92 children ( 82 % females ) with ages ranging from 1 month - 12 years old, mean: 4.3 years old. RS and DRC techniques were performed conventionally with a gamma-camera computer system. We determined the concordance or discordance between them, and the positive and negative predictive value of one method with respect to the other. For statistical analysis we used Chi square test. Results: We found a concordance of the results in both techniques in 69.5 %, with predominance of concordant normality 70%. In discordant results there were a predominance of abnormal RS with negative DRC in 78.6 %. The differences in this distribution was significant (p< 0.001). The predictive value of RS vs DRC was: PPV: 46 %, NPV: 88%. The predictive value of DRC vs RS was : PPV : 76 %, NPV: 67%. Conclusions: In children with recurrent urinary tract infection, our data support that: 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

  3. Failure to visualize acutely injured kidneys with technetium-99m DMSA does not preclude recoverable function

    International Nuclear Information System (INIS)

    A 35-yr-old patient developed severe acute tubular necrosis requiring hemodialysis. A [99mTc]dimercaptosuccinic acid scan of the kidneys showed no renal uptake at 4 or 24 hr, but the patient subsequently recovered normal renal function as judged by a normal serum creatinine. Based on this case report and a review of the literature, one cannot assume irreversible loss of function in patients with acute renal failure, based on the absence of radiopharmaceutical uptake by the kidneys

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Magnetic nanoparticle film reconstruction modulated by immersion within DMSA aqueous solution

    Science.gov (United States)

    Xiang, Qing; Borges Teixeira, Cimei; Sun, Li; Morais, Paulo Cesar

    2016-01-01

    The process of reconstruction of pre-fabricated films comprising maghemite nanoparticles deposited onto flat glass substrates triggered by immersion into aqueous solutions of meso-2,3-dimercaptosuccinic acid (DMSA) at increasing concentration (0.025, 0.050, and 0.100 mol/L) is herein reported. The evolution of this process was assessed by measuring the time (t) dependence of the particle analysis histogram width (W) extracted from atomic force microscopy images. Furthermore, a physical picture to model the film reconstruction which provides reconstruction time constants associated to single particles (τ1) and small agglomerates (τn), the key units associated to the process, ranging from τ1 = 2.9 and τn = 3.4 hour (0.025 mol/L) to τ1 = 5.1 and τn = 4.6 hour (0.100 mol/L) is proposed. The nanoparticle-based film reconstruction triggered by an exogenous stimulus, the use of the W versus t data to describe the process and the model picture accounting for the recorded data have not been previously reported. PMID:27008984

  6. Direct monophasic replacement of fatty acid by DMSA on SPION surface

    International Nuclear Information System (INIS)

    Highlights: ► Monophasic replacement of fatty acid coating. ► Ultrastable dispersion of hydrophilic SPION in a wide pH range. ► Unaltered microstructure and property on surface modification. - Abstract: Tailoring the surface and understanding the surface characteristics is necessary for biomedical applications of superparamagnetic nanoparticles. In this paper, superparamagnetic iron oxide nanoparticles (SPIONs) were prepared by thermal decomposition of iron nitrate in presence of stearic acid as surfactant. Due to the multilayer organization of surfactant molecules over the nanoparticle surface, the surface potential can be tuned by pH changes and hence the nanoparticles can be made dispersible in nonpolar as well as in polar solvents. We have presented a simple, facile procedure for controlled replacement of stearic acid from maghemite surface and subsequent derivatization by biocompatible dimercaptosuccinic acid (DMSA) to obtain ultrastable hydrophilic nanoparticles with unaltered morphology, phase and properties. The surface chemistry of the functionalized SPIONs was analyzed by Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA) and X-ray photoelectron spectroscopy (XPS) revealing the presence of bound and unbound thiol groups and disulfides, leading to its prolonged stability in aqueous medium. The consequence of spatially selective functionalization on the stability and solubility of surface hydrophilic SPION has also been realized.

  7. 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

  8. Hidrocolpo por ectopia ureteral em hemivagina associado a displasia renal: relato de caso e revisão da literatura Congenital hydrocolpos due to ectopic ureter in hemivagina associated with renal dysplasia: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Mario Flores Barba

    2004-04-01

    Full Text Available Os autores apresentam um caso de displasia renal associada a ectopia ureteral vaginal homolateral, com uretero-hidronefrose contralateral devida a compressão por hidrocolpo causado pela ectopia e por um septo vaginal oblíquo. Os exames de imagem utilizados foram urografia excretora, cistografia, ultra-sonografia, tomografia computadorizada e cintilografia renal com Tc-99m-DMSA. Foi realizada revisão da literatura sobre casos de hidrocolpo associado a malformações urinárias.The authors report a case of congenital hydrocolpos due to vaginal malformation (vaginal septae associated with ectopic ureter and renal displasia. Several imaging diagnostic procedures (ultrasonography, nuclear medicine, intravenous urography and computed tomography were performed. A review of the literature on hydrocolpos and its association with urinary malformations is also presented.

  9. [Renal elastography].

    Science.gov (United States)

    Correas, Jean-Michel; Anglicheau, Dany; Gennisson, Jean-Luc; Tanter, Mickael

    2016-04-01

    Renal elastography has become available with the development of noninvasive quantitative techniques (including shear-wave elastography), following the rapidly growing field of diagnosis and quantification of liver fibrosis, which has a demonstrated major clinical impact. Ultrasound or even magnetic resonance techniques are leaving the pure research area to reach the routine clinical use. With the increased incidence of chronic kidney disease and its specific morbidity and mortality, the noninvasive diagnosis of renal fibrosis can be of critical value. However, it is difficult to simply extend the application from one organ to the other due to a large number of anatomical and technical issues. Indeed, the kidney exhibits various features that make stiffness assessment more complex, such as the presence of various tissue types (cortex, medulla), high spatial orientation (anisotropy), local blood flow, fatty sinus with variable volume and echotexture, perirenal space with variable fatty content, and the variable depth of the organ. Furthermore, the stiffness changes of the renal parenchyma are not exclusively related to fibrosis, as renal perfusion or hydronephrosis will impact the local elasticity. Renal elastography might be able to diagnose acute or chronic obstruction, or to renal tumor or pseudotumor characterization. Today, renal elastography appears as a promising application that still requires optimization and validation, which is the contrary for liver stiffness assessment. PMID:26976058

  10. Variable threshold levels for estimation of renal uptake of 99mTc-dimercaptosuccinic acid based on single photon emission computed tomography

    International Nuclear Information System (INIS)

    To calculate renal uptake of 99mTc-dimercaptosuccinic acid (DMSA) more accurately using single photon emission computed tomography (SPECT), it is necessary to estimate values of threshold level, which corresponds to the ratio of kidney to background (BG ratio). Thus the phantom and clinical studies were conducted. Six kinds of renal phantoms of 80 to 339 ml, contained different radioactivity of 37 to 485 MBq were prepared. These phantoms were placed in a larger body phantom filled with 1 to 50% of radioactivity representing background. Clinical application of this method was also performed. A significant correlation between phantom volumes and estimated volumes obtained using threshold level based on BG ratio calculated on tomographic images was found (r=0.99). A significant correlation between total counts in estimated volumes and radioactivities in phantoms was recognized (r=0.94). Known radioactivity in phantoms and radioactivity in estimated volumes were highly related (r=0.98). Clinical application showed valuable results in patients with renal dysfunction. Thus, this method can calculate more accurate renal uptake of 99mTc-DMSA. (author)

  11. Osteodistrofia renal

    OpenAIRE

    Teles, Tobias José Freitas Trindade

    2014-01-01

    A doença renal crónica é um problema de saúde mundial, com incidência e prevalência crescentes. Apesar dos avanços científicos na compreensão da patogénese e o desenvolvimento de terapêuticas mais eficazes, a osteodistrofia renal continua a ser uma complicação importante nos doentes renais crónicos. A osteodistrofia renal abrange um espectro diverso de alterações ósseas nos doentes com doença renal crónica, classificada histologicamente por lesões de elevada ou baixa taxa de remodelação ó...

  12. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  13. Effects of gentamicin on the recovery of renal function after unilateral hydronephrosis

    International Nuclear Information System (INIS)

    Urinary tract infection is one of complications in hydronephrosis, and antibiotics such as gentamicin are indicated for the treatment. However, gentamicin is known to cause drug-induced nephropathy. Using a rat kidney model, we investigated the effects of gentamicin treatment on the functional recovery from unilateral hydronephrosis. Quantitative separate renal function study by means of Technetium-99m DMSA renoscintigraphy revealed that contralateral kidney was affected by the treatment right after the release of complete ureteral obstruction. Moreover, in the case of incomplete ureteral obstruction, bilateral kidneys were affected by the treatment. Morphological studies using in situ DNA3' -end labeling and immunohistochemical methods showed that regeneration in the bilateral kidney followed gentamicin treatment right after the release. These results suggest that we should take account of separate renal function failure after gentamicin administration in the perihydronephrotic periods. (author)

  14. Effects of gentamicin on the recovery of renal function after unilateral hydronephrosis

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Nobumitsu [Ehime Univ., Shigenobu (Japan). School of Medicine

    2002-06-01

    Urinary tract infection is one of complications in hydronephrosis, and antibiotics such as gentamicin are indicated for the treatment. However, gentamicin is known to cause drug-induced nephropathy. Using a rat kidney model, we investigated the effects of gentamicin treatment on the functional recovery from unilateral hydronephrosis. Quantitative separate renal function study by means of Technetium-99m DMSA renoscintigraphy revealed that contralateral kidney was affected by the treatment right after the release of complete ureteral obstruction. Moreover, in the case of incomplete ureteral obstruction, bilateral kidneys were affected by the treatment. Morphological studies using in situ DNA3' -end labeling and immunohistochemical methods showed that regeneration in the bilateral kidney followed gentamicin treatment right after the release. These results suggest that we should take account of separate renal function failure after gentamicin administration in the perihydronephrotic periods. (author)

  15. Urinary tract infection in childhood: lower or upper level? DMSA scintigraphic validation of a new clinical risk index

    International Nuclear Information System (INIS)

    Urinary tract infection in children can be limited most of time at the lower level of the urinary tractus but an extension to the upper level of the tractus should not be neglected due to the asymptomatic nature of the disease. In our study, we suggest a new graph to predict the probability of acute pyelonephritis only if the bacteriological urinary analyse were obtained in good conditions and without any treatment. In the other cases, a DMSA scintigram should be proposed at the earlier phase of the diagnosis not to underestimate the risk of asymptomatic pyelonephritis. (authors)

  16. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  17. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  18. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  19. Renal liposarcoma

    OpenAIRE

    Diogo A.L. Bader; Luis A.B. Peres; Sérgio L. Bader

    2004-01-01

    INTRODUCTION: Liposarcoma is a malignant mesenchymal tumor frequently located in retroperitoneum, and rarely presenting an isolated lesion in kidney. CASE REPORT: Female, Caucasian, 49-year old patient, with family history of renal polycystic disease, was selected for organ donation. During preoperative examinations a renal pleomorphic liposarcoma was detected. She was treated with radical nephrectomy and remains asymptomatic, without evidences of recurrence in control ecographic examinations...

  20. Development of renal simulators for use in nuclear medicine

    International Nuclear Information System (INIS)

    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 (99mTc-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

  1. 99mTc-(V)DMSA scintimammography in the assessment of breast lesions: comparative study with 99mTc-MIBI

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate and compare the diagnostic accuracy of pentavalent technetium-99m dimercaptosuccinic acid [99mTc-(V)DMSA] and 99mTc-methoxyisobutylisonitrile (MIBI) in the detection of primary breast cancer and metastatic lymph node involvement, and in the clarification of cases with indeterminate mammograms. Forty-one women (mean age±SD 55±7 years) referred for a suspicious breast lesion on physical examination and/or an abnormal mammogram underwent MIBI and (V)DMSA scintimammography (SMM) at separate sessions (48-h interval). Lateral prone and anterior supine images were obtained at 10 and 60 min after administration of 740-925 MBq of each tracer, in the arm contralateral to the breast lesion. The ipsilateral axillary region was also included in the field of view. The results of SMM and mammography were compared with histological findings. Breast cancer was histologically confirmed in 26 patients (mean diameter±SD 2.87±1.5 cm). Benign lesions were found in 15 patients (mean diameter±SD 2.04±2.7 cm). Mammography was definitely positive in 23/26 patients with breast cancer and indeterminate in 3/26 (sensitivity 88.4%). In benign lesions, mammography was true negative in 5/15 cases and indeterminate in 10/15 (specificity 33.3%). Both MIBI and (V)DMSA SMM detected 23/26 breast cancers (sensitivity 88.4%) and were true negative in 14/15 (specificity 93.3%). T/B ratios for breast cancer in MIBI and (V)DMSA scans were similar, and significantly higher than for benign lesions. MIBI correctly diagnosed 12/13 and (V)DMSA 11/13 cases in which the findings of mammography were indeterminate. In addition, (V)DMSA detected seven of eight cases of in situ ductal carcinoma (DCIS) associated with infiltrating carcinomas, while MIBI detected only two of these eight cases. (V)DSMA was also diffusely concentrated in benign lesions complicated by epithelial hyperplasia. Metastatic lymph node involvement was successfully imaged in 15/19 patients with

  2. Effect of ureteral reimplantation on prevention of urinary tract infection and renal growth in infants with primary vesicoureteral reflux

    International Nuclear Information System (INIS)

    We retrospectively reviewed the results of ureteral reimplantation in infants with primary vesicoureteral reflux (VUR) to evaluate the effect on prevention of urinary tract infection (UTI) and renal growth. From July 1991 to December 2001, a total of 205 infants (180 boys and 25 girls) with primary VUR underwent ureteral reimplantation at the Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. Indications for surgery were high-grade reflux (grade IV-V), breakthrough UTI and non-compliance of medical treatment. Age at surgery raged from 1 to 11 months (mean, 6.4 months). Ureteral reimplantation was performed according to Cohen's method. Only two of 336 refluxing ureters required ureteral tailoring. Follow-up ranged from 12 to 110 months (mean, 64 months). Surgical outcome, frequency of UTI and individual renal growth measured by 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy was evaluated. Postoperative ultrasound and voiding cystourethrography showed neither residual reflux nor ureterovesical obstruction. Contralateral low grade reflux occurred in six of 74 patients (8.1%) who had unilateral reflux preoperatively. After reimplantation, 10 patients documented 13 febrile UTI. Eleven of the 13 episodes occurred early in the postoperative period (<6 months). Frequency of febrile UTI reduced from 0.23538 before surgery to 0.00894 and 0.00081 per patient per month at 6 and 12 months after surgery, respectively. No development of renal scarring was seen in postoperative DMSA scan. Changes of differential renal function was <0.05 in all patients. The present results show ureteral reimplantation in infants is safe and very effective for the prevention of UTI. After surgical treatment in infancy, individual renal growth of children with primary VUR is stable. (authors)

  3. [Renal disease].

    Science.gov (United States)

    Espinosa-Cuevas, María de Los Ángeles

    2016-09-01

    Chronic renal failure in its various stages, requires certain nutritional restrictions associated with the accumulation of minerals and waste products that cannot be easily eliminated by the kidneys. Some of these restrictions modify the intake of proteins, sodium, and phosphorus. Milk and dairy products are sources of these nutrients. This article aims to inform the reader about the benefits including milk and dairy products relying on a scientific and critical view according to the clinical conditions and the stage of renal disease in which the patient is. PMID:27603894

  4. Variability in interpretation of static renal scintigraphy findings

    Directory of Open Access Journals (Sweden)

    Jakšić Emilija

    2005-01-01

    Full Text Available Background. Static renal scintigraphy with 99mTc-DMSA is a sensitive method for evaluation of any reduction of cortical mass function. There is not enough reliable references in the literature on scintigraphic reports in terms of objectivity and standardization. The aim of this paper was to assess the differences in interpretation of routine renal scintigraphic findings by nuclear medicine specialists from various institutions (interobserver variability. Methods. Both interobserver variability and agreement in the interpretation were evaluated in two groups. Six observers from four different institutions (group A, and three observers from the same institution (group B interpreted independently 60 static renal scintigraphy findings obtained by analogous imaging using x-ray films in four standard projections. Using at least two options, seven parameters of renal scintigraphy protocols were analyzed: size (1, uptake (2, outlines (3, scars (4, focal changes (5, relative function (6, and conclusions (7. Results. The interpretations of scintigraphic findings were in accordance in items 1 to 7 within the group A: 62, 42.5, 45, 9, 47, 52, and 34 percent respectively, and within the group B: 72, 55, 59, 22, 62, 60, and 41 percent, respectively. The conformity was more significant in the findings observed in group B as opposed to group A, which was statistically highly significant, especially for the category of scars (p<0.01. Significant variability was also observed by six observers in all the parameters of scintigraphic protocol, especially, again, in the scars analysis (p<0.01. Conclusion. Insignificant degree of accordance, especially in the assessment of scars necessitates the standardization of criteria and terminology in order to interpret the renal scintigraphy with more accuracy and objectivity.

  5. Renal function maturation in children: is normalization to surface area valid?

    International Nuclear Information System (INIS)

    Full text: Gamma camera DTPA renograms were analysed to measure renal function by the rate at which the kidneys took up tracer from the blood. This was expressed either directly as the fractional uptake rate (FUR), which is not related to body size, or it was converted to a camera-based GFR by the formula GFR blood volume x FUR, and this GFR was normalized to a body surface area of 1.73 m2. Most of the patients studied had one completely normal kidney, and one kidney with reflux but normal function and no large scars. The completely normal kidneys contributed, on average, 50% of the total renal function. The results were considered in age bands, to display the effect of age on renal function. The camera-GFR measurements showed the conventional results of poor renal function in early childhood, with a slow rise to near-adult values by the age of 2 years, and somewhat low values throughout childhood. The uptake values showed a different pattern, with renal function rising to adult equivalent values by the age of 4 months, and with children having better renal function than adults throughout most of their childhood. The standard deviations expressed as coefficients of variation (CV) were smaller for the FUR technique than the GFR (Wilcoxon rank test, P < 0.01). These results resemble recent published measurements of absolute DMSA uptake, which are also unrelated to body size and show early renal maturation. The results also suggest that the reason children have lower serum creatinine levels than adults is that they have better renal function. If this were confirmed, it would raise doubts about the usefulness of normalizing renal function to body surface area in children

  6. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... in TSC: renal cysts, renal angiomyolipoma and renal cell carcinoma . Renal angiomyolipomata, or angiomyolipomas, are usually the ... kidney failure, requiring dialysis or transplantation. Lastly, renal cell carcinoma, the least common renal association with TSC, ...

  7. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  8. Scintigraphy in the diagnosis and monitoring of renal scarring in hypertensive children; Rola badania scyntygraficznego w rozpoznaniu zmian bliznowatych w nerkach i ocena ich dynamiki u dzieci z nadcisnieniem tetniczym

    Energy Technology Data Exchange (ETDEWEB)

    Wieteska-Klimczak, A.; Wyszynska, T.; Toth, K.; Januszewicz, P. [Pracownia Medycyny Nuklearnej, Centrum Zdrowia Dziecka, Warsaw (Poland)

    1993-12-31

    The objective of this study was to assess the applicability of scintiscan using {sup 99m}Tc-DMSA to diagnose and evaluate renal scarring and its dynamics in children with hypertension due to reflux nephropathy. The study covered 51 children aged 1 to 18 years in whom a scintiscan was performed immediately after diagnosis of hypertension. This test was repeated in 23 of these patients after 1 to 5 years. Advanced bilateral scarring with normal renal function was found in over 80% of the children. Established hypertension was observed in 66% of the patients. No progression of scarring or deterioration of renal function was found in the majority (76%) of the reexamined patients. Those patients who responded poorly to treatment for hypertension and who initially had impaired and deteriorating renal function showed progression of scarring. (author) 24 refs, 2 figs, 3 tabs

  9. Renal failure (chronic)

    OpenAIRE

    Clase, Catherine

    2009-01-01

    Chronic renal failure is characterised by a gradual and sustained decline in renal clearance or glomerular filtration rate (GFR). Continued progression of renal failure will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Requirement for dialysis or transplantation is termed end-stage renal disease (ESRD).Diabetes, glomerulonephritis, hypertension, pyelone...

  10. Preparation of 99mTc-Carnosine and 99mTcO-(V-DMSA Complexes,Biological Distribution, and Estimation of Their Gene Anti- PolymorphismsInduced by -Irradiation

    Directory of Open Access Journals (Sweden)

    E.A. EL-Ghany, F. Marzouk, Samy A. Abd El-Azim1, M.H. Awwad2

    2007-12-01

    Full Text Available Background: Two chelating agents (Carnosine and DMSA were used to study their labeling conditions with technetium-99m followed by biological distribution investigation. Molecular studies were done via PCR/RFLP analysis of angiotensin II subtype II receptor gene for monitoring their antioxidant activity through free iron chelation leading to inhibition of Fenton reaction. Material and methods: Carnosine was labeled by mixing 4 mg with 30 mg glucose and 25 g SnCl2.2H2O, followed by pertechnetate and stand at room temperature for 60 minutes. Minor modification was done to prepare 99mTc(V-DMSA tracer in one step, by adding pertechnetate solution to the lyophilized kit contains 1mg DMSA, 0.1 mg SnCl2.2H2O, and 30 mg glucose at pH 9. The biodistribution of the two tracers in normal and tumor-induced mice. The molecular investigation of the anti-oxidant activity of both carnosine and DMSA in 6 Gy -irradiated rats using the anti-inflammatory angiotensin II subtype II receptor gene (AT2RG as indicator. Results: Carnosine and DMSA were labeled with Technetium-99m yielding 85% and 97%, respectively the ability of both tracers to localize in tumor sites but the priority to the 99mTc (V-DMSA. Molecular studies showed strong antioxidant activity of carnosine but not enough to block radiation induced oxidative stress and Moderate antioxidant activity of DMSA was achieved by chelating free iron and iron released through oxidative stress. Maximum protection was achieved through the dual action of both DMSA and carnosine. Conclusion: moderate and high labeling yield were achieved for both 99mTc(VDMSA and 99mTc-canosine respectively with higher selectivity of the former to tumor sites and maximum protection were achieved by the dual action of both chelating agents

  11. Rapid renal single-photon emission tomography by continuous infusion of iridium-191m

    International Nuclear Information System (INIS)

    Continuous infusion of iridium-191m (t1/2 = 5 s), produced with an 191Os/191mIr generator, was used to obtain rapid high-resolution single-photon emission tomography (SPET) of renal blood flow in the rabbit. SPET scans of the abdomen were obtained with a triple-detector SPET system (MS3, Siemens Gammasonics). The generator was eluted at a flow rate of 3 ml/min, which delivered a steady-state dose of 170 MBq (4.5 mCi) of 191mIr. The total 191Os breakthrough was 850 kBq (23 μCi). A 5-min SPET acquisition recorded a total of 2.8 million counts, resulting in images of high technical quality. Volume-rendered images clearly showed the abdominal aorta, splenic artery, spleen, renal arteries, kidneys and splanchnic vasculature. Tomographic slices through the kidneys revealed tracer primarily within the renal cortices without visualization of the collecting system. The estimated effective dose equivalent for a 5 min infusion of 191mIr at a steady-state dose of 170 MBq is 0.74 mSv compared with 2.7 mSv from a 170 MBq dose of 99mTc-DMSA. This study demonstrates the feasibility of high-resolution SPET of regional renal perfusion in the rabbit by continuous intravenous infusion of 191mIr. The renal distribution of continuously infused 191mIr is largely within the cortices, with minimal or no detectable activity in the region of the renal pelvicalyceal system. Using this technique, cortical renal SPET can be completed much more rapidly (191mIr that occur in animal models of altered renal perfusion. (orig.)

  12. In vivo and in vitro study of the 99mTc-DMSA radiopharmaceutical connection to blood elements

    International Nuclear Information System (INIS)

    Radiopharmaceuticals are widely used in nuclear medicine. The comprehension of their uptake mechanism in target organs, as well as their clearance may depend on the elucidation of their biochemical characteristics, for instance, their binding to blood elements. The reported precipitating studies of blood with radiopharmaceuticals have shown that the results can not be easily compared. Then, we decide evaluate of the binding proteins on the blood elements using trichloroacetic acid (TCA) to determine the radioactivity of the dimercaptosuccinic acid with technetium-99m (99mTc-DMSA) present in precipitating plasma (P) and blood cells (BC). Depending on the TCA concentration we have determined different values in the insoluble fractions of the plasma when the in vivo and in vitro evaluations were carried out. (author)

  13. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  14. Sulphasalazine induced renal failure.

    OpenAIRE

    Dwarakanath, A D; Michael, J.; Allan, R. N.

    1992-01-01

    Two men with longstanding ulcerative colitis who were treated with sulphasalazine for several years and who developed chronic renal failure are reported. Renal biopsy specimens showed histological changes consistent with drug induced chronic intestinal nephritis. Extensive investigation made other causes of chronic renal failure unlikely. One of these patients underwent renal transplantation, the other has impaired but stable renal function.

  15. Renal candidiasis

    International Nuclear Information System (INIS)

    Most fungal infections of the urinary tract are caused by Candida albicans, a yeast-like saprophytic fungus which may become apathogen under various conditions which lower the host resistance. The use of computed tomography in the diagnosis of renal fungus balls is the subject of this communication with emphasis on the radiologists role in the recognition of this entity. (H.W.). 6 refs.; 2 figs

  16. The role of iodine-131 MIBG and technetium-99m DMSA(V) in evaluation of malignant disease

    International Nuclear Information System (INIS)

    Full text: The aim of our work is to establish the protocols of preparation and application of 99mTc DMSA (V) and 131 1 MIBG in the patient with malignant diseases. Methods and Results: The radiopharmaceutical DMSA (V) was in house prepared as a sterile, pyrogen-free, freeze-drier product under nitrogen. Each vial contain DMSA-1.0 mg and Stannous chloride dehydrate 0.4 mg with the final PH 2.0. Before labeling the kit was reconstituted by the addition of 0.5 ml sterile, pyrogen-free 3.5% NaHCO3. Reconstitution and labeling was performed by addition of sterile, pyrogen-free, isotonic sodium 99mtechnetium pertechnetate - 6 ml final volume. The product contains no antimicrobial preservative. After incubation of 15 min. and before use, limpidity of the solution after preparation, pH (∼8) and radioactivity was checked. The quality control of this radiopharmaceutical was effected by: I . Paper Chromatograpy (PC) using two solvens -acetone and 0.9% NaCl. 2. Instant Thin Layer Chromatography (ITLC) using mixture of the n-butanol:acetic acid:water (3:2:3). We evaluated the percentage of labeled complex technetium 99mTc DMSA (V), hydrolyzed and free technetium 99mTc. In every samples the labeling efficiency resulted more than 95%. The normal in vivo biodistribution of this radiopharmaceutical was monitored in normal rats using imaging as well as counting dissected tissues, 2 and 4 hours after application. The 131 1 MIBG was prepared by iodination of meta-iodo-benzylguanidinum-sulfarte. 3mg MIBG and 6mg ammonium sulfate were dissolved in ethanol-water 1:1 mixture and 1% CuSo4. Adding 2.5 - 10 mCi Iodine and evaporating the solution carefully, under infrared lamp for 45-60 minutes was performed radiolabeling procedure. After evaporation, the vial was placed into the furnace for a labeling reaction by heating for 40 minutes at temperature between 166-1750C. After labeling the vial was cooled completely, measured the activity of the melt and dissolved with 3-4 ml of Walpole

  17. The urological and nephrological analysis of children with renal ectopia

    Directory of Open Access Journals (Sweden)

    Sevgi Yavuz

    2014-09-01

    Full Text Available Objective: To assess the morphological and clinical features of children with renal ectopia (RE and assess whether the lateralization of ectopia determines the prognosis. Methods:The clinical, laboratory and radiological data of 61 patients diagnosed as RE in our center between the years of 2004 and 2014 were retrospectively reviewed. Results: There were 32 girls (52.5% and 48 boys (47.5%. The median age was 48 (2-204 months and follow-up time was 60 (2-120 months. RE was right-sided in 33 (54% and left-sided in 26 (46% patients. 52 patients (85.2% had simple RE whereas 9 (14.8% had crossed RE. 27 children (44.3% had additional urinary abnormality, 15 (24.6% had extra-renal disease. The most common urinary tract malformation was vesicoureteral reflux (VUR (21%. Renal scarring (RS was detected in 17 patients (27.9% on DMSA scan. 32 patients (52.5% experienced urinary tract infection (UTI, 5 (8.2% had hypertension, 11 (11% had proteinuria, 5 (8% had chronic renal disease (CKD. No significant difference was found between ectopia sides for evelopment of additional urinary or systemic disease, UTI, proteinuria, hypertension and CKD (p> 0.05. Conclusion: The children with RE should be carefully examined for additional urinary or systemic abnormalities. Voiding cystourethrogram might be recommended in those patients for the increased risk of VUR. The patients with RE should be closely followed-up for avoiding long term complications including proteinuria, hypertension and CKD because of susceptibility to UTI and RS. The lateralization of ectopia might not affect the incidence of additional abnormality or late complications.

  18. Procalcitonin implication in renal cell apoptosis induced by acute pyelonephritis in children

    Science.gov (United States)

    Belhadj-Tahar, Hafid; Coulais, Yvon; Tafani, Mathieu; Bouissou, François

    2008-01-01

    The aim of this biomedical trial was to clarify the physiological role of procalcitonin (PCT) in renal parenchyma apoptosis and fibrosis caused by acute childhood pyelonephritis. This prospective study enrolled 183 children. All children were treated with bi-therapy according to the French consensus on acute pyelonephritis treatment dated November 16, 1990: intra-vascular administration of ceftriaxone 50 mg/kg/day and netromicine 7 mg/kg/day during the first 48 hours, followed by specific antibiotherapy suited to antibiogram. On admission, PCT, C-reactive protein, and phospholipase A2 were quantified in serum. Scintigraphy monitoring with 99mTc-DMSA was performed on day 4 and 9 months later, in the presence of persistent abnormalities. On day 4, 78% presented renal parenchyma alterations and 30% renal fibrosis 9 months after admission. Paradoxically, PCT level was significantly lower in the presence of renal fibrosis due to cell apoptosis (4.19 vs 7.59 μgL−1). A significant increase in PCT indicated favorable progress (recovery 7.55 vs aggravation 3.34) and no difference between recovery and improvement. This result suggests the protective effect of PCT against apoptosis by nitric oxide down-regulation. PMID:21694876

  19. Calculation of renal depth by conjugate-view method using dual-head gamma camera

    International Nuclear Information System (INIS)

    In this study, we developed a new method for the determination of renal depth with anterior and posterior renal scintigrams in a dual-head gamma camera, considering the attenuation factor e-μx of the conjugate-view method. We developed abdomen and kidney phantoms to perform experiments using Technetium-99m dimercaptosuccinic acid (99mTc-DMSA). The phantom images were obtained by dual-head gamma camera equipped with low-energy, high-resolution, parallel-hole collimators (ICONf, Siemens). The equation was derived from the linear integration of emission γ-ray considering attenuation from the posterior abdomen to the anterior abdomen phantom surface. The program for measurement was developed by Microsoft Visual C++ 6.0. Renal depths of the phantoms were derived from the derived equations and compared with the exact geometrical values. Differences between the measured and the calculated values were the range of 0.1 to 0.7 cm (0.029± 0.15 cm, mean ±S. D.). The present study showed that the use of the derived equations for renal depth measurement, combined with quantitative planar imaging using duel-head gamma camera, could provide more accurate results for individual variation than the conventional method

  20. Calculation of renal depth by conjugate-view method in dual-head gamma camera

    International Nuclear Information System (INIS)

    In this study, we developed a new method for the determination of renal depth with anterior and posterior renal scintigram in a dual-head gamma camera, considering the attenuation factor e-μx of the conjugate-view method. We developed abdomen and kidney phantoms to perform experiments using 99mTc-DMSA. The phantom images were obtained parallel-hole, low-energy, high-resolution collimators (ICONf, Siemens). The equation was derived from the linear integration of emission Υ-ray considering attenuation from the posterior abdomen to the anterior abdomen phantom surface. The program for measurement was developed by Microsoft Visual C++ 6.0. Renal depths of the phantoms were derived from the derived equations and compared with the exact geometrical values. Differences between the measured and the calculated values were the range of 0.1 to 0.7 cm (0.029±0.15cm, mean ±S.D.). The present study showed that the use of the derived equations for renal depth measurements, combined with quantitative planar imaging using dual-head gamma camera, could provide more accurate results for individual variation than the conventional method

  1. Predisposing factors for renal scarring in children with urinary tract infection

    Directory of Open Access Journals (Sweden)

    Fatemeh Beiraghdar

    2012-01-01

    Full Text Available This study was undertaken to determine the predisposing factors for renal scarring in children with urinary tract infection. In this prospective cohort study, 176 children with documented urinary tract infection were categorized into four groups: ≤1 year old, 1-2 years old, 2-7 years and 7-14 years old. Ultrasonography and Technetium-99 m-DMSA scan were used to detect the possible abnormalities. Infants under 12 months old presented as the most common group for renal scarring (27 cases, 52.9%, and vesicoureteral reflux (VUR was diagnosed in 29 cases (56.8%. Fifteen (41.67% children between the ages of one and two years had renal scar, and VUR was detected in half of the patients. In the third group, 36.3%, and in fourth group, 41.6% of the patients had renal scar. Also, 38.6% in group three and 50% in the final group had VUR. A co-incidental finding that was observed in this study was the high incidence of pseudohypoaldesteronism (PHA in our patients: in 39.2% of the children in group one, 22.2% in group two and 4% in group three. In group four however, none of the patients had PHA. Risk of scar formation with urinary tract infection (UTI was higher in the younger age group and in those with recurrent UTIs.

  2. Dystopic dysplastic kidney with ectopic ureter: improved localization by fusion of MR urography and {sup 99m}Tc-DMSA SPECT datasets

    Energy Technology Data Exchange (ETDEWEB)

    Kreissl, Michael C.; Lorenz, Reinhard [University Clinic Wuerzburg, Clinic and Polyclinic of Nuclear Medicine, Wuerzburg (Germany); Ohnheiser, Gerd [University Clinic Wuerzburg, Zentrum Operative Medizin, Clinic and Polyclinic of Urology, Wuerzburg (Germany); Darge, Kassa [University Clinic Wuerzburg, Department of Paediatric Radiology, Institute of Radiodiagnosis, Wuerzburg (Germany)

    2008-02-15

    We report a 12-year-old girl with a long history of constant urinary dribbling and apparently only a left kidney. Using a multimodality approach involving the fusion of MR urography and {sup 99m}Tc-dimercaptosuccinic acid (DMSA) SPECT datasets, it was finally possible to exactly localize the very small dystopic, dysplastic right kidney and its ectopic ureter draining into the vagina. (orig.)

  3. Dystopic dysplastic kidney with ectopic ureter: improved localization by fusion of MR urography and 99mTc-DMSA SPECT datasets

    International Nuclear Information System (INIS)

    We report a 12-year-old girl with a long history of constant urinary dribbling and apparently only a left kidney. Using a multimodality approach involving the fusion of MR urography and 99mTc-dimercaptosuccinic acid (DMSA) SPECT datasets, it was finally possible to exactly localize the very small dystopic, dysplastic right kidney and its ectopic ureter draining into the vagina. (orig.)

  4. Utility of the dimercapto succinic acid pentavalent (99m Tc- DMSA V) in the diagnostic of secondary bone leisure at metastasis of diverse primary tumours. Preliminary study

    International Nuclear Information System (INIS)

    The more used method in the diagnosis of secondary bone lesions to become cancerous it is by means of having derived of phosphates like it is the 99mTc- MDP. The reason of acquiring searching with the radiopharmaceutical 99mTc- DMSA V is with the purpose to find other bone lesions that are not visualized with the gammagraphy with diphosphonate and therefore to increase the specificity of the study. (Author)

  5. Evaluation of the absorbed dose to the kidneys due to Tc99m (DTPA) / Tc99m (Mag3) and Tc99m (Dmsa)

    International Nuclear Information System (INIS)

    The absorbed dose in the kidneys of adult patients has been assessed using the biokinetics of radiopharmaceuticals containing Tc99m (DTPA) / Tc99m (Mag3) or Tc99m (Dmsa).The absorbed dose was calculated using the formalism MIRD and the Cristy-Eckerman representation for the kidneys. The absorbed dose to the kidneys due to Tc99m (DTPA) / Tc99m (Mag3), are given by 0.00466 mGy.MBq-1 / 0.00339 mGy.MBq-1. Approximately 21.2% of the absorbed dose is due to the bladder (content) and the remaining tissue, included in biokinetics of Tc99m (DTPA) / Tc99m (Mag3). The absorbed dose to the kidneys due to Tc99m (Dmsa) is 0.17881 mGy.MBq-1. Here, 1.7% of the absorbed dose is due to the bladder, spleen, liver and the remaining tissue, included in biokinetics of Tc99m (Dmsa). (Author)

  6. Renal calculus

    CERN Document Server

    Pyrah, Leslie N

    1979-01-01

    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

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

    Directory of Open Access Journals (Sweden)

    Anna Alice Rolim Chaves

    2010-01-01

    Full Text Available 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 (51Cr-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 51Cr-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 (51Cr-EDTA and 99mTc-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 m² in the group wuth renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m² 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/1.73m², p=0.001 and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m², p=0.68. Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA did not show

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  9. TRANSPLANTE RENAL

    Directory of Open Access Journals (Sweden)

    Soraia Geraldo Rozza Lopes

    2014-01-01

    Full Text Available El objetivo del estudio fue comprender el significado de espera del trasplante renal para las mujeres en hemodiálisis. Se trata de un estudio cualitativo-interpretativo, realizado con 12 mujeres en hemodiálisis en Florianópolis. Los datos fueron recolectados a través de entrevistas en profundidad en el domicilio. Fue utilizado el software Etnografh 6.0 para la pre-codificación y posterior al análisis interpretativo emergieron dos categorías: “las sombras del momento actual”, que mostró que las dificultades iniciales de la enfermedad están presentes, pero las mujeres pueden hacer frente mejor a la enfermedad y el tratamiento. La segunda categoría, “la luz del trasplante renal”, muestra la esperanza impulsada por la entrada en la lista de espera para un trasplante.

  10. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930564 Dwell times affect the local host de-fence mechanism of peritoneal dialysis patients.WANG Tao(汪涛),et al.Renal Instit,SunYatsen Med Univ,Guangzhou,510080.Chin JNephrol 1993;9(2):75—77.The effect of different intraperitoneal awelltimes on the local host defence in 6 peritonealdialysis patients was studied.A significant de-crease in the number of peritoneal cells,IgG con-centration and the phagoeytosis and bactericidalactivity of macrophages was determined when thedwell time decreased from 12 to 4 hs or form 4 to0.5hs,but the peroxidase activity in macrophagesincreased significantly.All variables,except theperoxidase activity in macrophages,showed nosignificant difference between patients of high or

  11. Chromophobe Renal Cell Carcinoma

    OpenAIRE

    Jyotsna Vijaykumar Wader; Sujata S Kumbhar; Huddedar AD; Wasim GM Khatib

    2013-01-01

    Renal cell carcinoma is the most common neoplasm of the kidney comprised of different histological variants. Chromophobe renal cell carcinoma (ChRCC) is a rare subtype of renal cell carcinoma (RCC) mainly diagnosed in the sixth decade of life. It is important to identify this entity because it has significantly better prognosis than the clear cell (conventional) and papillary renal cell carcinomas. The chromophobe renal cell carcinoma should be differentiated from oncocytoma and clear cell ca...

  12. Value of 111In-DTPA-D-Phe-1-octreotide (111In-OCT) and 99mTc-dimercaptosuccinic acid (99mTc-DMSA-V) scans in medullary thyroid carcinoma (MTC)

    International Nuclear Information System (INIS)

    Background: Although serum calcitonin and CEA are sensitive indicators for the presence of MTC, the localization of tumor sites continuous to be a diagnostic challenge, especially, when calcitonin is elevated after curative surgery and conventional radiological techniques fail to disclose the tumor site(s). Methods: In an approach to localize MTC lesions we performed comparative studies in 31 patients with MTC using 99mTc-DMSA(V) and 111In-OCT. Results: 111In-OCT localized the primary tumor in 11 of 17 patients (64 %). In 3 of 6 patients (50 %) with suspected recurrent/metastatic MTC 111In-OCT failed to demonstrate a pathological uptake. 99mTc-DMSA(V) whole body studies detected in 10 of 17 patients (71 %) the primary tumors, whereas in 2 of 3 (66 %) patients with suspected recurrent disease the tumor sites were demonstrable. 99mTc-DMSA(V) scan was able to detect the tumor sites in 3 patients with negative 111In-OCT scans. In 1 of patients the 111In-OCT scan was superior to the 99mTc-DMSA(V) scan. Conclusions: We conclude that 99mTc-DMSA(V) and 111In-OCT studies may be useful for the localization of primary MTC lesions, while both imaging techniques have limited sensitivity in the detection of recurrent disease. A combined use of both scans in patients with MTC is mandatory if all conventional imaging modalities fail to demonstrate the tumor sites. (author)

  13. Kidney volume estimation using 99Tcm-DMSA RSPECT: evaluation by phantom study

    International Nuclear Information System (INIS)

    Renal parenchymal volume is important for clinical interpretation. The phantom study was carried out to validate the volume calculation. The volume of kidney phantom was determined using reoriented single photon emission computed tomography (RSPECT). The phantom volume range was 20-300 ml. There are two major factors in the determination of volume which are radioactivity concentration and organ/background ratio. Our results showed that the effect of radioactivity concentration on the volume in the kidney phantom is -3.3 to 7.5% whereas the effect of organ/background ratio was only 2.2%. Our relative volume deviation, therefore, from the real volume was 1.43%. We concluded that it is feasible to use kidney volume in clinical work. (Author)

  14. Evaluation of vesico-ureteral reflux in children with renal scarring by radionuclide imaging

    International Nuclear Information System (INIS)

    Objective: To determine the relationship between vesico-ureteral reflux (VUR) and acute pyelonephritis (APN), renal scarring and to evaluate the radionuclide imaging in children with urinary tract infection (UTI). Methods: The study included 48 children with upper urinary tract infection (UUTI) proven for the first time clinically. All children were diagnosed as with APN by 99Tcm-dimercaptosuccinic acid (DMSA) renal cortical scintigraphy. Within 10 d after renal imaging, all cases underwent direct radionuclide cystography (DRC) for evaluating the presence of VUR. Results: 1) Of 48 children with APN, 29.2%(14/48) had renal scarring, and also 47.9%(23/48) patients and 44.8%(30/67) involved kidneys had VUR. 2) The incidence (85.7%) of VUR in patients with renal scarring was significantly higher than that (32.4%) in patients without scarring (P<0.01). The incidence (88.2%) of VUR in kidneys with scarring was also higher than that (30.0%) in kidneys without scarring (P<0.01). 3) Of 30 kidneys with VUR, the incidence of scarring was 73.3% in kidneys with severe reflux, but was 11.5% in kidneys without reflux, or with mild or moderate reflux (P<0.01). Conclusions: The association between VUR and scarring is documented. The VUR may be one of the risk factors in predisposing the post-pyelonephritis to renal scarring. DRC is a sensitive, practical and much lower radiation exposure technique for detecting VUR and especially suitable for children

  15. Renal cell cancer without a renal primary

    OpenAIRE

    Cumani B; Bratcher J; Wang W.; Wayne M.; Kasmin F; Cooperman A

    2010-01-01

    Abstract Renal cell carcinoma has been increasing in incidence over the past two decades. Men are affected more than women and metastatic disease at presentation occurs in up to one third of patients. Metastasis can occur to virtually any organ, and involvement of multiple organs is not uncommon. To date, no reports have been found of metastatic disease without a renal primary. We present a case of renal cell cancer initially presenting as a subcutaneous mass with subsequent pancreatic and pa...

  16. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... renal (kidney) disease during their lifetime. There are three particular renal disorders in TSC: renal cysts, renal ... at the time of diagnosis, and at 2-3 year intervals if no cysts or angiomyolipomas are ...

  17. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... during their lifetime. There are three particular renal disorders in TSC: renal cysts, renal angiomyolipoma and renal ... Government Action Team TS Alliance Online Support Community Facebook Twitter YouTube How to Make a Donation Research ...

  18. Utility of the dimercapto succinic acid pentavalent ({sup 99m} Tc- DMSA V) in the diagnostic of secondary bone leisure at metastasis of diverse primary tumours. Preliminary study; Utilidad del acido dimercapto succinico pentavalente ({sup 99m} Tc-DMSA V) en el diagnostico de lesiones oseas secundarias a metastasis de diversos tumores primarios. Estudio preliminar

    Energy Technology Data Exchange (ETDEWEB)

    Ortega L, N. [Hospital de Especialidades ' Dr. Antonio Fraga Mouret' Centro Medico Nacional ' La Raza' , IMSS Mexico D.F. (Mexico); Pichardo R, P.A. [Medico Nuclear adscrito al servicio de Medicina Nuclear del Hospital de Oncologia, Centro Medico Nacional Siglo XXI, IMSS, Mexico D.F. (Mexico); Marquez H, A. [Departamento de Medicina Nuclear, IMSS, Mexico D.F. (Mexico)

    2005-07-01

    The more used method in the diagnosis of secondary bone lesions to become cancerous it is by means of having derived of phosphates like it is the {sup 99m}Tc- MDP. The reason of acquiring searching with the radiopharmaceutical {sup 99m}Tc- DMSA V is with the purpose to find other bone lesions that are not visualized with the gammagraphy with diphosphonate and therefore to increase the specificity of the study. (Author)

  19. Evaluation of the absorbed dose to the kidneys due to Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3) and Tc{sup 99m} (Dmsa); Evaluacion de la dosis absorbida en los rinones debido al Tc{sup 99m} (DTPA) / Tc{sup 99m} (MAG3) y Tc{sup 99m} (DMSA)

    Energy Technology Data Exchange (ETDEWEB)

    Vasquez A, M.; Murillo C, F.; Castillo D, C.; Rocha J, J.; Sifuentes D, Y.; Sanchez S, P. [Universidad Nacional de Trujillo, Av. Juan Pablo II s/n, Trujillo (Peru); Idrogo C, J.; Marquez P, F., E-mail: marvva@hotmail.com [Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos 2520, Lima (Peru)

    2015-10-15

    The absorbed dose in the kidneys of adult patients has been assessed using the biokinetics of radiopharmaceuticals containing Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3) or Tc{sup 99m} (Dmsa).The absorbed dose was calculated using the formalism MIRD and the Cristy-Eckerman representation for the kidneys. The absorbed dose to the kidneys due to Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3), are given by 0.00466 mGy.MBq{sup -1} / 0.00339 mGy.MBq{sup -1}. Approximately 21.2% of the absorbed dose is due to the bladder (content) and the remaining tissue, included in biokinetics of Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3). The absorbed dose to the kidneys due to Tc{sup 99m} (Dmsa) is 0.17881 mGy.MBq{sup -1}. Here, 1.7% of the absorbed dose is due to the bladder, spleen, liver and the remaining tissue, included in biokinetics of Tc{sup 99m} (Dmsa). (Author)

  20. Model-based comparison of maternal and foetal organ doses from 99mTc pertechnetate, DMSA, DTPA, HDP, MAA and MAG3 diagnostic intakes during pregnancy

    International Nuclear Information System (INIS)

    Organ residence times were calculated for diagnostic intakes of 99mTc pertechnetate, 2,3-dimercaptosuccinic acid (DMSA), diethylene triamine penta-acetic acid (DTPA), hydroxymethylene diphosphonate (HDP), macroaggregated albumin (MAA) and mercapto-acetyltriglycine (MAG3) during the 1st and 3rd stages of pregnancy and used with the MIRDOSE3 pregnant female phantoms for generation of dose estimates. At stage 3 individual foetal organ doses were estimated via a surrogate phantom based on that for the new-born but with mean dose/cumulated activity (S) values scaled for compatibility with foetal whole body S. Stage 1 or 3 whole foetus doses ranged from 5.2 to 0.77 μGy MBq-1 respectively, analogous to current ICRP estimates for these agents using similar in vivo biodistribution model databases. Most stage 3 maternal and foetal organ doses were similar within a factor of 3, being higher in the foetus than the mother with pertechnetate, DTPA and MAG3, and lower with DMSA, HDP and MAA. Doses were more uniformly distributed among foetal organs than in the mother. Placental transfer was greatest with pertechnetate, where dose to the stage 3 foetal thyroid was 60-140 μGy MBq-1. With each agent there was more placental transfer in stage 3 than in stage 1, but doses to stage 1 whole foetus were always higher, with the contribution from the mother dominant. For DMSA, HDP and MAG3 the maternal contribution to total foetal body dose exceeded 93% for both stages. (orig.)

  1. Cardio Renal Syndrome

    Directory of Open Access Journals (Sweden)

    KV Sahasranam

    2014-10-01

    Full Text Available For a long time, physicians have recognized that the kidney and the heart are related especially when there is severe dysfunction of either of them. Dysfunction of one of these organs seldom occurs in isolation. Of late the cardio renal syndrome is assuming significance because of its increasing incidence, awareness and complications. There is no definite definition of the cardio renal syndrome. However, an attempted definition states that it is a "decline in renal function in the setting of advanced heart failure". This definition does not cover the whole gamut of the cardio renal syndrome. Cardiac diseases are associated independently with a decrease in renal function and progression of existing renal disease. Chronic Kidney disease (CKD is an independent risk factor for cardiovascular events and outcome. This bidirectional nature of cardiac and renal interaction is called Cardio Renal Syndrome (CRS.

  2. Renal papillary necrosis

    Science.gov (United States)

    ... your provider. Alternative Names Necrosis - renal papillae; Renal medullary necrosis Images Kidney anatomy Kidney - blood and urine flow References Ruggenenti P, Cravedi P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Taal MW, Chertow GM, ...

  3. Kidney (Renal) Failure

    Science.gov (United States)

    ... How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ... marrow and strengthen the bones. The term kidney (renal) failure describes a situation in which the kidneys have ...

  4. Renal cell carcinoma

    Science.gov (United States)

    Renal cell carcinoma is a type of kidney cancer that starts in the lining of very small tubes (tubules) in the kidney. ... cancer; Kidney cancer; Hypernephroma; Adenocarcinoma of renal cells; Cancer - kidney

  5. Effect of a commercial extract of Paullinia cupana (guarana) on the binding of 99mTc-DMSA on blood constituents: An in vivo study.

    Science.gov (United States)

    Freitas, R S; Moreno, S R F; Lima-Filho, G L; Fonseca, A S; Bernardo-Filho, M

    2007-05-01

    We studied the influence of a commercial extract of Paullinia cupana (guarana) on the binding of technetium-99m-dimercaptosuccinic acid ((99m)Tc-DMSA) on blood constituents. Plasma (P) and blood cells (BC) from Wistar rats (control and treated) were separated. P and BC were precipitated with trichloroacetic acid (TCA) or ammonium sulphate (AS) and soluble (SF) and insoluble fractions (IF) isolated. The percentage of incorporated radioactivity (%ATI) in each fraction was determined. The treatment influenced the %ATI in IF-P and in IF-BC isolated by TCA precipitation. PMID:17350271

  6. Effect of a commercial extract of Paullinia cupana (guarana) on the binding of 99mTc-DMSA on blood constituents: An in vivo study

    International Nuclear Information System (INIS)

    We studied the influence of a commercial extract of Paullinia cupana (guarana) on the binding of technetium-99m-dimercaptosuccinic acid (99mTc-DMSA) on blood constituents. Plasma (P) and blood cells (BC) from Wistar rats (control and treated) were separated. P and BC were precipitated with trichloroacetic acid (TCA) or ammonium sulphate (AS) and soluble (SF) and insoluble fractions (IF) isolated. The percentage of incorporated radioactivity (%ATI) in each fraction was determined. The treatment influenced the %ATI in IF-P and in IF-BC isolated by TCA precipitation

  7. Effect of a commercial extract of Paullinia cupana (guarana) on the binding of 99mTc-DMSA on blood constituents: An in vivo study

    Energy Technology Data Exchange (ETDEWEB)

    Freitas, R.S. [Departamento de Biofisica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Avenida 28 de Setembro, 87 Fundos, 4 Andar, Rio de Janeiro 20551-030 (Brazil); Moreno, S.R.F. [Departamento de Biofisica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Avenida 28 de Setembro, 87 Fundos, 4 Andar, Rio de Janeiro 20551-030 (Brazil); Lima-Filho, G.L. [Departamento de Biofisica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Avenida 28 de Setembro, 87 Fundos, 4 Andar, Rio de Janeiro 20551-030 (Brazil); Fonseca, A.S. [Departamento de Farmacologia e Psicobiologia, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Avenida 28 de Setembro, 87 Fundos, 5 Andar, Rio de Janeiro, 20551-030 (Brazil)]. E-mail: adenilso@uerj.br; Bernardo-Filho, M. [Departamento de Biofisica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Avenida 28 de Setembro, 87 Fundos, 4 Andar, Rio de Janeiro 20551-030 (Brazil); Instituto Nacional do Cancer, Coordenadoria de Pesquisa, Praca Cruz Vermelha 23, Rio de Janeiro, 20230-130 (Brazil)

    2007-05-15

    We studied the influence of a commercial extract of Paullinia cupana (guarana) on the binding of technetium-99m-dimercaptosuccinic acid ({sup 99m}Tc-DMSA) on blood constituents. Plasma (P) and blood cells (BC) from Wistar rats (control and treated) were separated. P and BC were precipitated with trichloroacetic acid (TCA) or ammonium sulphate (AS) and soluble (SF) and insoluble fractions (IF) isolated. The percentage of incorporated radioactivity (%ATI) in each fraction was determined. The treatment influenced the %ATI in IF-P and in IF-BC isolated by TCA precipitation.

  8. On Renal Artery Stenosis

    OpenAIRE

    Eklöf, Hampus

    2005-01-01

    Renal artery stenosis (RAS) is a potentially curable cause of hypertension and azotemia. Besides intra-arterial renal angiography there are several non-invasive techniques utilized to diagnose patients with suspicion of renal artery stenosis. Removing the stenosis by revascularization to restore unobstructed blood flow to the kidney is known to improve and even cure hypertension/azotemia, but is associated with a significant complication rate. To visualize renal arteries with x-ray technique...

  9. RENAL INVOLVEMENT IN LEPTOSPIROSIS

    OpenAIRE

    Galya I. Gancheva

    2012-01-01

    Renal involvement is a common feature of leptospirosis. It is variable from mild to severe acute renal failure. Materials and methods: We performed analysis of 100 consecutive leptospirosis cases treated in Clinic of Infectious Diseases at University Hospital – Pleven (1976-2012) (90 male, age 37±18 years, lethal outcome in 13%), followed by comparative analysis of group with renal involvement (n1=59) versus group without renal involvement (controls: n2=41). Results: Fever (100%), hepatomegal...

  10. Recurrent acute renal failure

    OpenAIRE

    Satish, S.; Rajesh, R.; Kurian, G.; Seethalekshmi, N. V.; Unni, M.; Unni, V. N.

    2010-01-01

    While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

  11. Incidental renal neoplasms

    DEFF Research Database (Denmark)

    Rabjerg, Maj; Mikkelsen, Minne Nedergaard; Walter, Steen;

    2014-01-01

    On the basis of associations between tumor size, pathological stage, histological subtype and tumor grade in incidentally detected renal cell carcinoma vs symptomatic renal cell carcinoma, we discussed the need for a screening program of renal cell carcinoma in Denmark. We analyzed a consecutive ...

  12. Hernia of the bladder through the broad ligament with renal agenesis and ipsilateral ureter blind ending.

    Science.gov (United States)

    El Madi, Aziz; Khattala, Khalid; Rami, Mohammed; Bouabdallah, Youssef

    2014-01-01

    Hernia through a defect of the broad ligament is extremely rare in children. These defects can result from a developmental defect or a spontaneous rupture of cystic formations remnants of mesonephric ducts or Müller. Genital anomalies associated with unilateral renal agenesis are more common in females. We report the case of a 13 months girl allowed for assessment of recurrent urinary tract infection; abdominal examination did not objectified palpable mass, the external genitalia were without abnormalities. Abdominal ultrasound revealed a left renal space is empty with a retrovesical cyst. Cystography was requested that objectified a large pelvic cystic mass retrovesical communicating with the bladder, there was also a left vesicoureteral reflux. Uro- MRI showed a cystic formation retrovesical communicating with the bladder, the right pelvic kidney; uterus is normal size for age. DMSA scintigraphy confirmed the absence of the left kidney with the right kidney that ensures 100% of total renal function. To surgical exploration we found a hernia of the bladder through the left broad ligament, the uterus was dislocated on the right side; left ovary was hypoplasic; the ipsilateral ureter was blind with renal agenesis, we performed by reduction of the bladder then closing the hernial orifice, dissection of the ureter with its ligation and section at the vesical stoma. The postoperative course was uneventful. Evolution is favorable. This observation illustrates a hernia of the bladder through the broad ligament associated with ovarian hypoplasia, renal agenesis and ipsilateral ureter blind ending; this association was not described to our knowledge in the literature. PMID:25422693

  13. Renal cell carcinoma in patient with crossed fused renal ectopia

    OpenAIRE

    Ozgur Cakmak; Cemal Selcuk Isoglu; Ercument Aziz Peker; Huseyin Tarhan; Ulku Kucuk; Orcun Celik; Ferruh Zorlu; Yusuf Ozlem Ilbey

    2016-01-01

    Primary renal cell carcinomas have rarely been reported in patients with crossed fused renal ectopia. We presented a patient with right to left crossed fused kidney harbouring renal tumor. The most frequent tumor encountered in crossed fused renal ectopia is renal cell carcinoma. In this case, partial nephrectomy was performed which pave way to preservation of the uninvolved both renal units. Due to unpredictable anatomy, careful preoperative planning and meticulous delineation of renal vascu...

  14. Renal function in children with congenital neurogenic bladder

    Directory of Open Access Journals (Sweden)

    Karen Previdi Olandoski

    2011-01-01

    Full Text Available AIMS: Preservation of renal function in children with congenital neurogenic bladder is an important goal of treatment for the disease. This study analyzed the evolution of renal function in patients with congenital neurogenic bladder. METHODS: We reviewed the records of 58 pediatric patients with respect to the following attributes: gender, age, etiology of neurogenic bladder, reason for referral, medical/surgical management, episodes of treated urinary tract infections, urodynamics, DMSA scintigraphy, weight, height, blood pressure, glomerular filtration rate, microalbuminuria and metabolic acidosis. Statistical analysis was performed, adopting the 5% significance level. RESULTS: The mean age at presentation was 4.2 ± 3.5 years. Myelomeningocele was the most frequent etiology (71.4%. Recurrent urinary tract infection was the reason for referral in 82.8% of the patients. Recurrent urinary tract infections were diagnosed in 84.5% of the patients initially; 83.7% of those patients experienced improvement during follow-up. The initial mean glomerular filtration rate was 146.7 ± 70.1 mL/1.73 m²/min, and the final mean was 193.6 ± 93.6 mL/1.73 m²/min, p = 0.0004. Microalbuminuria was diagnosed in 54.1% of the patients initially and in 69% in the final evaluation. Metabolic acidosis was present in 19% of the patients initially and in 32.8% in the final assessment. CONCLUSIONS: Patient referral to a pediatric nephrologist was late. A reduction in the number of urinary tract infections was observed with adequate treatment, but microalbuminuria and metabolic acidosis occurred frequently despite adequate management.

  15. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive......Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...

  16. Riesgo de daño renal cicatrizal después de infección del tracto urinario en recién nacidos Risk of cicatricial renal damage after urinary tract infection in newborns

    Directory of Open Access Journals (Sweden)

    Manuel Díaz Alvarez

    2007-03-01

    Full Text Available El presente trabajo se realizó con el objetivo de determinar la prevalencia de daño renal cicatrizal e identificar los factores de riesgo a él contribuyentes en niños recién nacidos con la primera infección del tracto urinario. Se llevó a cabo un estudio analítico de factores de riesgo, caso-control, con regresión logística binominal, en recién nacidos con infección del tracto urinario de localización alta, adquirida en la comunidad, que fueron ingresados consecutivamente en el Hospital Pediátrico Universitario «Juan M. Márquez», entre febrero de 1992 y diciembre de 2004. Se realizó gammagrafía renal con DMSA para identificar cicatrices renales. Las pruebas de chi cuadrado y regresión logística se aplicaron para identificar factores de riesgo independientes. La prevalencia de daño renal cicatrizal fue de 25,4 %. En el modelo de regresión se incluyeron para análisis multivariado los factores de riesgo: ultrasonido prenatal con pielectasia, microorganismo diferente de Escherichia coli, ultrasonido renal posnatal con anomalías, presencia de reflujo vesicoureteral de cualquier grado, reinfección en los primeros 3 meses de vida, sexo masculino, retardo en inicio del tratamiento antibiótico ≥ 4 d, leucocituria ≥ 10 000/mL, respuesta desfavorable al tratamiento inicial y bacteriemia al mismo microorganismo de la infección urinaria. Finalmente solo resultaron significativos (p The present paper was aimed at determining the prevalence of cicatricial renal damage and to identify the risk factors contributing to it in newborns with urinary tract infection for the first time. An analytical case-control study of the risk factors was conducted by binominal logistic regression in newborns with an upper urinary tract infection acquired in the community that were consecutively admitted in “ Juan Manuel Márquez” University Children Hospital from February 1992 to December 2004. A renal scintigraphy with DMSA was performed to

  17. 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

  18. Renal Preservation Therapy for Renal Cell Carcinoma

    OpenAIRE

    Yichun Chiu; Allen W. Chiu

    2012-01-01

    Renal preservation therapy has been a promising concept for the treatment of localized renal cell carcinoma (RCC) for 20 years. Nowadays partial nephrectomy (PN) is well accepted to treat the localized RCC and the oncological control is proved to be the same as the radical nephrectomy (RN). Under the result of well oncological control, minimal invasive method gains more popularity than the open PN, like laparoscopic partial nephrectomy (LPN) and robot assisted laparoscopic partial nephrectomy...

  19. Renal function after renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    George S. Hanzel; Mark Downes; Peter A. McCullough

    2005-01-01

    @@ Atherosclerotic renal artery stenosis (ARAS), a common clinical finding, is increasing in prevalence as the population ages. ARAS is seen in ~ 7% of persons over 65 years of age1 and in ~ 20% of patients at the time of coronary angiography.2 It is an important cause of chronic kidney disease and may result in 11-14% of cases of end stage renal disease.3

  20. Evaluation of three algorithms to calculate the relative renal function with 99Tc-DTPA

    International Nuclear Information System (INIS)

    The aim of our study is to estimate the reproducibility and the exactitude of three algorithms to determine with 99mTc-DTPA the relative function of each kidney. Methods: a prospective study was carried out in voluntary patients. Reproducibility was studied in 11 patients who underwent had two examinations with 99mTc-DTPA. Exactitude was evaluated in 35 patients who had an additional scintigraphy with 99mTc-DMSA taken as a reference. To determine the relative renal function with 99mTc-DTPA, three algorithms using various background subtraction methods and time intervals were applied. Results and conclusion: the method of the integral was the most reproducible and exact. It was little influenced by the choice of the interval of time. The reproducibility and the exactitude of the Patlak method were worse, especially in case of renal insufficiency or hydronephrosis. A high background and poor counting statistics explain why Patlak was less powerful with 99mTc-DTPA than with 99mTc-MAG3. The method of the slopes should not be recommended any more. (author)

  1. Renal cystic disease

    Energy Technology Data Exchange (ETDEWEB)

    Hartman, D.S.

    1988-01-01

    The book begins with an overview of renal cystic disease and a presentation of simple renal cysts. Subsequent chapters cover cystic disease in association with renal neoplasms and medullary sponge kidney. The chapters addressing autosomal-dominant and autosomal-recessive polycystic kidney disease discuss and differentiate the infantile and adult forms of the disease. There are also separate discussions of medullary cystic disease, multicystic dysplastic kidney, and cysts of the renarenal sinus.

  2. Rupture of Renal Transplant

    OpenAIRE

    Shona Baker; Maria Popescu; Jacob A Akoh

    2015-01-01

    Background. Rupture of renal allograft is a rare and serious complication of transplantation that is usually attributed to acute rejection, acute tubular necrosis, or renal vein thrombosis. Case Presentation. LD, a 26-year-old male with established renal failure, underwent deceased donor transplantation using kidney from a 50-year-old donor with acute kidney injury (Cr 430 mmol/L). LD had a stormy posttransplant recovery and required exploration immediately for significant bleeding. On day th...

  3. Distal renal tubular acidosis in recurrent renal stone formers

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    metabolic disturbances in renal stone formers. Distal renal tubular acidosis (dRTA) was relatively more common in female stone formers and most often found in patients with bilateral stone disease (36%). Since prophylactic treatment in renal stone formers with renal acidification defects is available, this...... (1.1%) had complete distal renal tubular acidosis and 14 (15.5%) incomplete distal renal tubular acidosis. Our results confirm that distal renal tubular acidification defects are associated with a more severe form of stone disease and make distal renal tubular acidosis one of the most frequent...

  4. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... methods to diagnosis these renal abnormalities include renal ultrasonography, CT scanning and magnetic resonance imaging (MRI). These ... in almost every major medical center. The renal ultrasound provides the least detailed image of the kidney, ...

  5. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... the kidneys are filled with cysts. If kidney failure occurs, renal replacement therapy such as dialysis or transplantation is ... can develop in infancy or early childhood and renal failure most often occurs in early adulthood. Renal Angiomyolipomas ...

  6. FARMACOFISIOLOGÍA RENAL

    Directory of Open Access Journals (Sweden)

    Musso CG

    2014-03-01

    Full Text Available Renal physiology plays a key role in the pharmacokinetics of many drugs. Knowledge of the particularities of each nephron function (filtration, secretion, reabsorption and excretion and each of renal tubular transport mechanisms (simple diffusion, facilitated diffusion, facilitated transport, active transport, endocytosis and pinocytosis is fundamental to achieve better management of drug prescriptions.

  7. Renal Function in Hypothyroidism

    International Nuclear Information System (INIS)

    Background hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatraemia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective renal function is profoundly influenced by thyroid status, the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and patients in 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate(GFR) using modified in diet renal disease (MDRD) formula. Result in hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR increased. The hypothyroid patients showed elevated serum creatinine levels(>1.1 mg/d1) compared to control group (p value= 000). In patients mean estimated GFR increased in the control group (p value=.002).Conclusion thus the kidney, in addition to the brain, heart and muscle, is an important target of the action of thyroid hormones.(Author)

  8. Renal Function in Hypothyroidism

    International Nuclear Information System (INIS)

    Background Hypothyroidism induces significant changes in the function of organ systems such as the heart, muscles and brain. Renal function is also influenced by thyroid status. Physiological effects include changes in water and electrolyte metabolism, notably hyponatremia, and reliable alterations of renal hemodynamics, including decrements in renal blood flow, renal plasma flow, glomerular filtration rate (GFR). Objective Renal function is profoundly influenced by thyroid status; the purpose of the present study was to determine the relationship between renal function and thyroid status of patients with hypothyroidism. Design and Patients In 5 patients with primary hypothyroidism and control group renal functions are measured by serum creatinine and glomerular filtration rate (GFR) using modified in diet renal disease (MDRD) formula. Result In hypothyroidism, mean serum creatinine increased and mean estimated GFR decreased, compared to the control group mean serum creatinine decreased and mean estimated GFR Increased. The hypothyroid patients showed elevated serum creatinine levels (> 1.1mg/dl) compared to control group (p value .000). In patients mean estimated GFR decreased, compared to mean estimated GFR increased in the control group (p value= .002).

  9. Eligibility for renal denervation

    DEFF Research Database (Denmark)

    Persu, Alexandre; Jin, Yu; Baelen, Marie;

    2014-01-01

    Based on the SYMPLICITY studies and CE (Conformité Européenne) certification, renal denervation is currently applied as a novel treatment of resistant hypertension in Europe. However, information on the proportion of patients with resistant hypertension qualifying for renal denervation after a th...

  10. Is there a correlation between the size of the BCG scar and renal scar of urinary tract infections in children?

    Directory of Open Access Journals (Sweden)

    Salih Kavukçu

    2013-03-01

    Full Text Available Objective: Pyelonephritis cause cellular death, and developmentof scars in kidneys. The aim of this study is todemonstrate a correlation (if any between renal scar, andsize of the scar induced by BCG vaccine in children whohad experienced urinary tract infections. In case of detectionof any correlation, BCG scar formation can be usedas a determinative marker of renal scars, which developfollowing urinary tract infection.Methods: Patients with a history of urinary tract infectionat least 4 months old who had undergone 99mTcDMSAscanning were included in this study. Vertical and horizontaldiameters of BCG scars of the patients in the studygroup were measured. For statistical analysis the greatestdiameter was taken into consideration, and the patientswere divided into 2 subgroups based on the greatest diameterof their BCG scars (Subgroups 1, ≤5 mm, and 2,>5 mm. The patients were also evaluated in 2 groupsas those with (Group 1 or without (Group 2 scars. Bothgroups were compared with subgroups with the largestscar diameters of ≤ 5mm or >5 mmResults: Study population included 108 (82 girls patients.DMSA detected scars in a total of 51 patients.Mean ages of the patients with and without scars were notdifferent (p=0.414. No significant difference was found insize of the BCG scars between renal scar positive andnegative groups (p>0.05.Conclusion: No correlation was found between developmentof renal scar and the size of BCG scar in childrenafter urinary tract infection. J Clin Exp Invest 2013; 4 (1:8-12Key words: BCG scar, renal scar, urinary tract infection,children

  11. Renal replacement therapy after cardiac surgery; renal function recovers

    DEFF Research Database (Denmark)

    Steinthorsdottir, Kristin Julia; Kandler, Kristian; Agerlin Windeløv, Nis;

    2013-01-01

    To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy.......To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy....

  12. Renal Preservation Therapy for Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Yichun Chiu

    2012-01-01

    Full Text Available Renal preservation therapy has been a promising concept for the treatment of localized renal cell carcinoma (RCC for 20 years. Nowadays partial nephrectomy (PN is well accepted to treat the localized RCC and the oncological control is proved to be the same as the radical nephrectomy (RN. Under the result of well oncological control, minimal invasive method gains more popularity than the open PN, like laparoscopic partial nephrectomy (LPN and robot assisted laparoscopic partial nephrectomy (RPN. On the other hand, thermoablative therapy and cryoablation also play an important role in the renal preservation therapy to improve the patient procedural tolerance. Novel modalities, but limited to small number of patients, include high-intensity ultrasound (HIFU, radiosurgery, microwave therapy (MWT, laser interstitial thermal therapy (LITT, and pulsed cavitational ultrasound (PCU. Although initial results are encouraging, their real clinical roles are still under evaluation. On the other hand, active surveillance (AS has also been advocated by some for patients who are unfit for surgery. It is reasonable to choose the best therapeutic method among varieties of treatment modalities according to patients' age, physical status, and financial aid to maximize the treatment effect among cancer control, patient morbidity, and preservation of renal function.

  13. Renal infarction in patients presenting with suspected renal colic *

    OpenAIRE

    Seetho, Ian W.; Bungay, Peter M.; Taal, Maarten W.; Fluck, Richard J.; Leung, Janson C. H.

    2009-01-01

    Acute renal infarction is a serious medical emergency. The diagnosis is often delayed or missed as it is not common. Hence, the exact incidence of acute renal infarction is not known. Failure to consider renal infarction in the initial differential diagnosis results in a delay in diagnosis and treatment, which in turn leads to permanent loss of renal function. We present two cases of acute kidney infarction that were initially treated as renal colic. In addition, we present a third case when ...

  14. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... in TSC: renal cysts, renal angiomyolipoma and renal cell carcinoma . Renal angiomyolipomata, or angiomyolipomas, are usually the greatest concern in TSC. The blood vessels within angiomyolipomas are abnormal and can develop weak spots in their wall, called aneurysms, that can burst and lead to ...

  15. Perioperative acute renal failure.

    LENUS (Irish Health Repository)

    Mahon, Padraig

    2012-02-03

    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  16. Acute renal failure in children

    International Nuclear Information System (INIS)

    Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% ± 1.40 S.D.) and group B (5.95 mg% ± 1.96 S.D.), p < 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity. (orig.)

  17. Insuficiencia renal aguda.

    OpenAIRE

    Carlos Hernán Mejía

    2009-01-01

    La insuficiencia renal aguda se diagnostica aproximadamente en 5% de los pacientes hospitalizados. Sus principales causas se relacionan con la alteración del flujo sanguíneo renal, sea por depleción de volumen, baja perfusión renal o por distribución intrarrenal inadecuada y obstrucción del árbol urinario. El diagnóstico parte de la historia clínica y un buen examen físico que corrobore el estado de volemia del paciente y se complementa con el uso adecuado de los índices urinarios (excreción ...

  18. Insuficiencia renal aguda

    OpenAIRE

    Carlos Hernán Mejía

    1985-01-01

    La insuficiencia renal aguda se diagnostica aproximadamente en 5% de los pacientes hospitalizados. Sus principales causas se relacionan con la alteración del flujo sanguíneo renal, sea por depleción de volumen, baja perfusión renal o por distribución intrarrenal inadecuada y obstrucción del árbol urinario. El diagnóstico parte de la historia clínica y un buen examen físico que corrobore el estado de volemia del paciente y se complementa con el uso adecuado de los índices urinarios (excreción ...

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

    International Nuclear Information System (INIS)

    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

  20. Renal tumors in infancy

    International Nuclear Information System (INIS)

    The classification of childhood renal masses in updated, including the clinical signs and imaging techniques currently employed to confirm their presence and type them. Several bening and malignant childhood tumors are described in substantial detail. (Author) 24 refs

  1. Dopamins renale virkninger

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal

    1990-01-01

    which are possible not exclusively secondary to alterations in the renal haemodynamics but may also be due to specific tubular effects. Recent investigations have revealed that dopamine does not increase RBF and GFR in patients with chronic renal failure if GFR is less than 60 ml/minute. Dopamine in low...... doses is frequently employed in cases of acute oliguric renal failure but the results available concerning the therapeutic effect are frequently retrospective and uncontrolled. The results suggest that early treatment with 1-3 micrograms/kg/min dopamine combined with furosemide can postpone or possibly......Dopamine is an endogenic catecholamine which, in addition to being the direct precursor of noradrenaline, has also an effect on peripheral dopaminergic receptors. These are localized mainly in the heart, splanchnic nerves and the kidneys. Dopamine is produced in the kidneys and the renal metabolism...

  2. Primary renal synovial sarcoma

    Directory of Open Access Journals (Sweden)

    Girish D. Bakhshi

    2012-03-01

    Full Text Available Primary Renal Sarcoma is rare tumor comprising only 1% of all renal tumours. Synovial sarcomas are generally deep-seated tumors arising in the proximity of large joints of adolescents and young adults and account for 5-10% of all soft tissue tumours. Primary synovial sarcoma of kidney is rare and has poor prognosis. It can only be diagnosed by immunohistochemistry. It should be considered as a differential in sarcomatoid and spindle cell tumours. We present a case of 33-year-old female, who underwent left sided radical nephrectomy for renal tumour. Histopathology and genetic analysis diagnosed it to be primary renal synovial sarcoma. Patient underwent radiation therapy and 2 years follow up is uneventful. A brief case report with review of literature is presented.

  3. OBSTETRIC RENAL FAILURE

    Directory of Open Access Journals (Sweden)

    Rajeshwari

    2015-11-01

    Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

  4. Primary Renal Synovial Sarcoma

    OpenAIRE

    Halil Ciftci; Adem Altunkol; Ismail Ozdemir; Dilek Mil; Ilyas Ozardali; Murat Savas; Ercan Yeni; Mehmet Gulum

    2011-01-01

    Synovial sarcomas are generally deep-seated tumors that most often occur in the proximity of large joints of adolescents and young adults. We describe two cases of primary renal synovial sarcoma that were treated successfully by radical nephrectomy. Synovial sarcoma originating from the kidney is extremely rare and the histogenesis is uncertain. Surgical resection and ifosfamide based chemotherapy are the mainstay for the management of renal synovial sarcoma. Fewer than 40 patients have been ...

  5. Renal failure in malaria

    OpenAIRE

    B.S. Das

    2008-01-01

    Acute renal failure (ARF) is seen mostly in Plasmodium falciparum infection, but P. vivax and P. malariae can occasionally contribute for renal impairment. Malarial ARF is commonly found in non-immune adults and older children with falciparum malaria. Occurance of ARF in severe falciparum malaria is quite common in southeast Asia and Indian subcontinent where intensity of malaria transmission is usually low with occasional microfoci of intense transmission. Since precise mechanism of malaria...

  6. Renal clearance of melatonin

    OpenAIRE

    Editorial Office

    1996-01-01

    Only two publications exist in which actual values for the renal clearance of intact melatonin in man is described. The melatonin clearance values were, however, obtained either after the oral intake of melatonin, or by applying different techniques for the determination of melatonin in urine and plasma. In this study, renal clearance of melatonin was determined during the hours where melatonin concentrations are relatively constant. Melatonin levels in plasma and urine respectively were e...

  7. Disappearing renal calculus

    OpenAIRE

    Cui, Helen; Thomas, Johanna; Kumar, Sunil

    2013-01-01

    We present a case of a renal calculus treated solely with antibiotics which has not been previously reported in the literature. A man with a 17 mm lower pole renal calculus and concurrent Escherichia coli urine infection was being worked up to undergo percutaneous nephrolithotomy. However, after a course of preoperative antibiotics the stone was no longer seen on retrograde pyelography or CT imaging.

  8. Malignant renal tumors in children

    Directory of Open Access Journals (Sweden)

    Justin Scott Lee

    2015-05-01

    Full Text Available Renal malignancies are common in children. While the majority of malignant renal masses are secondary to Wilms tumor, it can be challenging to distinguish from more aggressive renal masses. For suspicious renal lesions, it is crucial to ensure prompt diagnosis in order to select the appropriate surgical procedure and treatment. This review article will discuss the common differential diagnosis that can be encountered when evaluating a suspicious renal mass in the pediatric population. This includes clear cell sarcoma of the kidney, malignant rhabdoid tumor, renal medullary carcinoma and lymphoma. 

  9. CT diagnosis of renal and extrarenal complications after renal transplantation

    International Nuclear Information System (INIS)

    Methods and results of static and dynamic CT of renal transplants are presented. Validity of the method concerning morphologic and functional lesions of the organ and of extrarenal structures are outlined. Special attention is paid to functional changes and differential diagnosis of the most frequent complications after renal transplantation. Whereas CT diagnosis of renal and pararenal morphology is unquestioned, the problem of differentiating between acute tubular necrosis and acute rejection is not yet solved. Nevertheless description of renal function is possible. (orig.)

  10. Management of renal cell carcinoma presenting as inflammatory renal mass

    OpenAIRE

    Ehab Eltahawy; Mohamed Kamel; Mahmoud Ezzet

    2015-01-01

    Introduction: Renal cell carcinoma (RCC) can have a wide spectrum of clinical presentations. In the immunocompromised patient fever and an inflammatory renal mass can harbor RCC. Materials and Methods: We reviewed the charts of patients who were managed at our department during 1998-2008 as renal abscess or perinephric collection. Renal ultrasound and subsequently abdominal CT was done. Medical treatment in the form of antibiotics, control of diabetes and drainage was done. Percutaneous ...

  11. Renal consequences of obesity.

    Science.gov (United States)

    Naumnik, Beata; Myśliwiec, Michał

    2010-08-01

    The worldwide prevalence of obesity and its associated metabolic and cardiovascular disorders has risen dramatically within the past 2 decades. Our objective is to review the mechanisms that link obesity with altered kidney function. Current evidence suggests that excess weight gain may be responsible for 65-75% of the risk for arterial hypertension. Impaired renal pressure natriuresis, initially due to increased renal tubular sodium reabsorption, is a key factor linking obesity with hypertension. Obesity increases renal sodium reabsorption by activating the renin-angiotensin and sympathetic nervous systems, and by altering intrarenal physical forces. Adipose tissue functions as an endocrine organ, secreting hormones/cytokines (e.g., leptin) which may trigger sodium retention and hypertension. Additionally, excess visceral adipose tissue may physically compress the kidneys, increasing intrarenal pressures and tubular reabsorption. Eventually, sustained obesity via hyperinsulinemia, due to resistance to insulin, causes hyperfiltration, resulting in structural changes in the kidneys--glomerular hyperthrophy and occasionally focal segmental glomerulosclerosis. The consequences of kidney injury are continuous loss of glomerular filtration rate, further increase of arterial pressure and escalation of cardiovascular morbidity and mortality. There is a growing awareness of the renal consequences of obesity, and considerable progress is being made in understanding its pathophysiology. Weight reduction results in lowered proteinuria. Aside from low sodium diet and exercises, more widespread use of renoprotective therapy (e.g., ACE inhibitors and statins) in treatment of hypertension in obese subjects should be advocated. Renal protection should result in reducing the cardiovascular complications of obesity. PMID:20671624

  12. Renal sympathetic denervation: MDCT evaluation of the renal arteries.

    LENUS (Irish Health Repository)

    Hutchinson, Barry D

    2013-08-01

    Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

  13. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... severe kidney disease can develop in infancy or early childhood and renal failure most often occurs in early adulthood. Renal Angiomyolipomas Angiomyolipomas are named because they ...

  14. Leiomyosarcoma of the renal pelvis

    Directory of Open Access Journals (Sweden)

    Dhamne Sagar

    2009-10-01

    Full Text Available Leiomyosarcomas are rare malignant tumors of the kidney. They may arise from the renal capsule, renal vein, renal pelvic musculature or renal parenchyma. Renal pelvis is an uncommon site of occurrence, with around 10 cases reported in the literature so far. Here we present a 60-year-old male who presented with increased urinary frequency, lower limb weakness, anorexia and weight loss. Imaging showed a right renal mass. A renal cell carcinoma was suspected clinically. A right nephrectomy was performed, which showed a large circumscribed mass in the hilar region. Histology revealed a tumor mass arising from the renal pelvis. The tumor was composed of spindle cells arranged in fascicles. Immunohistochemistry showed tumor cells to be positive for smooth muscle actin (SMA and desmin (Des and negative for cytokeratin (CK, HMB 45, CD117 (C-kit, and CD34. That confirmed the diagnosis of leiomyosarcoma.

  15. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... must be kept in mind. Diagnosis The current methods to diagnosis these renal abnormalities include renal ultrasonography, ... cells, which surround a fluid-filled cavity. Some children and adults with TSC and severe cystic kidneys ...

  16. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... in about 50 percent of individuals with TSC. These cysts, even if they are not very common, ... in mind. Diagnosis The current methods to diagnosis these renal abnormalities include renal ultrasonography, CT scanning and ...

  17. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... to kidney impairment and even kidney failure, requiring dialysis or transplantation. Lastly, renal cell carcinoma, the least ... kidney failure occurs, renal replacement therapy such as dialysis or transplantation is necessary. How kidney cysts develop ...

  18. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC Download a PDF of this information. The majority of individuals ( ... the least common renal association with TSC, is a cancerous growth of the kidney. Although it is ...

  19. Polyhydramnios and acute renal failure

    OpenAIRE

    Hamilton, D. V.; Kelly, Moira B.; Pryor, J. S.

    1980-01-01

    Acute renal failure secondary to ureteric obstruction is described in a primigravida with twin gestation and polyhydramnios. Relief of the obstruction occurred on drainage of the liquor and return to normal renal function following delivery.

  20. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... lesion must be kept in mind. Diagnosis The current methods to diagnosis these renal abnormalities include renal ... about clinical trials and see a list of current trials/studies related to TSC. Enroll now in ...

  1. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... For Individuals & Families For Healthcare Professionals For Researchers & Scientists For School Issues What Is TSC? How Is ... must be kept in mind. Diagnosis The current methods to diagnosis these renal abnormalities include renal ultrasonography, ...

  2. Renal Tumor Biopsy Technique

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2016-01-01

    Objective:To review hot issues and future direction of renal tumor biopsy (RTB) technique.Data Sources:The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on RTB technique in English,with no limitation of study design.Results:Computed tomography and ultrasound were usually used for guiding RTB with respective advantages.Core biopsy is more preferred over fine needle aspiration because of superior accuracy.A minimum of two good-quality cores for a single renal tumor is generally accepted.The use of coaxial guide is recommended.For biopsy location,sampling different regions including central and peripheral biopsies are recommended.Conclusion:In spite of some limitations,RTB technique is relatively mature to help optimize the treatment of renal tumors.

  3. Embolic renal infarction mimicking renal colic

    OpenAIRE

    Mahamid M; Francis A.; Abid A; Awawde M; Abu-Elhija O

    2014-01-01

    Mahmud Mahamid,1,3 Adi Francis,2 Ali Abid,1 Mohammed Awawde,1 Omar Abu-Elhija11Department of Internal Medicine, 2Cardiac Care Unit, Holy Family Hospital, Bar-Ilan University, Nazareth, Israel; 3Digestive Disease Institute, Liver Unit, Shaare Zedek Medical Center, Jerusalem, IsraelAbstract: Atrial fibrillation is a major health problem with risk of systemic arterial embolism. Acute embolic renal infarction is a rare condition with symptoms that are often nonspecific. We present a 36-year-old p...

  4. Contemporary Management of Renal Trauma

    Science.gov (United States)

    Shoobridge, Jennifer J; Corcoran, Niall M; Martin, Katherine A; Koukounaras, Jim; Royce, Peter L; Bultitude, Matthew F

    2011-01-01

    In the management of renal trauma, surgical exploration inevitably leads to nephrectomy in all but a few specialized centers. With current management options, the majority of hemodynamically stable patients with renal injuries can be successfully managed nonoperatively. Improved radiographic techniques and the development of a validated renal injury scoring system have led to improved staging of injury severity that is relatively easy to monitor. This article reviews a multidisciplinary approach to facilitate the care of patients with renal injury. PMID:21941463

  5. Renal denervation and hypertension.

    Science.gov (United States)

    Schlaich, Markus P; Krum, Henry; Sobotka, Paul A; Esler, Murray D

    2011-06-01

    Essential hypertension remains one of the biggest challenges in medicine with an enormous impact on both individual and society levels. With the exception of relatively rare monogenetic forms of hypertension, there is now general agreement that the condition is multifactorial in nature and hence requires therapeutic approaches targeting several aspects of the underlying pathophysiology. Accordingly, all major guidelines promote a combination of lifestyle interventions and combination pharmacotherapy to reach target blood pressure (BP) levels in order to reduce overall cardiovascular risk in affected patients. Although this approach works for many, it fails in a considerable number of patients for various reasons including drug-intolerance, noncompliance, physician inertia, and others, leaving them at unacceptably high cardiovascular risk. The quest for additional therapeutic approaches to safely and effectively manage hypertension continues and expands to the reappraisal of older concepts such as renal denervation. Based on the robust preclinical and clinical data surrounding the role of renal sympathetic nerves in various aspects of BP control very recent efforts have led to the development of a novel catheter-based approach using radiofrequency (RF) energy to selectively target and disrupt the renal nerves. The available evidence from the limited number of uncontrolled hypertensive patients in whom renal denervation has been performed are auspicious and indicate that the procedure has a favorable safety profile and is associated with a substantial and presumably sustained BP reduction. Although promising, a myriad of questions are far from being conclusively answered and require our concerted research efforts to explore the full potential and possible risks of this approach. Here we briefly review the science surrounding renal denervation, summarize the current data on safety and efficacy of renal nerve ablation, and discuss some of the open questions that need

  6. Primary renal synovial sarcoma

    OpenAIRE

    Bakhshi, Girish D.; Arshad S. Khan; Shaikh, Aftab S; Khan, Mohammad Ashraf A.; Mohammad Adil A. Khan; Jamadar, Nilofar M.

    2012-01-01

    Primary Renal Sarcoma is rare tumor comprising only 1% of all renal tumours. Synovial sarcomas are generally deep-seated tumors arising in the proximity of large joints of adolescents and young adults and account for 5-10% of all soft tissue tumours. Primary synovial sarcoma of kidney is rare and has poor prognosis. It can only be diagnosed by immunohistochemistry. It should be considered as a differential in sarcomatoid and spindle cell tumours. We present a case of 33-year-old female, who u...

  7. Renal lithiasis and nutrition

    Directory of Open Access Journals (Sweden)

    Prieto Rafel M

    2006-09-01

    Full Text Available Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine is discussed.

  8. Sarcomatoid renal cell carcinoma

    OpenAIRE

    Kafil Akhtar; Ahmad Shamshad; Zaheer Sufian; Mansoor Tariq

    2011-01-01

    Sarcomatoid renal cell carcinoma (SRCC) is an aggressive tumor variant thought to arise predominantly from differentiation of clear cell carcinoma. A few reports of SRCC asso-ciated with non-clear cell tumors led to the presumption that SRCC may arise from any renal cell carcinoma, although direct evidence of this is lacking. We report a case of a 70-year-old male patient, who presented with acute left upper quadrant abdominal pain and was diagnosed to have SRCC after pathological examination...

  9. Renal Failure in Pregnancy.

    Science.gov (United States)

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause. PMID:26600445

  10. Renal trapping of cadmium

    International Nuclear Information System (INIS)

    Renal Cd retention is well known; its mechanism was here studied in rabbits. 109CdCl2 or 65ZnCl2 were injected IA, together with SH-ethanol (ME) to prevent isotope binding to plasma protein; the bolus was trapped in the kidney for 40 s by aortic occlusion as described previously. Total uptake (TU, in % of renal load) = the sum of (A) reabsorbed metal, calculated on the basis of free filtrn. of ME complexes, their insignificant urinary excretion, and av. filtrn. fraction of 20%; and (B) basolateral (BL) extraction, determined from recoveries of metal compared to that of inulin in renal venous samples collected over 3 min after release of occlusion. TU averaged 32% for Cd (n=6), and 42% for Zn (n=4). Three ± 10% (SD) of TU Cd but 86 ± 37% of TU Zn returned to blood. These findings recall the positive correlation between relative affinities of Cd, Zn and Ni for metallothionein (MT), and their retention by jejunal mucosa (AJP 253:G134,1987); endogenous MT has been directly implicated in Cd retention by that tissue (Tox. 38:285,1986). Present results similarly support the commonly postulated role of MT in renal Cd retention, and reemphasize the contribution BL uptake of nonMT Cd can make to total Cd accumulation

  11. Insuficiencia renal aguda.

    Directory of Open Access Journals (Sweden)

    Carlos Hernán Mejía

    2009-10-01

    Full Text Available La insuficiencia renal aguda se diagnostica aproximadamente en 5% de los pacientes hospitalizados. Sus principales causas se relacionan con la alteración del flujo sanguíneo renal, sea por depleción de volumen, baja perfusión renal o por distribución intrarrenal inadecuada y obstrucción del árbol urinario. El diagnóstico parte de la historia clínica y un buen examen físico que corrobore el estado de volemia del paciente y se complementa con el uso adecuado de los índices urinarios (excreción de sodio y osmolaridad, el uroanálisis y la ecografía renal. Su tratamiento consiste en una adecuada recuperación del volumen, manejo de los diuréticos, soporte nutricional, conservación del equilibrio hidroelectrolítico y brindar terapia de diálisis si hay toxicidad urémica, hipercaliemia severa (>6.5 mEq/l, acidosis metabólica o sobrecarga severa de volumen.

  12. ''Aggressive'' renal angiomyolipoma

    International Nuclear Information System (INIS)

    We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an 'aggressive' appearance, and review the literature. The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggessive behavior. Conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. (orig./MG)

  13. ``Aggressive`` renal angiomyolipoma

    Energy Technology Data Exchange (ETDEWEB)

    Cittadini, G. Jr. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, F. [Univ. of Trieste (Italy). Dept. of Radiology; Danza, F.M. [Catholic Sacro Cuore Univ., Rome (Italy). Dept. of Radiology; Derchi, L.E. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, R.S. [Univ. of Trieste (Italy). Dept. of Radiology

    1996-11-01

    We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an `aggressive` appearance, and review the literature. The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggessive behavior. Conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. (orig./MG).

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

    International Nuclear Information System (INIS)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-05-01

    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.

  16. Use of dimercaptosuccinic acid labelled with 99mTc (99mTc-DMSA) in the functional examination of kidneys. IV. Distribution in a population sample, effect of body weight, age and sex

    International Nuclear Information System (INIS)

    The nature of distribution of the 99mTc-DMSA fraction accumulated by the kidneys was investigated 2 hours after intravenous administration to a population sample of 327 patients. The effect of age, body weight and sex was established. The left-skewed distribution obtained is due to the physiological nature of the parameter examined and the kind of the population sample. The magnitude of the parameter decreases with increasing age and body weight and is higher for females than for males. (author)

  17. Screening renal stone formers for distal renal tubular acidosis

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted......; 13 had incomplete and 1 had complete distal RTA. Distal RTA was found particularly in recurrent stone formers (17%), and especially in those with bilateral stone disease, where a distal renal tubular acidification defect was found in 50%. We have been unable to differentiate primary from secondary...... RTA in renal stone formers. Regardless of whether the acidification defect is primary or secondary to stone formation, however, all renal stone formers with distal RTA can expect to benefit from prophylactic alkaline therapy and it is recommended that the screening procedure, which is easy to use in...

  18. Improvement of renal function after opening occluded atherosclerotic renal arteries.

    Science.gov (United States)

    Kanamori, Hiroshi; Toma, Masanao; Fukatsu, Atsushi

    2009-09-01

    Percutaneous transluminal renal angioplasty (PTRA) with stenting has been effective in the control of hypertension, renal function and pulmonary edema caused by atherosclerotic renal artery stenosis (ARAS). However, concerning the viability of renal function, this procedure has not been fully established, especially in the presence of renal atrophy or severe renal parenchymal disease. We report a dramatically improved case of acute renal failure caused by acute worsening ARAS treated by stenting. A 72-year-old female was admitted for accelerated renal dysfunction (serum ceatinine; 1.2-2.3 mg/dl) and hypertension (190/100 mmHg). At 10 days after admission, the patient's serum ceatinine increased to 6.7 mg/dl, her pulmonary edema was exaggerated and hemodialysis was required. Ultrasonography showed bilateral high-echoic kidneys, but no apparent finding of renal artery stenosis (RAS). At day 15, computed tomographic angiography indicated bilateral ostial RAS. Renal angiography demonstrated total occlusion of the right and severe (90%) disease in the left. ARAS was diagnosed by intravascular ultrasonography. The guidewire was inserted in both renal arteries, PTRA with stenting was performed in the right and a stent was directly implanted in the left. Immediately, each kidney enlarged to almost normal size, leading to satisfactory urination. She was released from hemodialysis the next day since her serum creatinine was normal and the pulmonary edema was improved. Although there is still no reliable prognostic factor including resistive index or kidney size, it is important that PTRA with stenting in ARAS should be considered in a case of accelerated renal dysfunction because of the possible improvement. PMID:19726830

  19. Renal aspergillosis secondary to renal intrumentation in immunocompetent patient

    OpenAIRE

    Paul, Sagorika; Singh, Viswajeet; Sankhwar, Satyanarayan; Garg, Manish

    2013-01-01

    Primary renal aspergillosis is a rare urological entity and immune-compromised persons are commonly prone to it. The clinical presentation resembles that of usual bacterial pyelonephritis. We report a case of localised unilateral renal aspergillosis with obstructive uropathy (hypoplastic contralateral kidney) in a young man, occurring after the endoscopic removal of impacted right upper ureteric calculus in a non-immunocompromised patient. In view of deranged renal function, he was initially ...

  20. Primary renal synovial sarcoma

    Directory of Open Access Journals (Sweden)

    Vandana U Grampurohit

    2011-01-01

    Full Text Available Primary synovial sarcoma (SS of kidney is very rare and difficult to diagnose. Here, we present a case of a 21-year-old female clinically diagnosed as renal cell carcinoma. Right nephrectomy specimen showed a cystic tumor in the upper pole of kidney with areas of hemorrhage and solid growth. Histologically, it showed poorly differentiated cells with hemangiopericytoma-like vascular pattern. Morphologic and immunohistochemical features were compatible with the diagnosis of poorly differentiated SS of kidney. Primary renal SS is a recently described entity. To the best of our knowledge, approximately 34 cases have been reported till date and this is the eighth documented case of poorly differentiated variant. Most of the time, poorly differentiated SS of kidney exhibits hemangiopericytoma like histology. Reverse transcriptase-polymerase chain reaction analysis to demonstrate SYT-SSX fusion gene transcript helps to confirm the diagnosis.

  1. Papillary renal cell carcinoma

    International Nuclear Information System (INIS)

    Between 1976 and 1987, 395 patients with kidney tumors were studied with radiological techniques and sonography. In 37 cases (9.4%) histopathology diagnosed pure papillary renal cell carcinoma. Analyzing the radiographic patterns of these neoplasms, the authors observed constantly diminished vascularity (100%) frequent calcifications (35.1%) and necrotic areas (51.3%). Such X-ray features are not specific: nevertheless, their coexistence is strongly suggestive of papillary renal cell cancer. No consistent US pattern was found; however, necrotic areas were easily demonstrated in most cases. It must be stressed how patients with papillary carcinoma experienced a longer post-operative survival; it has not yet been established whether such favorable behavior is due to low biological aggressiveness or to earlier diagnosis

  2. Renal Medullary Interstitial Cells

    Science.gov (United States)

    Rao, Reena; Hao, Chuan-Ming; Breyer, Matthew D.

    2007-04-01

    Renal medullary interstitial cells (RMICs) are specialized fibroblast-like cells that reside in the renal medulla among the vasa recta, the thin limbs of Henle's loop, and medullary collecting ducts. These cells are characterized by abundant lipid droplets in the cytoplasm. The lipid droplets are composed of triglycerides, cholesterol esters and free long-chain fatty acids, including arachidonic acid. RMICs are also a major site of cyclooxygenase2 (COX-2) expression, and thus a major site of COX-2 derived prostanoid biosynthesis. RMICs are also a potential target of hormones such as angiotensin II and endothelin. The RMIC COX-2 expression and the abundance of lipid droplets change with salt and water intake. These properties of RMICs are consistent with an important role of these cells in modulating physiologic and pathologic processes of the kidney.

  3. Measurement of renal function by calculation of fractional uptake of technetium-99m dimercaptosuccinic acid

    International Nuclear Information System (INIS)

    The purpose of this study was to set up normal values of the fractional uptake (FU) of technetium-99m dimercaptosuccinic acid in adults and in the pediatric population, as well as to evaluate the validity of this parameter at different levels of renal function. A total of 86 subjects was divided into seven groups. In group A there were 23 potential kidney donors and in group B, 18 children in remission after a first urinary tract infection. Another three groups consisted of patients with diabetes i.e. group C, seven patients with normal values of albuminuria, group D, 16 patients with microalbuminuria and group E, five patients with macroalbuminuria. In group F, there were ten patients with a well-functioning transplanted kidney and in group G, seven patients with suspected acute rejection. The procedure began with the quantification of the doses of 99mTc-DMSA to be injected and the measurement of the empty syringe lying on the gamma camera collimator. Thereafter, four planar views of the kidneys were acquired three hours after the injection. The counts from the posterior and anterior views were subtracted for background and corrected for radioactive decay time and patient thickness. The FU was calculated by the geometric mean of counts per second from the posterior and anterior view. It was expressed as a fraction of the injected dose. The mean values of FU in healthy adults were 0.227 ± 0.077 for one kidney and 0.454 ± 0.146 for both kidneys. The mean values of FU for the left and right kidney were 0.225± 0.071 and 0.229 ± 0.079, respectively. In children, the mean values were 0.220 ± 0.092 for one kidney and 0.432 ± 0.094 for both kidneys. The highest values of FU of 0.322 ± 0.078 (0.644 ± 0.138 for both kidneys) were measured in group C. In group D, FU was 0.185 ± 0.065 (0.361 ± 0.125 for both kidneys) and in group E 0.082 ± 0.040 (0.163 ± 0.080 total). In patients with a transplanted kidney, fractional uptake was 0.162 ± 0.039 in group F and 0

  4. Renal lithiasis and nutrition

    OpenAIRE

    Prieto Rafel M; Costa-Bauza Antonia; Grases Felix

    2006-01-01

    Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins) and each type of...

  5. Renal Clearance of Nanoparticles

    OpenAIRE

    Choi, Hak Soo; Liu, Wenhao; Misra, Preeti; Tanaka, Eiichi; Zimmer, John P.; Ipe, Binil Itty; Bawendi, Moungi G.; Frangioni, John V.

    2007-01-01

    The field of nanotechnology holds great promise for the diagnosis and treatment of human disease. However, the size and charge of most nanoparticles preclude their efficient clearance from the body as intact nanoparticles. Without such clearance or their biodegradation into biologically benign components, toxicity is potentially amplified and radiological imaging is hindered. Using quantum dots (QDs) as a model system, we have precisely defined the requirements for renal filtration and urinar...

  6. Renal Replacement Therapy

    OpenAIRE

    Zaccaria Ricci; Stefano Romagnoli; Claudio Ronco

    2016-01-01

    During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute...

  7. Hyperparathyroidism of Renal Disease

    Science.gov (United States)

    Yuen, Noah K; Ananthakrishnan, Shubha; Campbell, Michael J

    2016-01-01

    Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. The Kidney Disease: Improving Global Outcomes guidelines recommend that screening and management of rHPT be initiated for all patients with chronic kidney disease stage 3 (estimated glomerular filtration rate, disease. PMID:27479950

  8. Renal Replacement Therapy.

    Science.gov (United States)

    Ricci, Zaccaria; Romagnoli, Stefano; Ronco, Claudio

    2016-01-01

    During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients' clinical picture (e.g. sepsis, fluid overload, pediatric). The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the "Tower of Babel" of critical care nephrology. PMID:26918174

  9. Drug-induced renal disorders.

    Science.gov (United States)

    Ghane Shahrbaf, Fatemeh; Assadi, Farahnak

    2015-01-01

    Drug-induced nephrotoxicity are more common among infants and young children and in certain clinical situations such as underlying renal dysfunction and cardiovascular disease. Drugs can cause acute renal injury, intrarenal obstruction, interstitial nephritis, nephrotic syndrome, and acid-base and fluid electrolytes disorders. Certain drugs can cause alteration in intraglomerular hemodynamics, inflammatory changes in renal tubular cells, leading to acute kidney injury (AKI), tubulointerstitial disease and renal scarring. Drug-induced nephrotoxicity tends to occur more frequently in patients with intravascular volume depletion, diabetes, congestive heart failure, chronic kidney disease, and sepsis. Therefore, early detection of drugs adverse effects is important to prevent progression to end-stage renal disease. Preventive measures requires knowledge of mechanisms of drug-induced nephrotoxicity, understanding patients and drug-related risk factors coupled with therapeutic intervention by correcting risk factors, assessing baseline renal function before initiation of therapy, adjusting the drug dosage and avoiding use of nephrotoxic drug combinations. PMID:26468475

  10. Trasplante renal Kidney transplant

    Directory of Open Access Journals (Sweden)

    P. Martín

    2006-08-01

    Full Text Available El trasplante renal es la terapia de elección para la mayoría de las causas de insuficiencia renal crónica terminal porque mejora la calidad de vida y la supervivencia frente a la diálisis. El trasplante renal de donante vivo es una excelente alternativa para el paciente joven en situación de prediálisis porque ofrece mejores resultados. El tratamiento inmunosupresor debe ser individualizado buscando la sinergia inmunosupresora y el mejor perfil de seguridad, y debe adaptarse a las diferentes etapas del trasplante renal. En el seguimiento del trasplante renal hay que tener muy en cuenta los factores de riesgo cardiovascular y los tumores puesto que la muerte del paciente con injerto funcionante es la segunda causa de pérdida del injerto tras el primer año del trasplante. La función alterada del injerto es un factor de mortalidad cardiovascular independiente que requerirá seguimiento y control de todas sus complicaciones para retrasar la entrada en diálisis.The kidney transplant is the therapy of choice for the majority of the causes of chronic terminal kidney insufficiency, because it improves the quality of life and survival in comparison with dialysis. A kidney transplant from a live donor is an excellent alternative for the young patient in a state of pre-dialysis because it offers the best results. Immunosuppressive treatment must be individualised, seeking immunosuppressive synergy and the best safety profile, and must be adapted to the different stages of the kidney transplant. In the follow-up to the kidney transplant, cardiovascular risk factors and tumours must be especially taken into account, given that the death of the patient with a working graft is the second cause of loss of the graft following the first year of the transplant. The altered function of the graft is a factor of independent cardiovascular mortality that will require follow-up and the control of all its complications to postpone the entrance in dialysis.

  11. The epidemiology of renal trauma

    OpenAIRE

    Voelzke, Bryan B.; Leddy, Laura

    2014-01-01

    Introduction Nonoperative and minimally invasive management techniques for both blunt and penetrating renal trauma have become standard of care over the past decades. We sought to examine the modern epidemiology of renal trauma over the past decade. Methods A systematic review of PubMed from the past decade was conducted to examine adult and pediatric renal trauma. A total of 605 articles were identified. Of these, 15 adult and 5 pediatric articles met our a priori search criteria. Results Th...

  12. Renal Dysfunction and Cardiovascular Disease

    OpenAIRE

    Soveri, Inga

    2006-01-01

    Kidney dysfunction increases cardiovascular disease (CVD) risk. The mechanisms for the risk increase seem to involve a combination of traditional and non-traditional CVD risk factors. We studied renal dysfunction as CVD and mortality risk factor in middle-aged men free from diabetes and CVD. The risk for myocardial infarction (MI) and CVD mortality was increased by ~40% in the 16.5% of men with worse renal function, independent of other CVD risk factors. Renal transplant dysfunction as CVD an...

  13. Taurine and the renal system

    OpenAIRE

    Chesney Russell W; Han Xiaobin; Patters Andrea B

    2010-01-01

    Abstract Taurine participates in a number of different physiologic and biologic processes in the kidney, often reflected by urinary excretion patterns. The kidney is key to aspects of taurine body pool size and homeostasis. This review will examine the renal-taurine interactions relative to ion reabsorption; renal blood flow and renal vascular endothelial function; antioxidant properties, especially in the glomerulus; and the role of taurine in ischemia and reperfusion injury. In addition, ta...

  14. Renal replacement therapy in ICU

    Directory of Open Access Journals (Sweden)

    C Deepa

    2012-01-01

    Full Text Available Diagnosing and managing critically ill patients with renal dysfunction is a part of the daily routine of an intensivist. Acute kidney insufficiency substantially contributes to the morbidity and mortality of critically ill patients. Renal replacement therapy (RRT not only does play a significant role in the treatment of patients with renal failure, acute as well as chronic, but also has spread its domains to the treatment of many other disease conditions such as myaesthenia gravis, septic shock and acute on chronic liver failure. This article briefly outlines the role of renal replacement therapy in ICU.

  15. Renal Carcinogenesis After Uninephrectomy1

    OpenAIRE

    Sui, Yi; ZHAO, HAI-LU; Lee, Heung Man; Guan, Jing; He, Lan; Lai, Fernand MM; Tong, Peter CY; Chan, Juliana CN

    2009-01-01

    Nephrectomized rats have widely been used to study chronic renal failure. Interestingly, renal cell carcinoma occurred in the remnant kidney after uninephrectomy (UNX). In this study, we probed insulin-like growth factor (IGF)-1 signaling pathway in UNX-induced renal cancer. Adult male Sprague-Dawley rats were randomized into two groups: UNX rats (n = 22) and sham-operated rats (n = 12). Rats were killed at 3, 7, and 10 months. After 7 months after nephrectomy, the UNX rats developed renal ce...

  16. Segmental renal dysplasia--a case report.

    OpenAIRE

    Gupta S; Chumber S; Sharma L

    1995-01-01

    A case of segmental renal dysplasia presenting with loin pain, a renal mass and hypertension in a young girl of 16 years is being reported. Clinical and histological features of this rare renal anomaly are discussed.

  17. Genetics Home Reference: renal coloboma syndrome

    Science.gov (United States)

    ... syndrome include backflow of urine from the bladder (vesicoureteral reflux), multiple kidney cysts, loose joints, and mild hearing ... disease coloboma-ureteral-renal syndrome ONCR optic coloboma, vesicoureteral reflux, and renal anomalies optic nerve coloboma renal syndrome ...

  18. The renal scan in pregnant renal transplant patients

    International Nuclear Information System (INIS)

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts

  19. Early diagnosis of renal disease and renal failure.

    Science.gov (United States)

    Lees, George E

    2004-07-01

    The main goal of early diagnosis of renal disease and renal failure in dogs and cats is to enable timely application of therapeutic interventions that may slow or halt disease progression. Strategies for early diagnosis of renal disease use urine tests that detect proteinuria that is a manifestation of altered glomerular permselectivity or impaired urine-concentrating ability as well blood tests to evaluate plasma creatinine concentration. Animals with progressive renal disease should be carefully investigated and treated appropriately. Animals with mild, possibly nonprogressive, renal disease should be monitored adequately to detect any worsening trends,which should lead to further investigation and treatment even if the increments of change are small. PMID:15223206

  20. Renal posttransplant's vascular complications

    Directory of Open Access Journals (Sweden)

    Bašić Dragoslav

    2003-01-01

    Full Text Available INTRODUCTION Despite high graft and recipient survival figures worldwide today, a variety of technical complications can threaten the transplant in the postoperative period. Vascular complications are commonly related to technical problems in establishing vascular continuity or to damage that occurs during donor nephrectomy or preservation [13]. AIM The aim of the presenting study is to evaluate counts and rates of vascular complications after renal transplantation and to compare the outcome by donor type. MATERIAL AND METHODS A total of 463 kidneys (319 from living related donor LD and 144 from cadaveric donor - CD were transplanted during the period between June 1975 and December 1998 at the Urology & Nephrology Institute of Clinical Centre of Serbia in Belgrade. Average recipients' age was 33.7 years (15-54 in LD group and 39.8 (19-62 in CD group. Retrospectively, we analyzed medical records of all recipients. Statistical analysis is estimated using Hi-squared test and Fischer's test of exact probability. RESULTS Major vascular complications including vascular anastomosis thrombosis, internal iliac artery stenosis, internal iliac artery rupture obliterant vasculitis and external iliac vein rupture were analyzed. In 25 recipients (5.4% some of major vascular complications were detected. Among these cases, 22 of them were from CD group vs. three from LD group. Relative rate of these complications was higher in CD group vs. LD group (p<0.0001. Among these complications dominant one was vascular anastomosis thrombosis which occurred in 18 recipients (17 from CD vs. one from LD. Of these recipients 16 from CD lost the graft, while the rest of two (one from each group had lethal outcome. DISCUSSION Thrombosis of renal allograft vascular anastomosis site is the most severe complication following renal transplantation. In the literature, renal allograft thrombosis is reported with different incidence rates, from 0.5-4% [14, 15, 16]. Data from the

  1. Citrato y litiasis renal

    Directory of Open Access Journals (Sweden)

    Elisa E. Del Valle

    2013-08-01

    Full Text Available El citrato es un potente inhibidor de la cristalización de sales de calcio. La hipocitraturia es una alteración bioquímica frecuente en la formación de cálculos de calcio en adultos y especialmente en niños. El pH ácido (sistémico, tubular e intracelular es el principal determinante de la excreción de citrato en la orina. Si bien la mayoría de los pacientes con litiasis renal presentan hipocitraturia idiopática, hay un número de causas para esta anormalidad que incluyen acidosis tubular renal distal, hipokalemia, dietas ricas en proteínas de origen animal y/o dietas bajas en álcalis y ciertas drogas, como la acetazolamida, topiramato, IECA y tiazidas. Las modificaciones dietéticas que benefician a estos pacientes incluyen: alta ingesta de líquidos y frutas, especialmente cítricos, restricción de sodio y proteínas, con consumo normal de calcio. El tratamiento con citrato de potasio es efectivo en pacientes con hipocitraturia primaria o secundaria y en aquellos desordenes en la acidificación, que provocan un pH urinario persistentemente ácido. Los efectos adversos son bajos y están referidos al tracto gastrointestinal. Si bien hay diferentes preparaciones de citrato (citrato de potasio, citrato de sodio, citrato de potasio-magnesio en nuestro país solo está disponible el citrato de potasio en polvo que es muy útil para corregir la hipocitraturia y el pH urinario bajo, y reducir marcadamente la recurrencia de la litiasis renal.

  2. Renal metabolism of calcitonin

    International Nuclear Information System (INIS)

    The kidneys account for approximately two-thirds of the metabolism of calcitonin, but relatively little is known regarding the details thereof. To further characterize this process, we examined the renal handling and metabolism of human calcitonin (hCT) by the isolated perfused rat kidney. We also studied the degradation of radiolabeled salmon calcitonin (sCT) by subcellular fractions prepared from isolated rabbit proximal tubules. The total renal (organ) clearance of immunoreactive hCT by the isolated kidney was 1.96 +/- 0.18 ml/min. This was independent of the perfusate total calcium concentration from 5.5 to 10.2 mg/dl. Total renal clearance exceeded the glomerular filtration rate (GFR, 0.68 +/- 0.05 ml/min), indicating filtration-independent removal. Urinary calcitonin clearance as a fraction of GFR averaged 2.6%. Gel filtration chromatography of medium from isolated kidneys perfused with 125I-labeled sCT showed the principal degradation products to be low molecular weight forms eluting with monoiodotyrosine. Intermediate size products were not detected. In the subcellular fractionation experiments, when carried out at pH 5.0, calcitonin hydrolysis exclusively followed the activities of the lysosomal enzyme N-acetyl-beta-glucosaminidase. Typically, at pH 7.5, 42% of total degradation occurred in the region of the brush-border enzyme alanyl aminopeptidase and 29% occurred in the region of the cytosolic enzyme phosphoglucomutase. Although 9% of the calcitonin-degrading activity was associated with basolateral membrane fractions, most of this activity could be accounted for by the presence of brush-border membranes

  3. Imaging of renal metastases

    International Nuclear Information System (INIS)

    Metastases are the most frequent malignant tumors of the kidney, but these lesions are of late onset in neoplastic disease. The 19 cases reported here were all investigated with various imaging techniques (CT 12 cases, ultrasonography 12 cases, urography 8 cases, angiography 2 cases, MRI 1 case). The most common primary malignancies were lung cancer, melanoma and cancer of the controlateral kidney. In this series, 8 of the lesions were solitary, and 9 were unilateral. Tumor vascularity was evaluated in 15 cases: 14 of these lesions were hypovascular. The differential diagnosis includes small cysts, lymphoma, bilateral renal cancer, multiple small abscesses and multiple small infarcts

  4. Leiomyosarcoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Lemos Gustavo C.

    2003-01-01

    Full Text Available Leiomyosarcoma of the renal vein is a rare tumor of complex diagnosis. We presented a case of renal vein leiomyosarcoma detected in a routine study. The primary treatment was complete surgical removal of the mass. In cases where surgical removal is not possible the prognosis is poor, with high rates of local recurrence and distant spread.

  5. Future aspects of renal transplantation*

    OpenAIRE

    Makowka, L.; Lopatin, W.B.; Shapiro, R.; Tzakis, A.G.; Starzl, T.E.

    1988-01-01

    New and exciting advances in renal transplantation are continuously being made, and the horizons for organ transplantation are bright and open. This article reviews only a few of the newer advances that will allow renal transplantation to become even more widespread and successful. The important and exciting implications for extrarenal organ transplantation are immediately evident.

  6. Renal involvement in behcet's disease

    International Nuclear Information System (INIS)

    There are conflicting reports about the renal involvement in Behcet's disease (BD). In this study we aimed to study the frequency and type of renal involvement in a group of patients with BD in Azerbaijan province that is one of the prevalent areas of BD in Iran. All cases of BD were prospectively followed between June 2004 and January 2007, and evaluated for renal dys-function (serum creatinine > 1.7 mg/dL), glomerular hematuria and proteinuria. Those patients with proteinuria > 500 mg/day and serum creatinine level > 2 mg/dL, underwent renal biopsy. From a total number of 100 patients, six patients (6%) had obvious renal involvements. Four patients had glomerular hematuria and proteinuria. Renal biopsy in two of them revealed measangial proliferative glumerulonephritis with IgA deposit in one of them and membranoproliferative glumerolonephritis in another one. Two remaining patients had serum creatinine > 2 mg/dL without any hematuria or proteinuria. Serologic study for viral agents and collagen vascular disease were negative in all patients with renal involvements. In conclusion, renal involvement in BD is not infrequent, although in most cases it is mild in nature and may be missed. (author)

  7. Renal replacement therapy in Europe

    DEFF Research Database (Denmark)

    Pippias, Maria; Stel, Vianda S; Abad Diez, José Maria;

    2015-01-01

    BACKGROUND: This article summarizes the 2012 European Renal Association-European Dialysis and Transplant Association Registry Annual Report (available at www.era-edta-reg.org) with a specific focus on older patients (defined as ≥65 years). METHODS: Data provided by 45 national or regional renal r...

  8. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... renal abnormalities include renal ultrasonography, CT scanning and magnetic resonance imaging (MRI). These are all non-invasive procedures that are ... least detailed image of the kidney, while the MRI provides the most detailed. In general, the ultrasound ...

  9. Renal Heme Oxygenase-1 Induction with Hemin Augments Renal Hemodynamics, Renal Autoregulation, and Excretory Function

    Science.gov (United States)

    Botros, Fady T.; Dobrowolski, Leszek; Navar, L. Gabriel

    2012-01-01

    Heme oxygenases (HO-1; HO-2) catalyze conversion of heme to free iron, carbon monoxide, and biliverdin/bilirubin. To determine the effects of renal HO-1 induction on blood pressure and renal function, normal control rats (n = 7) and hemin-treated rats (n = 6) were studied. Renal clearance studies were performed on anesthetized rats to assess renal function; renal blood flow (RBF) was measured using a transonic flow probe placed around the left renal artery. Hemin treatment significantly induced renal HO-1. Mean arterial pressure and heart rate were not different (115 ± 5 mmHg versus 112 ± 4 mmHg and 331 ± 16 versus 346 ± 10 bpm). However, RBF was significantly higher (9.1 ± 0.8 versus 7.0 ± 0.5 mL/min/g, P < 0.05), and renal vascular resistance was significantly lower (13.0 ± 0.9 versus 16.6 ± 1.4 [mmHg/(mL/min/g)], P < 0.05). Likewise, glomerular filtration rate was significantly elevated (1.4 ± 0.2 versus 1.0 ± 0.1 mL/min/g, P < 0.05), and urine flow and sodium excretion were also higher (18.9 ± 3.9 versus 8.2 ± 1.0 μL/min/g, P < 0.05 and 1.9 ± 0.6 versus 0.2 ± 0.1 μmol/min/g, P < 0.05, resp.). The plateau of the autoregulation relationship was elevated, and renal vascular responses to acute angiotensin II infusion were attenuated in hemin-treated rats reflecting the vasodilatory effect of HO-1 induction. We conclude that renal HO-1 induction augments renal function which may contribute to the antihypertensive effects of HO-1 induction observed in hypertension models. PMID:22518281

  10. Renal biopsy: methods and interpretation.

    Science.gov (United States)

    Vaden, Shelly L

    2004-07-01

    Renal biopsy most often is indicated in the management of dogs and cats with glomerular disease or acute renal failure. Renal biopsy can readily be performed in dogs and cats via either percutaneous or surgical methods. Care should be taken to ensure that proper technique is used. When proper technique is employed and patient factors are properly addressed, renal biopsy is a relatively safe procedure that minimally affects renal function. Patients should be monitored during the post biopsy period for severe hemorrhage, the most common complication. Accurate diagnosis of glomerular disease, and therefore, accurate treatment planning,requires that the biopsy specimens not only be evaluated by light microscopy using special stains but by electron and immunofluorescent microscopy. PMID:15223207

  11. Renal transplantation in infants.

    Science.gov (United States)

    Jalanko, Hannu; Mattila, Ilkka; Holmberg, Christer

    2016-05-01

    Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively. PMID:26115617

  12. Ultrasound of renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Baxter, G.M

    2001-10-01

    The most effective primary treatment of chronic renal failure is renal transplantation. A significant improvement in lifestyle and family life in conjunction with it being an extremely cost-effective procedure has resulted in an intense monitoring and imaging programme to help ensure a successful outcome. Ultrasound, both grey-scale and colour-flow Doppler, are useful monitoring techniques when interpreted in the clinical context, and in the delineation of peri-transplant collections, some of which can be drained under ultrasound guidance. After the early post-operative period it can also be utilized in the diagnosis of chronic vascular complications including transplant artery stenosis and arteriovenous fistula, although it is of limited use in the diagnosis of chronic rejection. This article will discuss the role of ultrasound in all its guises and how its efficacy in both the early transplant period in the monitoring of graft dysfunction and in the detection of the more chronic conditions including transplant artery stenosis and arteriovenous fistulae. A more limited role for ultrasound also exists in the long-term follow-up of patients and to aid the detection of complications including susceptibility to malignancy. Baxter, G.M. (2001)

  13. 99Tcm-diethylenetriaminepenta hydroxamic acid renal dynamic imaging to evaluate split renal GFR of unilateral renal function failure patient

    International Nuclear Information System (INIS)

    Objective: To explore the use of evaluating split glomerular flow rate (GFB) in patients with unilateral renal function failure by 99Tcm-diethylenetriaminepenta hydroxamic acid renal dynamic imaging. Methods: Split GFR of 82 cases with unilateral renal function failure was evaluated by 99Tcm- DTPA renal dynamic imaging, and was correlated with serum creatinine (SCr). Beside, causes of renal function failure were analyzed. Results: Split CFR were negatively correlated with SCr(r=-0.643, P99Tcm-DTPA renal dynamic imaging to treat early and reserve renal function. (authors)

  14. Renal acidification defects in medullary sponge kidney

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1988-01-01

    Thirteen patients with medullary sponge kidney underwent a short ammonium chloride loading test to investigate their renal acidification capacity. All but 1 presented with a history of recurrent renal calculi and showed bilateral widespread renal medullary calcification on X-ray examination. Nine...... renal calculi in medullary sponge kidney, have considerable therapeutic implications....

  15. Integrated imaging of neonatal renal masses

    Energy Technology Data Exchange (ETDEWEB)

    Kirks, D.R.; Rosenberg, E.R.; Johnson, D.G.; King, L.R.

    1985-02-01

    Thirty-three neonatal renal masses were evaluated during a 2 year interval. The final diagnoses in these 33 patients were hydronephrosis, multicystic dysplastic kidney, renal vein thrombosis, obstructed upper pole duplication, polycystic kidney disease, nephroblastomatosis, and mesoblastic nephroma. We recommend an integrated imaging approach that utilizes sonography to clarify anatomy and renal scintigraphy or excretory urography to determine renal function.

  16. RENAL DAMAGE WITH MALIGNANT NEOPLASMS

    Directory of Open Access Journals (Sweden)

    I. B. Kolina

    2015-01-01

    Full Text Available The relationship between renal damage and malignant neoplasms is one of the most actual problems of the medicine of internal diseases. Very often, exactly availability of renal damage determines the forecast of cancer patients. The range of renal pathologies associated with tumors is unusually wide: from the mechanical effect of the tumor or metastases on the kidneys and/or the urinary tract and paraneoplastic manifestations in the form of nephritis or amyloidosis to nephropathies induced with drugs or tumor lysis, etc. Thrombotic complications that develop as a result of exposure to tumor effects, side effects of certain drugs or irradiation also play an important role in the development of the kidney damage. The most frequent variants of renal damage observed in the practice of medical internists (therapists, urologists, surgeons, etc., as well as methods of diagnosis and treatment approaches are described in the article. Timely and successful prevention and treatment of tumor-associated nephropathies give hope for retaining renal functions, therefore, a higher life standard after completion of anti-tumor therapy. Even a shortterm episode of acute renal damage suffered by a cancer patient must be accompanied with relevant examination and treatment. In the caseof transformation of acute renal damage into the chronic kidney disease, such patients need systematic and weighted renoprotective therapy and correct dosing of nephrotoxic drugs.

  17. Mature Cystic Renal Teratoma

    International Nuclear Information System (INIS)

    Teratomas are rare germline tumors that originate from one or more embryonic germ cell layers. Teratoma of the kidney is extremely rare, and less than 30 cases of primary intrarenal teratomas have been published to date. We report the main radiologic features of an unusual case of mature cystic teratoma arising from the left kidney in a two-year-old boy. A left-sided abdominal mass was detected on physical examination and B-Mod Ultrasound (US) examination revealed a heterogeneous mass with central cystic component. Computed tomography (CT) demonstrated a lobulated, heterogeneous, hypodense mass extending craniocaudally from the splenic hilum to the level of the left iliac fossa. Nephrectomy was performed and a large, fatty mass arising from the left kidney was excised. The final pathologic diagnosis was confirmed as cystic renal teratoma

  18. [Cystic renal pathology].

    Science.gov (United States)

    Rosi, P; Cesaroni, M; Bracarda, S; Rociola, W; Virgili, G

    1993-08-01

    Ultrasonography has a great interest in diagnosis of cystic kidney disorders for typical eco-pattern of this pathology. In this work we show the eco-pattern of the most common cystic kidney disorders. Particularly we examine simple cysts (typical, atypical, complicated), multicystic kidney dysplasia, autosomal recessive polycystic kidney disease (infantile) autosomal dominant polycystic kidney disease (adult age). The so-called neoplastic cysts (multiloculated cysts, multiloculated cysts nephroma, cystic nephroblastoma), medullar cysts (medullary sponge kidney, medullary cystic disease), parapyelic cysts, acquired cystic kidney disease in renal failure patients, parasitic cysts, epidermoid cysts. About this disorders we present the more typical and expressive ultrasonographic appearance and we define the role and the opportunity of diagnostic setting by echography, moreover ultrasonography allows us to make a differential diagnosis between cystic kidney disorders and other kidney disease. PMID:8353538

  19. Genetic Counseling in Renal Masses

    OpenAIRE

    José Antonio López-Guerrero; Zaida García-Casado; Antonio Fernández-Serra; José Rubio-Briones

    2008-01-01

    All urologists have faced patients suffering a renal cancer asking for the occurrence of the disease in their offspring and very often the answer to this question has not been well founded from the scientific point of view, and only in few cases a familial segregation tree is performed. The grate shift seen in the detection of small renal masses and renal cancer in the last decades will prompt us to know the indications for familial studies, which and when are necessary, and probably to refer...

  20. Non-renal urological lymphomas

    International Nuclear Information System (INIS)

    IVP, US and CT findings for 5 rare cases of non-renal lymphomas of the urinary tract are discussed. The 4 non-Hodgkin lymphomas (NHL) and 1 Hodgkin's disease (HD) involved the ureter (2 cases), bladder (2 cases) and renal pelvis (1 case). US and CT visualised the pyelic lesion (undetected by urography) as wall thickening and detected the two ureteral lesions (which were also revealed by antegrade pyelography for the 1 HD and by retrograde pyelography for an ureteral NHL). One bladder lesion was associated with a renal lesion (CT demonstrated retroperitoneal lymph nodes); the other was a multinodular form infiltrating the entire bladder. (orig.)

  1. Hypertension Caused by Renal Arteriovenous Fistula

    OpenAIRE

    An, Hye-Sung; Kang, Tae-Gon; Yun, Hyun-Jin; Kim, Myo-Jing; Jung, Jin-A; Yoo, Jae-Ho; Lee, Young-Seok

    2009-01-01

    We describe a case of secondary hypertension caused by renal arteriovenous fistula. An 8-year old girl was hospitalized with a severe headache, vomiting, and seizure. Renal angiography demonstrated multiple renal arteriovenous fistula and increased blood renin concentration in the left renal vein. Thus, left renal arteriovenous fistula and renin induced secondary hypertension were diagnosed. Her blood pressure was well controlled by medication with angiotensin converting enzyme inhibitor.

  2. Renal vein thrombosis in transitional cell carcinoma

    International Nuclear Information System (INIS)

    Full text: A rare case of renal transitional cell carcinoma (TCC) associated with bland thrombus of the renal vein extending into the inferior vena cava is described. Tumour thrombus in renal cell carcinoma is frequently encountered, but only very rarely occurs with TCC. Bland renal vein thrombosis occurring with renal TCC has not been described before. Contrast enhanced computed tomography assisted in distinguishing between bland and tumour thrombosis and aided in surgical management

  3. Case of hereditary papillary renal cell carcinoma

    OpenAIRE

    Mustafa, Sadaf; Jadidi, Nima; Faraj, Sheila F.; Rodriquez, Ronald

    2012-01-01

    Renal cell carcinoma is the most common type of renal malignancy and it originates from the renal tubular epithelium. Due to the diversity in the histopathological and molecular characteristics, it is typically subclassified into five different categories. Papillary renal cell carcinoma is one subclassification and it includes two variants: sporadic and hereditary. Although the hereditary form comprises a smaller number of cases of papillary renal cell carcinoma, an understanding of the molec...

  4. Acute renal dysfunction in liver diseases

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Renal dysfunction is common in liver diseases, either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. The presence of renal impairment in both groups is a poor prognostic indicator. Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction. Obstructive or post renal dysfunction only rarely complicates liver disease. Hepatorenal syndrome (MRS) is a unique form of renal failure associated with advanced liver disease or cirrhosis, and is characterized by functional renal impairment without significant changes in renal histology. Irrespective of the type of renal failure, renal hypoperfusion is the central pathogenetic mechanism, due either to reduced perfusion pressure or increased renal vascular resistance. Volume expansion, avoidance of precipitating factors and treatment of underlying liver disease constitute the mainstay of therapy to prevent and reverse renal impairment. Splanchnic vasoconstrictor agents, such as terlipressin, along with volume expansion, and early placement of transjugular intrahepatic portosystemic shunt (TIPS) may be effective in improving renal function in HRS. Continuous renal replacement therapy (CRRT) and molecular absorbent recirculating system (MARS) in selected patients may be life saving while awaiting liver transplantation.

  5. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... transplantation would be indicated. Renal Cell Carcinoma (Kidney Cancer) Over the past 20 years, there have been at least 25 published reports of kidney cancer occurring in individuals with TSC. Drs. Bjornsson, Short, ...

  6. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... and lead to bleeding. About 20% of the time this bleeding is life-threatening. Approximately 80 percent ... with TSC will experience angiomyolipomas. Most of the time both kidneys are involved. Renal cysts are often ...

  7. Radiological evaluation of renal transplantation

    International Nuclear Information System (INIS)

    Briefly discussed the nephrologic complications, episodes of rejection, acute tubular necrosis, cyclosporine, urologic complications, perirenal fluid collections, small asymptomatic hematomas, urinomas, abscesses, lymphocele, ureteral obstruction, cascular complications, imaging of the renal allograft, radionuclide imaging, ultrasonography, conventional radiography, cystograhy (8 refs.)

  8. Renal cell carcinoma in childhood

    International Nuclear Information System (INIS)

    The authors present five cases of renal cell carcinoma in children, describing its aspects on excretory urography, ultra-sonography and computerized tomography. The clinical, pathological and radiological features are compared with those of the literature. (author)

  9. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... abdominal or back pain, nausea and vomiting and fever. For the individual who is non-verbal, this ... significant back or abdominal pain, nausea, vomiting and fever. If these growths involve both kidneys, renal failure ...

  10. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... kidney disease can develop in infancy or early childhood and renal failure most often occurs in early ... should be performed by a team with TSC experience, many individuals with TSC can maintain normal kidney ...

  11. Clinical study on renal trauma

    International Nuclear Information System (INIS)

    We analyzed 26 cases of renal trauma, which occurred during the last 7 years and 6 months. Computed tomography was performed in all cases. Four cases were of type Ib, 13 cases of type II, 3 cases of type IIIa, 5 cases of type IIIb and 1 case of type IVa, according to the classification of renal injury by the Japanese association for the surgery of trauma. Conservative treatment was done in 21 cases, selective transcatheter arterial embolization (TAE) in 4 cases, and surgical treatment in 1 case. Conservative treatment was effective for type I and II renal trauma. In the cases of type IIIa and IIIb renal trauma, open surgery could be avoided and the affected kidney preserved by early TAE. (author)

  12. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... majority of individuals (greater than 80 percent) with tuberous sclerosis complex (TSC) will develop some form of renal ( ... Dallas, TX. November 2013. **This publication from the Tuberous Sclerosis Alliance is intended to provide basic information about ...

  13. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... History Database Tissue Donation Audio & Video Archives Brochures, Books, & Booklets Information Sheets Perspective Magazine Archives Life Stages ... Scientific Advisory Board 2015 International TSC Research Conference Text Size Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC ...

  14. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... increased blood pressure, but usually they do not cause discomfort. However, sometimes the kidney is filled with cysts, and this can lead to kidney impairment and even kidney failure, requiring dialysis or transplantation. Lastly, renal cell carcinoma, ...

  15. Markers of renal function tests

    Directory of Open Access Journals (Sweden)

    Shivaraj Gowda

    2010-01-01

    Full Text Available Background : The markers of renal function test assess the normal functioning of kidneys. These markers may be radioactive and non radioactive. They indicate the glomerular filtration rate, concentrating and diluting capacity of kidneys (tubular function. If there is an increase or decrease in the valves of these markers it indicates dysfunction of kidney. Aim: The aim of this review is to compare and analyze the present and newer markers of renal function tests which help in diagnosis of clinical disorders. Material & Methods: An extensive literature survey was done aiming to compare and compile renal function tests makers required in diagnosis of diseases. Results: Creatinine, urea, uric acid and electrolytes are makers for routine analysis whereas several studies have confirmed and consolidated the usefulness of markers such as cystatin C and β-Trace Protein. Conclusion: We conclude that further investigation is necessary to define these biomarkers in terms of usefulness in assessing renal function.

  16. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... depending on the size of the involvement, further management can be recommended. Individuals with TSC and angiomyolipomas less than 4 cm would benefit from repeat renal imaging every one to two ...

  17. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... with cysts. If kidney failure occurs, renal replacement therapy such as dialysis or transplantation is necessary. How kidney cysts develop is not known. The TSC genes are tumor suppressor genes. Normally, tumor suppressor genes ...

  18. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... of individuals (greater than 80 percent) with tuberous sclerosis complex (TSC) will develop some form of renal ( ... TX. November 2013. **This publication from the Tuberous Sclerosis Alliance is intended to provide basic information about ...

  19. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... rare, such a lesion must be kept in mind. Diagnosis The current methods to diagnosis these renal ... nor does it, constitute medical or other advice. Readers are warned not to take any action with ...

  20. Pulmonary edema in renal failure

    International Nuclear Information System (INIS)

    Forty-nine cases of pulmonary edema in nephropatic patients were studied. The most frequent radiologic findings are discussed. The unreliability of a precise differentiation between ''cardiac'' and ''renal'' patterns of pulmonary edema in nephropatic patients is emphasized

  1. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... include renal ultrasonography, CT scanning and magnetic resonance imaging (MRI). These are all non-invasive procedures that ... be done to calibrate and correlate with ultrasound imaging. Repeat CT scans should be limited to reduce ...

  2. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... with cysts. If kidney failure occurs, renal replacement therapy such as dialysis or transplantation is necessary. How ... significant and occasionally life threatening. Therefore, diagnosis and treatment guidelines have been proposed to initially identify which ...

  3. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... procedures that are available in almost every major medical center. The renal ultrasound provides the least detailed ... Henske, M.D., Brigham and Women's Hospital, Harvard Medical School and Dana Farber Cancer Institute, Boston, MA, ...

  4. Stages of Renal Cell Cancer

    Science.gov (United States)

    ... cell cancer is a disease in which malignant (cancer) cells form in tubules of the kidney. Renal cell ... diagnosed, tests are done to find out if cancer cells have spread within the kidney or to other ...

  5. Transcatheter embolisation of renal angiomyolipoma.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-01

    Angiomyolipomas (AML) are rare benign renal tumours which are associated with aneurysms that can cause haemorrhage. Embolisation of AML greater than 4 cm with a variety of embolic agents is now the first-line treatment in these cases.

  6. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... individuals (greater than 80 percent) with tuberous sclerosis complex (TSC) will develop some form of renal (kidney) ... intended to provide basic information about tuberous sclerosis complex (TSC). It is not intended to, nor does ...

  7. Cystic renal neoplasms and renal neoplasms associated with cystic renal diseases in adults: cross-sectional imaging findings.

    Science.gov (United States)

    Katabathina, Venkata S; Garg, Deepak; Prasad, Srinivasa R; Vikram, Raghu

    2012-01-01

    Cystic renal neoplasms in adults are a heterogeneous group of tumors with characteristic histogenesis, pathological findings, and variable biological profiles. They include disparate entities that are either biologically benign (lymphangioma, cystic nephroma, and mixed epithelial and stromal tumor) or malignant (cystic renal cell carcinoma, multilocular cystic renal cell carcinoma, and primary renal synovial sarcoma). Renal cystic diseases are characterized by cystic changes of the kidneys due to hereditary, developmental, or acquired etiology. Cystic renal diseases such as acquired cystic kidney disease, von Hippel-Lindau disease, and tuberous sclerosis are associated with the development of a wide spectrum of benign and malignant renal neoplasms. Most cystic renal tumors and cystic disease-associated renal neoplasms show characteristic cross-sectional imaging findings that permit accurate diagnosis. In addition, cross-sectional imaging is pivotal in the follow-up and surveillance of adult cystic tumors of the kidney. PMID:23192202

  8. New treatments for renal carcinoma

    OpenAIRE

    Perez-Gracia, J L; Lopez-Picazo, J M; Olier, C. (Clara); ALFARO, C.; Garcia-Foncillas, J; Melero, I; Gurpide, A

    2007-01-01

    Renal cell carcinoma presents several unique features, which distinguish it from other tumours. The increase in survival that has been described in patients with renal cell carcinoma following nephrectomy breaks a classical rule of oncology, which states that surgery of the primary tumour has no role in the treatment of patients with advanced disease. Together with melanoma, it is the only tumour in which immunomodulatory treatments with drugs such as interleukin-2 produces a clinical benefit...

  9. On renal pathophysiology in preeclampsia

    OpenAIRE

    Penning, Maria Elisabeth (Marlies)

    2014-01-01

    Preeclampsia is a complication of pregnancy which can suddenly change from a relatively mild phenotype into a life-threatening situation. One of the organs that is always involved during preeclampsia is the kidney. The placenta plays an important role in the renal pathophysiology of preeclampsia. The placenta produces excessive amounts of anti-angiogenic factors which are associated with systemic endothelial dysfunction. Although the underlying mechanisms of renal injury during preeclampsia r...

  10. Chickenpox infection after renal transplantation

    OpenAIRE

    Kaul, Anupma; Sharma, Raj K.; Bhadhuria, Dharmendra; Gupta, Amit; Prasad, Narayan

    2012-01-01

    Background. Chicken pox, although a common infection among children, is rare in immunocompromised patients, particularly renal transplant recipients, and carries a very high incidence of morbidity and mortality There is little data on chickenpox in adult renal transplant recipients, although reports have suggested that it may follow a virulent course requiring frequent hospitalization, and in severe cases can cause death. Aims. To evaluate the incidence, severity and complications of a varice...

  11. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases

    OpenAIRE

    Xiao, Jiantao; LEI, JUN; He, Leye; YIN, GUANGMING

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute gr...

  12. MR Imaging of renal transplants

    International Nuclear Information System (INIS)

    The authors report their experience in the study of renal transplant recipients by MR, in order to determine its clinical potentials. The main purpose of this work is to focus on MR patterns in relation to clinical findings of rejector or normally fuctioning kidney. Twenty-four patients were examined with a 0.5 T superconductive magnete, body coil, spin-echo pulse sequence (SE) and inversion-recovery (IR). MRI patterns could be seen in normally functioning kidneys and transplant rejections, while variable MRI findings were observed in transplants with acute tubular necrosis (ATN). In the normally functioning transplanted kidney there is a clear corticomedullary differentiation (CMD), and the extent of vascular penetration into the renal parenchyma is clearly seen. In transplant rejection, CMD is either diminished or absent, and there is no vascular penetration into the parenchyma; to differentiate acute from chronic rejections, the increase/decrease in renal size and the change in renal shape (spherical shape in acute transplant rejection) respectively must be observed. MRI proves thus to be useful in the study of renal transplants, even in case of questionable clinical findings, and in patients in whom renal biopsy is contraindicated

  13. Pathophysiology and management of progressive renal disease.

    Science.gov (United States)

    Brown, S A; Crowell, W A; Brown, C A; Barsanti, J A; Finco, D R

    1997-09-01

    Recently, the hypothesis that all renal diseases are inherently progressive and self-perpetuating has focused attention on adaptive changes in renal structure and function that occur whenever renal function is reduced. These glomerular adaptations to renal disease include increases in filtration rate, capillary pressure and size, and are referred to as glomerular hyperfiltration, glomerular hypertension and glomerular hypertrophy, respectively. Extrarenal changes, such as dietary phosphate excess, systemic hypertension, hyperlipidaemia, acidosis and hyperparathyroidism occur in animals with renal disease and may be contributors to progression of renal disease. Emphasis in the management of companion animals with renal disease has shifted to identifying, understanding and controlling those processes that play a role in the progression from early to end-stage renal failure. Advances made by veterinary nephrologists in the past 15 years permit resolution of old controversies, formulation of new hypotheses and discussion of unresolved issues about the nature of progressive renal disease in dogs and cats. PMID:9308397

  14. Renal Heme Oxygenase-1 Induction with Hemin Augments Renal Hemodynamics, Renal Autoregulation, and Excretory Function

    Directory of Open Access Journals (Sweden)

    Fady T. Botros

    2012-01-01

    Full Text Available Heme oxygenases (HO-1; HO-2 catalyze conversion of heme to free iron, carbon monoxide, and biliverdin/bilirubin. To determine the effects of renal HO-1 induction on blood pressure and renal function, normal control rats (n=7 and hemin-treated rats (n=6 were studied. Renal clearance studies were performed on anesthetized rats to assess renal function; renal blood flow (RBF was measured using a transonic flow probe placed around the left renal artery. Hemin treatment significantly induced renal HO-1. Mean arterial pressure and heart rate were not different (115±5 mmHg versus 112±4 mmHg and 331±16 versus 346±10 bpm. However, RBF was significantly higher (9.1±0.8 versus 7.0±0.5 mL/min/g, P<0.05, and renal vascular resistance was significantly lower (13.0±0.9 versus 16.6±1.4 [mmHg/(mL/min/g], P<0.05. Likewise, glomerular filtration rate was significantly elevated (1.4±0.2 versus 1.0±0.1 mL/min/g, P<0.05, and urine flow and sodium excretion were also higher (18.9±3.9 versus 8.2±1.0 μL/min/g, P<0.05 and 1.9±0.6 versus 0.2±0.1 μmol/min/g, P<0.05, resp.. The plateau of the autoregulation relationship was elevated, and renal vascular responses to acute angiotensin II infusion were attenuated in hemin-treated rats reflecting the vasodilatory effect of HO-1 induction. We conclude that renal HO-1 induction augments renal function which may contribute to the antihypertensive effects of HO-1 induction observed in hypertension models.

  15. Renal trauma in adults - a pictorial review

    International Nuclear Information System (INIS)

    Full text: This review provides a framework for understanding the classification and features of renal trauma. Computed tomography (CT) is now the modality of choice in prompt diagnosis and staging of renal trauma. A retrospective review of the CT scans of all patients with blunt abdominal trauma sustaining renal injury that presented to our hospital within the last 2 years was undertaken. The patient list was obtained from our Trauma Registry database at the Trauma Services Unit. Representative cases of each category of renal injury are displayed on a poster, accompanied by explanatory notes. We also reviewed the literature on renal trauma between 1985-2001 on Medline. The indications for radiological assessment and the management of renal trauma remain controversial. Staging of renal trauma with CT imaging, when integrated with clinical information helps to facilitate appropriate management plan. Renal injuries are classified into four grades on the basis of imaging: - Grade 1: Minor cortical contusion, minor laceration with limited perinephric hematoma, and small cortical infarct. - Grade 2: Major renal lacerations extending to the medulla with or without involvement of the collecting system and segmental renal infarct. - Grade 3: Catastrophic injury which include multiple renal lacerations and injury to the renal vascular pedicle. - Grade 4: Ureteropelvic junction injuries. Diagnostic imaging and staging plays a major role in assessing patients with renal injuries and affects clinical management decisions. Understanding the radiologic classification of traumatic renal injuries and integrating the findings with clinical information assist in developing an optimal management plan. Copyright (2002) Blackwell Science Pty Ltd

  16. [Renal transplantation: ethical issues].

    Science.gov (United States)

    Mamzer-Bruneel, Marie-France; Laforêt, Emmanuelle Grand; Kreis, Henri; Thervet, Éric; Martinez, Frank; Snanoudj, Renaud; Hervé, Christian; Legendre, Christophe

    2012-12-01

    One of the most significant advances in medicine during the last 50 years is the development of organ transplantation. In the context of chronic kidney diseases, renal transplantation offers patients a better clinical outcome than other treatment options. However, the benefits of organ transplantation have not been maximized due to an inadequate supply of organs for transplantation. Despite the establishment of elaborate legal rules for organs procurement, both on deceased and living donors in numerous countries, ethical concerns remain. Most of them are consequences of the strategies implemented or proposed to address the so-called organ shortage. The involvement of society in these complex problems is crucial as numerous questions emerge: could actual state of organ procurement change? Is it possible and/or realistic to increase the number of organs, with respects to living donors or deceased persons? Is the shortage an indicator to limit the use of kidney transplantation? How do we maintain efficiency and justice, in this context. PMID:23168353

  17. Renal transplant NMR

    International Nuclear Information System (INIS)

    The preliminary results of NMR evaluation of renal transplants (Txs) are reported including correlation with nuclear medicine (NM) and ultrasound (US). Thirteen Txs (8 cadaver (Cd), 5 living related doner (LRD) in 13 patients (6M, 7F) ranging in age from 25-47 (x 35) were evaluated by NM (32), NMR (15) and US (5). Clinical diagnoses included: rejection (8), ATN (2), infarction (1), and normal (2). Of the 8 patients with rejection (5) Cd; 3 LRD) pathologic proof was obtained in 3. An experimental 0.12 T resistive magnet (GE) was used with a partial saturation technique with repetition time (TR) of 143 and 286 msec to provide T1 weighting. T2 weighted information was obtained with a spin echo technique with echo times (TE) of 20, 40, 60 and 80 msec. The NMR appearance of normal Txs consisted of a uniform signal intensity (Tx> pelvic musculature), well-defined internal architecture with good cortical medullary differentiation and normal appearing vessels. The NMR appearance of abnormal transplants consisted of a heterogeneous or overall decrease in signal intensity (kidney muscle) with poor cortical medullary differentiation with or without a halo of decreased signal intensity. Although NMR was able to differentiate normal from abnormal, it was unable to clearly discriminate between ATN and rejection. Advantages of NMR included the ability to demonstrate regional anatomy, vasculature, post operative fluid collections and hematomas, and associated avascular necrosis of the hips

  18. Effects of adenosine infusion into renal interstitium on renal hemodynamics

    International Nuclear Information System (INIS)

    This study was designed to investigate the hemodynamic effects of exogenous adenosine in the interstitium of the rat kidney. Adenosine or its analogues were infused into the renal interstitium by means of chronically implanted capsules. In fusion of adenosine decreased glomerular filtration rate (GFR) from 0.81 +/- 0.06 to 0.37 +/- 0.06 ml/min while having no effect on renal blood flow (RBF). The metabolically stable analogue, 2-chloradenosine (2-ClAdo), decreased GFR from 0.73 +/- 0.07 to 021 +/- 0.06 ml/min. Interstitial infusion of theophylline, an adenosine receptor antagonist, completely abolished the effects of adenosine and 2-ClAdo on GFR. The distribution of adenosine, when infused into the renal interstitium, was determined using radiolabeled 5'-(N-ethyl)-carboxamidoadenosine (NECA), a metabolically stable adenosine agonist. After continuous infusion, [3H]NECA was distributed throughout the kidney. The effects of NECA to reduce GFR were similar to those of adenosine and 2-ClAdo. They conclude that increased levels of adenosine in the renal interstitium markedly decrease GFR without affecting RBF in steady-state conditions. The marked effects of adenosine agonists during their infusion into the renal interstitium and the complete blockade of these effects by theophylline suggest an extracellular action of adenosine

  19. HYPERTENSION IN RENAL ALLOGRAFT RECIPIENTS

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To further evaluate the effect of hypertension on renal graft function, and the relationship between hypertension, hyperlipoidemia and ischemic heart disease. Methods 102 renal transplant recipients with a functioning renal graft for more than 1 year were enrolled in this study. Renal function was followed for the further 24 months. Results The overall prevalence of hypertension was 89.2%(91/102) and 36.2%(33/91) hypertensive patients had uncontrolled blood pressure. After 24 months those with high blood pressure had significantly higher Scr levels than normotensive patients (P<0.05). The number of different antihypertensive classes required was related to Scr (P<0.05). Plasma cholesterol levels in hypertension patients especially in blood pressure uncontrolled group were significantly elevated (P<0.01). Ischemic heart disease was more common in hypertensive patients (P<0.05). Cyclosporine A was associated with hypertension more frequently than azathioprine and FK506, whereas low-dose prednisolone did not appear to influence blood pressure. Conclusion The data further confirmed that hypertension was associated with hyperlipidemia and ischemic heart disease, and emerged as a predictor of renal graft dysfunction. Whether cyclosporine A should be converted to new immunosuppressive agents and which class of antihypertensive medication is more effective in this population remain open questions.

  20. Acute renal failure in rats

    International Nuclear Information System (INIS)

    It was demonstrated in rats that renal injury which follows transient renal hypoxia is potentiated by the contrast media metrizoate, ioxaglate, iopamidol and iohexol. Intravenous injection of 1 g I/kg of all four media alone to 82 rats caused no significant increase in serum urea 1, 3 and 7 days later. The percentage increase of serum urea is given in median values and interquartile range (in parentheses). Bilateral renal arterial occlusion alone for 40 minutes in 42 rats increased serum urea one day later by 40% (20-130). Intravenous injection of the media followed in one hour by bilateral renal arterial occlusion for 40 minutes in 104 rats caused serum urea to increase one day later by 130% (70-350) after metrizoate, by 220% (50-380) after ioxaglate, by 290 % (60-420) after iopamidol and by 160% (50-330) after iohexol. There were no significant differences between the potentiating effects of the various media on ischemic renal failure. (orig.)

  1. Protocol biopsies for renal transplantation

    Directory of Open Access Journals (Sweden)

    Rush David

    2010-01-01

    Full Text Available Protocol biopsies in renal transplantation are those that are procured at predetermined times post renal transplantation, regardless of renal function. These biopsies have been useful to study the natural history of the transplanted kidney as they have detected unexpected - i.e. "subclinical" pathology. The most significant subclinical pathologies that have been detected with protocol biopsies have been acute lesions, such as cellular and antibody mediated rejection, and chronic lesions, such as interstitial fibrosis and tubular atrophy, and transplant glomerulopathy. The potential benefit of early recognition of the above lesions is that their early treatment may result in improved long-term outcomes. Conversely, the identification of normal histology on a protocol biopsy, may inform us about the safety of reduction in overall immunosuppression. Our centre, as well as others, is attempting to develop non-invasive methods of immune monitoring of renal transplant patients. However, we believe that until such methods have been developed and validated, the protocol biopsy will remain an indispensable tool for the complete care of renal transplant patients.

  2. Exercise-induced acute renal failure and patchy renal vasoconstriction

    International Nuclear Information System (INIS)

    This paper evaluates the CT and MR findings and to understand the pathophysiology of kidneys in patients with acute renal failure accompanied by loin pain after participation in a track event. The authors obtained CT scan of the kidney enhanced by contrast material and 24- to 72-hour delayed scans without further use of contrast media were performed in all six patients with acute renal failure accompanied by severe loin pain after participation in a track event. MR imaging of the kidney was also performed in one patient. Five patients received analygensics

  3. Damaged renal parenchyma as a sign of renal tuberculosis

    International Nuclear Information System (INIS)

    Findings of urogenital tuberculosis in computed tomography have been reported seldom although this manifestation of the tuberculous disease is on the second place following pulmonary tuberculosis. We report on a 52 year old women suffering by culturally proven urogenital tuberculosis. The enhanced computed tomography showed hypodense lesions clearly decipted on the cortex border of the kidney. Other findings of renal tuberculosis reported in the current literature as hydrocalices or hydronephrosis were not seen at all. We postulate that the described finding is characteristic for an early stage of renal tuberculosis. (orig.)

  4. Interest of the SPECT-CT to D.M.S.A.-V images merging in the management of thyroid medullary carcinomas; Interets de la fusion d'image TEMP-TDM au DMSA-V dans la prise en charge des carcinomes medullaires de la thyroide

    Energy Technology Data Exchange (ETDEWEB)

    Menemani, A.; Mebarki, M.; Slama, A.; Khellil, N.; Meghelli, S.; Lachachi, B.; Krim, M.; Merad, S.; Berber, N. [CHU Tlemcen, Service de medecine nucleaire (Algeria)

    2010-07-01

    Purpose: hybrid imaging associating SPECT and CT, integers functional and anatomical data. The aim of this communication is to present the contribution of the SPECT coupled to CT with D.M.S.A. V. in our daily practice of the medullary thyroid carcinomas management. Conclusions: the SPECT/CT got by a system of images merging allows a better anatomical location and improves the management of thyroid medullary carcinomas. (N.C.)

  5. Renal artery stenosis due to neurofibromatosis

    OpenAIRE

    Malav Ishwar; Kothari S

    2009-01-01

    A 4-year-old boy with hypertension due to renal artery stenosis and neurofibromatosis type 1 is presented for its rarity. Renal artery stenosis due to neurofibromatosis is underrecognized and may masquerade Takayasu′s arteritis in Asian children.

  6. Treatment Option Overview (Renal Cell Cancer)

    Science.gov (United States)

    ... Genetics of Kidney Cancer Research Renal Cell Cancer Treatment (PDQ®)–Patient Version General Information About Renal Cell ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  7. Treatment Options for Renal Cell Cancer

    Science.gov (United States)

    ... Genetics of Kidney Cancer Research Renal Cell Cancer Treatment (PDQ®)–Patient Version General Information About Renal Cell ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  8. Radionuclide renal dynamic and function study

    International Nuclear Information System (INIS)

    The radionuclide dynamic and function study, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were reported in 14 cases of renal and ureteral calculi patients before and after extracorporeal shock wave lithotripsy (ESWL). In 12 cases with normal renal blood flow, within 3 months after ESWL, the GFR of shock and non-shock side decreased with different extent, while the individual ERPF had little change. In 5 cases followed up 1 year after ESWL, the individual GFR and ERPF were normal. In 2 cases of severe renal function insufficiency, there was no improvement in renal function in shock side, after 5 months and 1 year, the renal function was still at low level. Thereby it is considered that ESWL is not suitable for the renal calculi patients with severe renal function insufficiency

  9. The renal arterial resistive index and stage of chronic kidney disease in patients with renal allograft

    DEFF Research Database (Denmark)

    Winther, Stine O; Thiesson, Helle C; Poulsen, Lene N;

    2012-01-01

    The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft.......The study investigated the optimal threshold value of renal arterial resistive index as assessed by Doppler ultrasonography determining chronic kidney disease stage 4 or higher in patients with renal allograft....

  10. Future challenges in renal transplantation.

    Science.gov (United States)

    Whalen, H; Clancy, M; Jardine, A

    2012-02-01

    There is a worldwide increase in the incidence of end-stage renal disease. Renal transplantation has been shown to be cost effective, prolong survival and provide a better quality of life in comparison to dialysis. Consequently, there has been a steady increase in demand for organs leading to a shortage of available kidneys, and an increase in transplant waiting lists. Renal transplantation is therefore an expanding field with a number of unique future challenges to address. This article outlines strategies that may be employed to expand organ supply in order to meet increased demand. The ethical issues surrounding this are also summarized. Furthermore, we highlight techniques with the potential to minimize peri-transplant injury to the kidney on its journey from donor to recipient. Current and potential future management strategies to optimize graft and patient survival are also discussed. PMID:22361673

  11. Post-renal Transplantation de novo Renal Cell Carcinoma in a Middle-aged Man

    OpenAIRE

    Pandya, V. K.; Sutariya, H. C.

    2016-01-01

    Renal cell carcinoma is usually seen in the native kidney but may be seen in the renal allograft. We report a rare case of renal cell carcinoma in a 56-year-old renal allograft recipient who was transplanted for end-stage renal disease induced by analgesic nephropathy. This complication developed after 13 years of renal transplantation. Patient was investigated for hematuria and abdominal pain with a normal renal function. Computed tomography depicted a mass sized 9.0×7.3×6.8 cm that involved...

  12. Acute renal infarction Secondary to Atrial Fibrillation Mimicking Renal Stone Picture

    International Nuclear Information System (INIS)

    Acute renal infarction presents in a similar clinical picture to that of a renal stone. We report a 55-year-old Saudi female, known to have atrial fibrillation secondary to mitral stenosis due to rheumatic heart disease. She presented with a two day history of right flank pain that was treated initially as renal stone. Further investigations confirmed her as a case of renal infarction. Renal infarction is under-diagnosed because the similarity of its presentation to renal stone. Renal infarction should be considered in the differential diagnosis of loin pain, particularly in a patient with atrial fibrillation. (author)

  13. Unusual cause of the subcapsular renal haematoma

    International Nuclear Information System (INIS)

    In 2 woman patients, the authors found subcapsular renal haematomas after paravertebral injection of a local anaesthetic as part of lumbago treatment. Clinical course and radiological findings are demonstrated. Whereas formation of subcapsular renal haematomas is a well-known phenomenon after traumas, iatrogenic and intentional punctures and a few renal and general diseases, renal lesion after paravertebral injection of a local anaesthetic is an extremely rare occurrence. (orig.)

  14. Hyperpolarized Renal Magnetic Resonance Imaging

    DEFF Research Database (Denmark)

    Laustsen, Christoffer

    2016-01-01

    The introduction of dissolution dynamic nuclear polarization (d-DNP) technology has enabled a new paradigm for renal imaging investigations. It allows standard magnetic resonance imaging complementary renal metabolic and functional fingerprints within seconds without the use of ionizing radiation....... Increasing evidence supports its utility in preclinical research in which the real-time interrogation of metabolic turnover can aid the physiological and pathophysiological metabolic and functional effects in ex vivo and in vivo models. The method has already been translated to humans, although the clinical...

  15. Renal dendritic cells: an update

    OpenAIRE

    Velázquez, Peter; Dustin, Michael L.; Peter J Nelson

    2009-01-01

    Discovery into the role of renal dendritic cells (rDCs) in health and disease of the kidney is rapidly accelerating. Progress in deciphering DC precursors and the heterogeneity of monocyte subsets in mice and humans are providing insights into the biology of rDCs. Recent findings have extended knowledge of the origins, anatomy, and function of the rDC network at steady-state and during periods of injury to the renal parenchyma. This brief review highlights these new findings and provides an u...

  16. Emerging Entities in Renal Neoplasia.

    Science.gov (United States)

    Mehra, Rohit; Smith, Steven C; Divatia, Mukul; Amin, Mahul B

    2015-12-01

    This article reviews emerging entities in renal epithelial neoplasia, including tubulocystic carcinoma, clear-cell-papillary renal cell carcinoma (RCC), thyroid-like follicular RCC, ALK-related RCC, translocation RCC, acquired cystic disease-related RCC, succinate dehydrogenase-deficient RCC, and hereditary leiomyomatosis-RCC syndrome-associated RCC. Many of these rarer subtypes of RCC were recently studied in more depth and are included in the upcoming version of the World Health Organization classification of tumors. Emphasis is placed on common gross and morphologic features, differential diagnoses, use of ancillary studies for making accurate diagnoses, molecular alterations, and predicted biologic behavior based on previous studies. PMID:26612218

  17. Hypertensive encephalopathy complicating transplant renal artery stenosis.

    OpenAIRE

    McGonigle, R J; Bewick, M.; Trafford, J. A.; Parsons, V

    1984-01-01

    A 26-year-old female diabetic patient developed hypertensive encephalopathy with gross neurological abnormalities complicating renal artery stenosis of her transplant kidney. The elevated blood pressure was unresponsive to medical treatment. Surgical correction of the stenoses in the renal artery cured the hypertension and renal failure and led to the patient's complete recovery.

  18. Renal Cell Carcinoma Presenting as Dysphagia

    OpenAIRE

    Chauhan, Sharad; Yadav, Sher Singh; Tomar, Vinay

    2015-01-01

    Renal cell carcinoma presenting with dysphagia is rare. We report a case who presented with dysphagia as the only manifestations of renal malignancy. Biopsy from the pyriform fossa nodules revealed a clear cell neoplasm. Immuno-histochemical analysis of tissue confirmed metastasis of renal cell carcinoma.

  19. Multimodality imaging of renal inflammatory lesions

    OpenAIRE

    Das, Chandan J; Ahmad, Zohra; Sharma, Sanjay; Gupta, Arun K.

    2014-01-01

    Spectrum of acute renal infections includes acute pyelonephritis, renal and perirenal abscesses, pyonephrosis, emphysematous pyelonephritis and emphysematous cystitis. The chronic renal infections that we routinely encounter encompass chronic pyelonephritis, xanthogranulomatous pyelonephritis, and eosinophilic cystitis. Patients with diabetes, malignancy and leukaemia are frequently immunocompromised and more prone to fungal infections viz. angioinvasive aspergillus, candida and mucor. Tuberc...

  20. Secondary polycythaemia associated with bilateral renal lymphocoeles.

    OpenAIRE

    Burton, I E; Sambrook, P.; McWilliam, L J

    1994-01-01

    A patient with a 15 year history of secondary polycythaemia due to renal erythropoietin hypersecretion is presented. Subsequent spontaneous development of bilateral renal lymphocoeles, which contained high erythropoietin levels, was shown by computerized tomography. The lymphocoeles were successfully treated by bilateral peritoneal marsupialization. No cause for the persistent polycythaemia or lymphocoeles was found at laparotomy or on renal biopsy.

  1. Current treatments for renal cell carcinoma

    OpenAIRE

    Noble, Helen; Walsh, Ian

    2015-01-01

    Renal cell carcinoma (RCC), also known as kidney cancer, renal adenocarcinoma or hypernephroma, and metastatic renal cell carcinoma is a global burden. This article aims to provide a brief overview of RCC. It outlines epidemiology and presentation; invesitgation and staging; treatments and prognosis. The article also includes a focus on currently available drug treatments, and serves as an introduction to the topic.

  2. Acute Renal Failure in a Renal Center, Iraq

    International Nuclear Information System (INIS)

    We evaluated retrospectively the etiology and outcome of acute renal failure (ARF) in 84 patients in Rasheed Renal Center in Baghdad, Iraq from June 1998 through March 1999. They were 82 males and 2 females with ages that ranged between 5 and 80 years. Prerenal ARF was the commonest type found in 45 (53.6%) patients followed by renal ARF in 33 (39.3%) patients and acute obstructive uropathy six (7.1%) patients. Clinically, 74 patients presented with oligo-anuria, while 10 patients presented with non-oliguria. Of the oligo-anuria group, 61 ( 82.4%) patients required required renal replacement therapy (RRT) and 50 (67.6%) had complete recovery. The mortality rate was 25.67% in the oliguric group, while none in the non-oliguric group required RRT and the complete recvery rate was 100%. The overall survival in both groups was (77.4%). The patterns of ARF in our center were mostly compatible with the previous reports from the region. (author)

  3. Papillary adenocarcinoma of the renal pelvis with renal calculus: A rare case report

    OpenAIRE

    Li, Jianlong; Li, Qing; Yu, Yi

    2016-01-01

    Papillary adenocarcinoma of the renal pelvis is a rare clinicopathology of a kidney tumor with renal calculus. In the present case report, percutaneous renal biopsy, nephroscope lithotripsy and radical nephroureterectomy within a papillary adenocarcinoma of the renal pelvis accompanied with renal calculus was performed on a 65-year-old patient, also including a report on the patient's data and a literature review. The histopathological features confirmed the diagnosis of papillary adenocarcin...

  4. MRI appearance of massive renal replacement lipomatosis in the absence of renal calculus disease

    OpenAIRE

    Fitzgerald, E; Melamed, J.; Taneja, S. S.; Rosenkrantz, A.B.

    2011-01-01

    Renal replacement lipomatosis is a rare benign entity in which extensive fibrofatty proliferation of the renal sinus is associated with marked renal atrophy. In this report, we present a case of massive renal replacement lipomatosis demonstrated on MRI. The presentation was atypical given an absence of associated renal calculus disease, and an initial CT scan was interpreted as suspicious for a liposarcoma. The differential diagnosis and key MRI findings that served to establish this specific...

  5. 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.

  6. Functional impairment of the kidney after nephrolithotomy determinated by 99mtechnetium-dimercaptosuccinic acid uptake rate

    International Nuclear Information System (INIS)

    The effect of nephrolithotomy on renal function was assessed in 11 patients with unilateral renal calculi, using 99m Technetium dimercaptosuccinic acid (DMSA) renal uptake rate. There was mild decrease of DMSA uptake rate in the kidneys containing stones preoperatively. DMSA uptake rate of the operated kidneys decreased remarkably 3 weeks after operation. By one year after operation, DMSA uptake rate of the operated kidney recovered, but was still significantly lower than the preoperative value. We concluded that the rate of functional loss after nephrolithotomy was estimated to be about 5 % of the total renal function. (author)

  7. Renal function in diabetic nephropathy.

    Science.gov (United States)

    Dabla, Pradeep Kumar

    2010-05-15

    Diabetic nephropathy is the kidney disease that occurs as a result of diabetes. Cardiovascular and renal complications share common risk factors such as blood pressure, blood lipids, and glycemic control. Thus, chronic kidney disease may predict cardiovascular disease in the general population. The impact of diabetes on renal impairment changes with increasing age. Serum markers of glomerular filtration rate and microalbuminuria identify renal impairment in different segments of the diabetic population, indicating that serum markers as well as microalbuminuria tests should be used in screening for nephropathy in diabetic older people. The American Diabetes Association and the National Institutes of Health recommend Estimated glomerular filtration rate (eGFR) calculated from serum creatinine at least once a year in all people with diabetes for detection of kidney dysfunction. eGFR remains an independent and significant predictor after adjustment for conventional risk factors including age, sex, duration of diabetes, smoking, obesity, blood pressure, and glycemic and lipid control, as well as presence of diabetic retinopathy. Cystatin-C (Cys C) may in future be the preferred marker of diabetic nephropathy due differences in measurements of serum creatinine by various methods. The appropriate reference limit for Cys C in geriatric clinical practice must be defined by further research. Various studies have shown the importance of measurement of albuminuria, eGFR, serum creatinine and hemoglobin level to further enhance the prediction of end stage renal disease. PMID:21537427

  8. Genetic Counseling in Renal Masses

    Directory of Open Access Journals (Sweden)

    José Antonio López-Guerrero

    2008-01-01

    Full Text Available All urologists have faced patients suffering a renal cancer asking for the occurrence of the disease in their offspring and very often the answer to this question has not been well founded from the scientific point of view, and only in few cases a familial segregation tree is performed. The grate shift seen in the detection of small renal masses and renal cancer in the last decades will prompt us to know the indications for familial studies, which and when are necessary, and probably to refer those patients with a suspected familial syndrome to specialized oncological centers where the appropriate molecular and familial studies could be done. Use of molecular genetic testing for early identification of at-risk family members improves diagnostic certainty and would reduce costly screening procedures in at-risk members who have not inherited disease-causing mutations. This review will focus on the molecular bases of familial syndromes associated with small renal masses and the indications of familial studies in at-risk family members.

  9. Renal leiomyosarcoma in a cat.

    Science.gov (United States)

    Evans, Dawn; Fowlkes, Natalie

    2016-05-01

    Renal leiomyosarcoma was diagnosed in a 10-year-old Domestic Shorthair cat with a 3-year history of clinically managed, chronic renal disease. Sudden death was preceded by a brief episode of mental dullness and confusion. At postmortem examination, the gross appearance of the left kidney was suggestive of hydronephrosis, and a nephrolith was present in the contralateral kidney. However, histology revealed an infiltrative, poorly differentiated, spindle cell sarcoma bordering the grossly cavitated area. Neoplastic cells were immunoreactive for vimentin and smooth muscle actin, which led to a diagnosis of renal leiomyosarcoma; neoplastic cells were not immunoreactive for desmin. Leiomyosarcoma arising in the kidney is a rare occurrence in humans and an even rarer occurrence in veterinary medicine with no prior cases being reported in cats in the English literature. The macroscopic appearance of the tumor at postmortem examination was misleadingly suggestive of hydronephrosis as a result of the large cavitation and may be similar to particularly unusual cases of renal leiomyosarcomas in humans that have a cystic or cavitated appearance. PMID:26975352

  10. Shigella septicaemia following renal transplantation.

    OpenAIRE

    Severn, M; Michael, J

    1980-01-01

    Two patients are described who developed septicaemia with Shigella flexneri following renal transplantation. Pre-operative screening had not identified either patient as a chronic carrier of Shigella sp. The acute management and problems posed by unrecognized carriers amongst patients undergoing transplantation in areas of the world where Shigella is endemic, are discussed.

  11. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... of individuals (greater than 80 percent) with tuberous sclerosis complex (TSC) will develop some form of renal ( ... muscle (“myo”) and fat (“lipoma”). Usually angiomyolipomas are multiple and occur in both kidneys. The presence of ...

  12. Sequential Scintigraphy in Renal Transplantation

    International Nuclear Information System (INIS)

    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 performèd after renal transplantation in dogs. After intravenous injection of 500 μCi. 131I-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)

  13. [Renal failure and cystic kidney diseases].

    Science.gov (United States)

    Correas, J-M; Joly, D; Chauveau, D; Richard, S; Hélénon, O

    2011-04-01

    Cystic kidney diseases often are discovered at the time of initial work-up of renal failure through ultrasound or family history, or incidentally at the time of an imaging test. Hereditary diseases include autosomal dominant or recessive polycystic kidney disease (PKD), tuberous sclerosis (TS) and medullary cystic kidney disease (MCKD). Autosomal dominant PKD is characterized by large renal cysts developing in young adults. Renal failure is progressive and becomes severe around 50-60 years of age. Atypical cysts (hemorrhagic or hyperdense) are frequent on CT and MRI examinations. Imaging plays a valuable role in the management of acute complications such as cyst hemorrhage or infection. Autosomal recessive PKD is often detected in neonates, infants or young adults. It is characterized by renal enlargement due to the presence of small cysts and liver disease (fibrosis and biliary ductal dilatation). Late manifestation or slow progression of autosomal recessive PKD may be more difficult to distinguish from autosomal dominant PKD. These cystic kidney diseases should not be confused with non-hereditary incidental multiple renal cysts. In tuberous sclerosis, renal cysts are associated with angiomyolipomas and sometimes pulmonary lymphangioleiomyomatosis. Renal failure is inconstant. Other hereditary cystic kidney diseases, including MCKD and nephronophtisis, are usually associated with renal failure. Non-hereditary cystic kidney diseases include multicystic renal dysplasia (due to complete pelvi-ureteric atresia or hydronephrosis), acquired multicystic kidney disease (chronic renal failure, chronic hemodialysis) and varied cystic kidney diseases (multicystic renal disease, glomerulocystic kidney disease, microcystic kidney disease). PMID:21549887

  14. Metastatic renal cell carcinoma management

    Directory of Open Access Journals (Sweden)

    Flavio L. Heldwein

    2009-06-01

    Full Text Available PURPOSE: To assess the current treatment of metastatic renal cell carcinoma, focusing on medical treatment options. MATERIAL AND METHODS: The most important recent publications have been selected after a literature search employing PubMed using the search terms: advanced and metastatic renal cell carcinoma, anti-angiogenesis drugs and systemic therapy; also significant meeting abstracts were consulted. RESULTS: Progress in understanding the molecular basis of renal cell carcinoma, especially related to genetics and angiogenesis, has been achieved mainly through of the study of von Hippel-Lindau disease. A great variety of active agents have been developed and tested in metastatic renal cell carcinoma (mRCC patients. New specific molecular therapies in metastatic disease are discussed. Sunitinib, Sorafenib and Bevacizumab increase the progression-free survival when compared to therapy with cytokines. Temsirolimus increases overall survival in high-risk patients. Growth factors and regulatory enzymes, such as carbonic anhydrase IX may be targets for future therapies. CONCLUSIONS: A broader knowledge of clear cell carcinoma molecular biology has permitted the beginning of a new era in mRCC therapy. Benefits of these novel agents in terms of progression-free and overall survival have been observed in patients with mRCC, and, in many cases, have become the standard of care. Sunitinib is now considered the new reference first-line treatment for mRCC. Despite all the progress in recent years, complete responses are still very rare. Currently, many important issues regarding the use of these agents in the management of metastatic renal cancer still need to be properly addressed.

  15. Renal lesions of nondomestic felids.

    Science.gov (United States)

    Newkirk, K M; Newman, S J; White, L A; Rohrbach, B W; Ramsay, E C

    2011-05-01

    To comprehensively evaluate the occurrence of renal lesions in a variety of nondomestic felids, necropsy cases from 1978 to 2008 were reviewed from a municipal zoo and a large cat sanctuary for those in which the kidneys were examined histologically. Seventy exotic felids were identified (25 tigers, 18 lions, 6 cougars, 5 leopards, 3 snow leopards, 3 clouded leopards, 3 Canadian lynx, 2 ocelots, 2 bobcats, 2 cheetahs, 1 jaguar), and their histologic renal lesions were evaluated and compared. The most common lesion was tubulointerstitial nephritis (TIN); 36 of 70 (51%) cats were affected to some degree. Lymphocytic interstitial nephritis was the most common lesion in the tigers (9 of 25, 36%) and was rarely seen in other species. Although the renal pelvis was not available for all cats, 28 of 47 (60%) had some degree of lymphocytic pyelitis. There was no significant association between the presence of pyelitis and that of TIN. Only 1 cat had pyelonephritis. Renal papillary necrosis was present in 13 of 70 (19%) cats and was significantly associated with historical nonsteroidal anti-inflammatory drug treatment (odds ratio, 7.1; 95% confidence interval, 1.9 to 26.8). Only 1 cat (lion) had amyloid accumulation, and it was restricted to the corticomedullary junction. Primary glomerular lesions were absent in all cats. Intraepithelial pigment was identified in many of the cats but was not correlated with severity of TIN. Despite several previous reports describing primary glomerular disease or renal amyloidosis in exotic felids, these lesions were rare to absent in this population. PMID:20876911

  16. Imaging of haemodialysis: renal and extrarenal findings.

    Science.gov (United States)

    Degrassi, Ferruccio; Quaia, Emilio; Martingano, Paola; Cavallaro, Marco; Cova, Maria Assunta

    2015-06-01

    Electrolyte alterations and extra-renal disorders are quite frequent in patients undergoing haemodialysis or peritoneal dialysis. The native kidneys may be the site of important pathologies in patients undergoing dialysis, especially in the form of acquired renal cystic disease with frequent malignant transformation. Renal neoplasms represents an important complication of haemodialysis-associated acquired cystic kidney disease and imaging surveillance is suggested. Extra-renal complications include renal osteodistrophy, brown tumours, and thoracic and cardiovascular complications. Other important fields in which imaging techniques may provide important informations are arteriovenous fistula and graft complications. Teaching points • Renal neoplasms represent a dreaded complication of haemodialysis.• In renal osteodystrophy bone resorption typically manifests along the middle phalanges.• Brown tumours are well-defined lytic lesions radiographically, possibly causing bone expansion.• Vascular calcifications are very common in patients undergoing haemodialysis.• Principal complications of the AV fistula consist of thrombosis, aneurysms and pseudoaneurysms. PMID:25680325

  17. α1B-Adrenoceptors mediate adrenergically-induced renal vasoconstrictions in rats with renal impairment

    Institute of Scientific and Technical Information of China (English)

    Md Abdul Hye KHAN; Munavvar Abdul SATTAR; Nor Azizan ABDULLAH; Edward James JOHNS

    2008-01-01

    Aim: This study examined whether α1B-adrenoceptors are involved in mediating adrenergically-induced renal vasoconstrictor responses in rats with pathophysi-ological and normal physiological states. Methods: Male Wistar Kyoto and spon-taneously hypertensive rats were induced with acute renal failure or experimental early diabetic nephropathy by cisplatin or streptozotocin, respectively. Cisplatin-induced renal failure was confirmed by impaired renal function and pronounced tubular damage. Experimental early diabetic nephropathy was confirmed by hyperglycemia, changes in physiological parameters, and renal function. The hemodynamic study was conducted on anesthetized rats after 7 d of cisplatin (renal failure) and 4 weeks of streptozotocin (experimental early diabetic nephropathy). Results: In the rats with renal failure and experimental early dia-betic nephropathy, there were marked reductions in their baseline renal blood flow (P0.05) in the renal failure and experimental early diabetic nephropathy rats, respectively, as compared to their non-renal failure and non-diabetic nephropathy controls. In the rats with renal impairment, chloroethylclonidine caused either accentuation or attenuation (all P0.05). Conclusion: This study demonstrated the presence of functional α1B-adrenoceptors that mediated the adrenergically-induced renal vaso-constrictions in rats with renal impairment, but not in rats with normal renal function.

  18. Renal replacement therapy in sepsis-induced acute renal failure

    Directory of Open Access Journals (Sweden)

    Rajapakse Senaka

    2009-01-01

    Full Text Available Acute renal failure (ARF is a common complication of sepsis and carries a high mortality. Renal replacement therapy (RRT during the acute stage is the mainstay of therapy. Va-rious modalities of RRT are available. Continuous RRT using convective methods are preferred in sepsis-induced ARF, especially in hemodynamically unstable patients, although clear evidence of benefit over intermittent hemodialysis is still not available. Peritoneal dialysis is clearly inferior, and is not recommended. Early initiation of RRT is probably advantageous, although the optimal timing of dialysis is yet unknown. Higher doses of RRT are more likely to be beneficial. Use of bio-compatible membranes and bicarbonate buffer in the dialysate are preferred. Anticoagulation during dialysis must be carefully adjusted and monitored.

  19. Renal and post-renal causes of acute renal failure in children

    International Nuclear Information System (INIS)

    Objective: To identify the causes of acute renal failure (ARF) in pediatric population along with the identification of the age and gender most affected by the failure. Subjects and Methods: The study included children under the age of 12 years who presented with signs and symptoms suggestive of ARF (oliguria/anuria, vomiting, acidotic breathing etc.) along with raised blood urea nitrogen (BUN) serum creatinine and metabolic acidosis as shown by arterial blood gases (ABGs). Patients were divided into two group on the basis of age; group A consisting of 0-2 years and group B from >2 years. Patients presenting with transient pre-renal azotaemia were excluded from the study. After providing initial emergency cover, detailed history, physical examination and investigations were carried out according to a proforma specially designed to ascertain the cause of ARF. Patients were managed for ARF as per standard recommendations and investigations completed or repeated as and when required. Results: A total of 119 patients with ARF were admitted in the ward over a period of two years constituting 1.36% of the total admissions and 16.39% of the admissions due to renal pathology. Mean age of presentation was 4.5 years 16.7% of the patients under the age of 5 years. Male predominance was noted in all ages with an overall male to female ratio of 2.3:1. Most common cause leading to ARF in younger age group was found to be hemolytic uremic syndrome [25(54.34%)] followed by septicemia [7(15.21 %)]. In older patients renal calculus disease was the most common [22(30.13%)] underlying pathology followed by pre-existing, undiagnosed chronic renal failure [16(21.91 %)]. Conclusion: ARF is fairly cotton in children especially under the age of 5 years showing a male predominance. More than 90% of the cases can be prevented by improving primary health care and by early and prompt treatment of infections. (author)

  20. Retrograde Renal Cooling to Minimize Ischemia

    Directory of Open Access Journals (Sweden)

    Janet L. Colli

    2013-01-01

    Full Text Available Objective: During partial nephrectomy, renal hypothermia has been shown to decrease ischemia induced renal damage which occurs from renal hilar clamping. In this study we investigate the infusion rate required to safely cool the entire renal unit in a porcine model using retrograde irrigation of iced saline via dual-lumen ureteral catheter. Materials and Methods: Renal cortical, renal medullary, bowel and rectal temperatures during retrograde cooling in a laparoscopic porcine model were monitored in six renal units. Iced normal saline was infused at 300 cc/hour, 600 cc/hour, 1000 cc/hour and gravity (800 cc/hour for 600 seconds with and without hilar clamping. Results: Retrograde cooling with hilar clamping provided rapid medullary renal cooling and significant hypothermia of the medulla and cortex at infusion rates ≥ 600 cc/hour. With hilar clamping, cortical temperatures decreased at -0.9° C/min. reaching a threshold temperature of 26.9° C, and medullary temperatures decreased at -0.90 C/min. reaching a temperature of 26.1° C over 600 seconds on average for combined data at infusion rates ≥ 600 cc/hour. The lowest renal temperatures were achieved with gravity infusion. Without renal hilum clamping, retrograde cooling was minimal at all infusion rates. Conclusions: Significant renal cooling by gravity infusion of iced cold saline via a duel lumen catheter with a clamped renal hilum was achieved in a porcine model. Continuous retrograde irrigation with iced saline via a two way ureteral catheter may be an effective method to induce renal hypothermia in patients undergoing robotic assisted and/or laparoscopic partial nephrectomy.