Diuresis renography in children: methodological aspects; Nephrogramme isotopique avec epreuve d`hyperdiurese chez l`enfant: aspects methodologiques

Energy Technology Data Exchange (ETDEWEB)

Bonnin, F.; Le Stanc, E. [Hopital Beaujon, 92 - Clichy (France); Busquet, G.; Saidi, L. [Hopital Mignot, 78 - Versailles (France); Lyonnet, F. [Hopital Lapeyronie, 34 -Montpellier (France)

1995-12-31

In paediatrics, diuresis renography is used as a method to guide clinical management of hydronephrosis or hydro-uretero-nephrosis. Various pitfalls in the technique and other errors exist and may lead to a misinterpretation of the test. The methodology for performing and interpreting the diuresis renography is discussed. (authors). 12 refs., 4 figs.

CT volumetry is superior to nuclear renography for prediction of residual kidney function in living donors.

Science.gov (United States)

Barbas, Andrew S; Li, Yanhong; Zair, Murtuza; Van, Julie A; Famure, Olusegun; Dib, Martin J; Laurence, Jerome M; Kim, S Joseph; Ghanekar, Anand

2016-09-01

Living kidney donor evaluation commonly includes nuclear renography to assess split kidney function and computed tomography (CT) scan to evaluate anatomy. To streamline donor workup and minimize exposure to radioisotopes, we sought to assess the feasibility of using proportional kidney volume from CT volumetry in lieu of nuclear renography. We examined the correlation between techniques and assessed their ability to predict residual postoperative kidney function following live donor nephrectomy. In a cohort of 224 live kidney donors, we compared proportional kidney volume derived by CT volumetry with split kidney function derived from nuclear renography and found only modest correlation (left kidney R(2) =26.2%, right kidney R(2) =26.7%). In a subset of 88 live kidney donors with serum creatinine measured 6 months postoperatively, we compared observed estimated glomerular filtration rate (eGFR) at 6 months with predicted eGFR from preoperative imaging. Compared to nuclear renography, CT volumetry more closely approximated actual observed postoperative eGFR for Chronic Kidney Disease Epidemiology Collaboration (J-test: P=.02, Cox-Pesaran test: P=.01) and Mayo formulas (J-test: P=.004, Cox-Pesaran test: Pvolumetry for estimation of split kidney function in healthy individuals with normal kidney function and morphology. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Current status of diuretic renography

International Nuclear Information System (INIS)

O'Reilly, P.H.

1987-01-01

Percutaneous antegrade perfusion studies constitute a valuable contribution to the investigation of obstructive uropathy. In 1978, the first report of application of diuretic renogram techniques to this problem appeared in the literature. This was the first systematic report of a standardized protocol to be applied to a specific surgical problem. The purpose of the procedure, as with perfusion pressure-flow studies, is to help distinguish between a dilated urinary tract that is obstructed and requires surgery and a nonobstructed system in which urographic dilation and stasis mimic obstruction, but no genuine impedance to urine flow exists, and surgery is not required. The technique provides dual information. It gives quantitative data on individual renal function that perfusion pressure-flow studies do not, and it gives time-activity curves reflecting the urodynamics through the individual upper urinary tracts at normal and high urinary flow rates. In the early days, this information was obtained from probe studies, but the procedure is now almost exclusively performed using the gamma camera, images from which give additional information on the site of any suspected obstruction. In some ways, the development of diuretic renography and that of perfusion pressure-flow studies have proceeded in a competitive fashion, both attempting to answer the same questions by different means. In practice, however, the two tests would be regarded as complementary, as will be shown later in this chapter. The following sections describe the technique of diuretic renography, its current clinical application and status in surgical and nuclear medicine practice, and its role in comparison with other available tests for management of the dilated upper urinary tract

Evaluation of 99mTc-MAG3 (mercaptoacetyltriglycine) renography for pediatric patients

International Nuclear Information System (INIS)

Tabuchi, Kojiro; Adachi, Itaru; Doi, Kenji; Hou, Nobuyoshi; Komori, Tsuyoshi; Nakata, Yasunobu; Matsui, Ritsuo; Sueyoshi, Kouzou; Narabayashi, Isamu

1999-01-01

It is difficult to evaluate renal function with 99m Tc-MAG 3 renography in both adult and pediatric patients. We examined 109 pediatric patients with various renal diseases using 99m Tc-MAG 3 renography. Tenal diseases were classified as follows: 9 vesicoureteral reflux, 4 ureteropelvic junctional stenosis, 3 double pelvis, 23 hydronephrosis, 4 glomerulonephritis, 4 nephrotic syndrome, 24 hemolytic uremic syndrome, 10 others; and 24 patients without abnormal findings on other examinations. After hydration and sedation, 100-200 MBq of 99m Te-MAG 3 was injected intravenously. All patients were placed in the supine position, and dynamic data acquisition at 12 sec/frame x 100 frames was performed from the back. The renograms were prepared with the ROIs (regions of interest) set to include the entire kidney. Tmax and T1/2 of renograms were measured for 26 kidneys with no abnormal findings. The correlations between Tmax or T1/2 and age (days after birth) were determined by a linear or logarithmic function. The logarithmic function (Y=7.49-0.56 log e X, r 2 =0.134) yielded a higher correlation than did the linear function (Y=5.16-0.00194X, r 2 =0.089) between Tmax and age. For T1/2 and age (days after birth), the linear function (Y=8.07-0.00451X, r 2 =0.222) yielded a higher correlation than the logarithmic function (Y=11.9-0.986 log e X, r 2 =0.192). Our findings suggest that prolonged Tmax is normalized more rapidly than T1/2 after birth in infants. A delayed excretion phase is not suggestive of renal dysfunction, but is characteristic of renograms in pediatric patients. Abnormality was detected in all patients with hydronephrosis using 99m Tc-MAG 3 renography. On the other hand, a quantitative study was required because renography detected no abnormality for some of patients with disorders of renal parenchyma. (author)

Glomerular filtration rate estimated from the uptake phase of 99mTc-DTPA renography in chronic renal failure

DEFF Research Database (Denmark)

Petersen, L J; Petersen, J R; Talleruphuus, U

1999-01-01

The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea.......The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea....

Sensitivity of hippuran renography in experimental renovascular hypertension

International Nuclear Information System (INIS)

Jonker, G.J.; Zeeuw, D. de; Huisman, R.M.; Beekhuis, H.; Piers, D.A.

1988-01-01

The aim of this research project was to examine the influence of angiotensin converting enzyme inhibitors on the sensitivity of hippuran renography in case of renovascular hypertension. Dogs are used for the experiments. A new constrictor device has been used for external induction of renal artery stenosis in the dogs. After ACE-inhibition a sensitivity of 100% has been found for small stenosis. Without ACE-inhibition the sensitivity was 50%. 6 refs.; 6 figs

Exercise renography in essential hypertension; Belastungsrenografie bei essenzieller Hypertonie

Energy Technology Data Exchange (ETDEWEB)

Schlotmann, A. [Radiologische Klinik, Universitaetsklinikum Freiburg (Germany)

2010-09-15

Exercise renography using {sup 99m}Tc-mercaptoacetyltriglycine ({sup 99m}Tc-MAG{sub 3}) permits recognition of a disease specific renal functional disturbance of essential hypertension. This disturbance can be visualized scintigraphically as pronounced bilateral parenchymal/tissue tracer retention. Clearance determinations during light ergometric exercise demonstrated that transitory bilateral tissue tracer retention results from a selective and prominent reduction of glomerular filtration, while effective renal plasma flow (ERPF) remains comparatively stable. Results obtained with exercise renography and with clearance determinations suggest that the physiological relationship between glomerular filtration rate (GFR) and ERPF, i.e. a filtration fraction (FF) of 0.2, is severely disrupted (FF << 0.2) in about 60% of patient with essential hypertension. This functional disturbance must result in the activation of the renin-angiotensin axis. A particularly exciting consequence of this research was the recognition that {sup 99m}Tc-MAG{sub 3}-scintigraphy can visualize a reduced FF. This opens the door to a broad area of research unrelated to essential hypertension. Initial results in renovascular disease and in urinary tract obstruction demonstrated that a reduced FF puts the involved organs at risk. (orig.)

THE MECHANISM AND DIAGNOSTIC-VALUE OF ANGIOTENSIN-I CONVERTING ENZYME-INHIBITION RENOGRAPHY

NARCIS (Netherlands)

DEZEEUW, D; JONKER, GJ; HOVINGA, TKK; BEEKHUIS, H; PIERS, DA; HUISMAN, RM; DEJONG, PE

1991-01-01

The effect of angiotensin converting enzyme (ACE) inhibition on the sensitivity of radionuclide renography in the diagnosis of a unilateral renal artery stenosis was tested both in a conscious dog model and in the human situation. ACE inhibition (10 mg enalaprilic acid, intravenously) markedly

Role of F+0 diuretic renography in post-natal management of antenatal hydronephrosis

International Nuclear Information System (INIS)

Rakesh Kumar; Madhavi Tripathi; Devender Kumar Gupta; Chetan Patel; Gurupad Bandopadhayaya; Gauri Shankar Pant; Arun Malhotra

2004-01-01

Objective: To assess the role of the F+0 renography in discriminating obstructive from non-obstructive upper urinary tract dilatation in neonates and 20 min, a separate renal function of < 40%, and symptoms of obstruction (pain, sepsis). All these variables were measured at first diuretic renogram performed at 69.7±45.3 days of age and second follow-up diuretic renogram performed at 212±101 days of age. Renography was performed for 20 min after injection of Tc99m-MAG3 (7-15 MBq/kg), immediately followed by furosemide (1 mg/kg). Results: Of the 43 hydronephrotic kidneys, 27 were obstructive, 12 were non-obstructive and 4 were non-functioning. Among the 27 obstructive kidneys, 15 kidneys which were associated with either loss of differential renal functions and or recurrent clinical symptoms, therefore, underwent surgery. All these patients except one who underwent surgery showed improvement in renal functions post surgically. The 12 obstructive kidneys, which were followed-up conservatively, showed no change in renal functions in 8, fall in renal functions in 2 and improvement in renal functions in 2. No fall in renal function was noted on follow-up study among the kidneys which were non-obstructive at first renographic study. Conclusion: In neonates less than 6-month with antenatal diagnosis of hydronephrosis, Tc99m-MAG3 renography with early diuretic injection (F+0) can reliably differentiate obstructive from non-obstructive hydronephrosis. (authors)

Prognostic value of quantitative furosemide radionuclide renography in obstructive nephropathy

International Nuclear Information System (INIS)

Schuemichen, C.; Fischer, R.; Sierke, P.; Joseph, A.; Krause, T.

1988-01-01

Diuretic radionuclide renography is applied in patients with hydronephrosis in order to distinguish dilated, non-obstructed systems from those with significant mechanical obstruction. This is done after furosemide application by (semi) quantification of pelvic radioactivity outflow. In the dilated, non-obstructed pelvis, this outflow is increased, whereas in mechanical obstructed systems no response or even a decreased outflow is observed. It was expected that the latter outcome of the test is associated with an impaired renal function due to obstructive nephropathy. In the case that furosemide was given 30 min after 123 I hippuran application, this assumption could not be proved. When furosemide and 123 I hippuran were applied simultaneously, only a poor correlation was found between the response of pelvic outflow and the individual tubular clearance of the affected kidney. On the other hand, there was a clear correlation between the delay of pelvic outflow in the non-diuretic radionuclide renography and the individual tubular clearance. It can therefore be concluded that this test has little prognostic value and that other criteria in addition to the quantification of diuretic pelvic outflow are necessary for providing more reliable results. (orig.)

Clinical impact of renography in antenatally discovered pelviureteric stenosis: a short review of the literature

International Nuclear Information System (INIS)

Froekiaer, J.; Eskild-Jensen, A.

2003-01-01

Congenital unilateral hydronephrosis is a relatively frequent and often asymptomatic condition diagnosed in utero. The natural history and significance of congenital hydronephrosis on the development and long-term consequences on renal function is not sufficiently known. The present diagnostic methods do not provide prediction of the functional consequences of a potential presence of an obstruction. However, renography is an important method affecting the clinical treatment of children with prenatal unilateral hydronephrosis, and is the only method that satisfactory can provide serial accurate measurements of differential renal function. The present review briefly summarizes the clinical impact of renography in neonatally discovered hydronephrosis in relation to the pathophysiological characteristics of congenital unilateral hydronephrosis. (orig.) [de

Usefulness of 99mTc-DTPA renography and diuretic renography in predicting successful stone discharge following outpatient ESWL in patients with a single ureteral stone

International Nuclear Information System (INIS)

Soga, Norihito; Komeda, Yoshinori; Suzuki, Ryuichi; Kawamura, Juichi.

1996-01-01

We analyzed the 99m Tc-DTPA renogram with and without diuresis to predict the possibility of stone discharge on the outpatient basis by renogram patterns. Between October 1993 and December 1995, 99m Tc-DTPA renography was performed in 79 patients with a single ureteral stone. The 99m Tc-DTPA renogram pattern was classified into the three types of normal function, obstruction and lower function patterns and the complete stone discharge rate was 93, 63 and 25%, respectively. In addition, diuretic renography using Furosemide was performed in patients with an obstruction pattern and the three renogram patterns of return to the normal curve, a diuretic response and no response were obtained; the complete stone discharge rate was 44, 65.3 and 93%, respectively. From this study, patients with a single ureteral stone with a normal pattern on the regular DTPA renogram and patients with no response pattern on the diuretic renogram, even if in such patients an obstructive pattern was seen on the regular DTPA renogram, seem to be a good candidate for obtaining a high rate of a stone discharge with extracorporeal shock wave lithotripsy (ESWL) treatment in the outpatients basis. (author)

Usefulness of {sup 99m}Tc-DTPA renography and diuretic renography in predicting successful stone discharge following outpatient ESWL in patients with a single ureteral stone

Energy Technology Data Exchange (ETDEWEB)

Soga, Norihito; Komeda, Yoshinori [Yokkaichi Health Insurance Hospital, Mie (Japan); Suzuki, Ryuichi; Kawamura, Juichi

1996-11-01

We analyzed the {sup 99m}Tc-DTPA renogram with and without diuresis to predict the possibility of stone discharge on the outpatient basis by renogram patterns. Between October 1993 and December 1995, {sup 99m}Tc-DTPA renography was performed in 79 patients with a single ureteral stone. The {sup 99m}Tc-DTPA renogram pattern was classified into the three types of normal function, obstruction and lower function patterns and the complete stone discharge rate was 93, 63 and 25%, respectively. In addition, diuretic renography using Furosemide was performed in patients with an obstruction pattern and the three renogram patterns of return to the normal curve, a diuretic response and no response were obtained; the complete stone discharge rate was 44, 65.3 and 93%, respectively. From this study, patients with a single ureteral stone with a normal pattern on the regular DTPA renogram and patients with no response pattern on the diuretic renogram, even if in such patients an obstructive pattern was seen on the regular DTPA renogram, seem to be a good candidate for obtaining a high rate of a stone discharge with extracorporeal shock wave lithotripsy (ESWL) treatment in the outpatients basis. (author)

Early report: Comparison of breath-hold MR excretory urography, Doppler ultrasound and isotope renography in evaluation of symptomatic hydronephrosis in pregnancy

International Nuclear Information System (INIS)

Spencer, J.A.; Tomlinson, A.J.; Weston, M.J.; Lloyd, S.N.

2000-01-01

AIM: To compare assessment by MR excretory urography (MREU), Doppler ultrasound and isotope renography of women with symptomatic hydronephrosis in pregnancy and to define its cause. MATERIALS AND METHODS: Eleven women at 19-34 weeks of gestation were studied prospectively with gadolinium-enhanced breath-hold gradient echo MREU and transabdominal Doppler ultrasound compared with a 'gold standard' of isotope renography employing frusemide challenge. All studies were performed within 24 h, were reported independently in a blinded fashion and employed clearly defined criteria. Obstetric and infant outcomes were obtained. RESULTS: There were no adverse reactions to gadolinium administration in pregnancy and no adverse obstetric or infant outcomes. Three of the 11 women were unable to tolerate the complete MREU protocol. Ultrasound indices could not be used to predict ureteric obstruction as shown by isotope renography. MREU agreed with renographic findings in five of the six cases with obstruction and in two without obstruction. MREU directly demonstrated hydronephrosis to result from extrinsic compression of the ureter between the gravid uterus and iliopsoas muscle. CONCLUSION: MR excretory urography is a promising technique which affords equivalent functional and additional anatomical information to isotope renography. It is more accurate than Doppler ultrasound in the assessment of ureteric obstruction in pregnancy. Spencer, J. A. (2000)

Evaluation of module industrial usage possibility on the making of renography using serial port

International Nuclear Information System (INIS)

Santoso, Wiranto Budi

2003-01-01

The possibilities of using industrial modules on renography with serial port have been investigated. Industrial modules from Advantech company (ADAM 4000 series) have been chosen to be evaluated since they are cheapest among other industrial modules. The Adam 4080 counter modules is used as the pulse counters. This module has two counters so that the counters can be used to count the pulse from two renography detectors separately. Two Adam 4050 digital output modules are used to set the energy window of the Single Channel Analyzer. One module is used to set the energy level while the other one is used to set the delta energy. The investigation is conducted under Windows 98 operating system. For energy window setting the result is good. While for pulse counting, the result of counting depend on other activities working on the windows operating system

F+0 diuresis renography in infants and children

International Nuclear Information System (INIS)

Wong, D.C.; Rossleigh, M.A.; Farnsworth, R.H.; Sydney Children's Hospital, Sydney, NSW

2000-01-01

The purpose of this study was to evaluate the feasibility of modifying diuresis renography by the simultaneous administration of 99mTc-MAG3 and furosemide in the investigation of hydronephrosis and hydroureteronephrosis in infants and children. Two parameters were assessed: the diuretic response in normal kidneys and the ability of the F+0 study to differentiate between renal obstruction from non-obstruction, and to identify the level of obstruction in cases of renal obstruction. Seventy-two patients (48 males, 24 females; age 2 d to 7 y, median age 6 wk) with sonographic diagnoses of hydronephrosis or hydroureteronephrosis were reviewed prospectively over a 3-y period. All patients had prior sonographic studies and micturating cystourethrography. Bladder catheterisation was not routinely performed and only undertaken if the child had suspected VUJ obstruction or Grade II or more vesico-ureteric reflux. A weight-adjusted dose of 99mTc-MAG3 (maximum 200 MBq, minimum 20 MBq) and 1 mg/kg of furosemide (maximum 40 mg) were administered intravenously at the same time. Posterior imaging of the kidneys and bladder was performed for 90 min and followed by gravity-assisted drainage or imaging after voiding. All patients were followed up for 6-12 mo and the final diagnoses were based on either surgery or conservative management with repeat sonography or follow-up 99mTc-MAG3 studies (or both). The results of the F+0 diuresis renography were the compared to the final diagnoses. A renal unit was defined as a kidney and its ureter. There were 151 renal units with one patient having bilateral duplex kidneys, six patients having unilateral duplex kidneys and one patient having a solitary kidney. 55 normal renal units and 96 abnormal renal units on the basis of sonographic findings were assessed. The T1/2 for the 55 normal renal units was 1.3-6.3 min (mean 3.8 min). Of the 96 abnormal renal units, 53 were classified as nonobstructed and 43 were classified as obstructed. Of the 53

Utility of diuretic renography in patients with urinary diversion procedures secondary to pelvic malignancies

International Nuclear Information System (INIS)

Podoloff, D.A.; Lamki, L.A.; Kim, E.E.; Haynie, T.P.

1988-01-01

The authors performed diuretic renography in 17 patients with pelvic malignancy and urinary tract diversion. After injection of 10 mCi of Tc-99m-labeled DTPA, perfusion and dynamic images of renal function were obtained. Patients received furosemide, 0.5 mg/kg intravenously, 20-21 minutes into the study. Background subtracted whole-kidney time activity curves were generated. Studies were interpreted as normal, intermediate, or obstructed, depending on the contour of the washout phase of the renogram. In the immediate postoperative period, 82% of patients showed an intermediate pattern. In these patients with urinary diversion procedures, the standard criterion of a half-life of 10 minutes or less could not be used. Instead, serial studies over time best separated patients into three groups: normal, dilated without obstruction, and obstruction. Diuretic renography is useful in the follow-up of patients who have undergone urinary diversion procedures

Measurement of single-kidney glomerular filtration function from magnetic resonance perfusion renography

Energy Technology Data Exchange (ETDEWEB)

Zeng, Meiying; Cheng, Yingsheng [Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai 200233 (China); Zhao, Binghui, E-mail: binghuizhao@163.com [Department of Radiology, Shanghai Tenth People' s Hospital, Tongji University, Shanghai 200072 (China)

2015-08-15

Highlights: • MRPR monitors the transit of contrast material through nephron. • MRPR could reveal renal physiological characteristics in quality and quantity. • This review outlines the basics and future challenges of DCE MRPR. - Abstract: Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney, and is considered to be the reference standard in the evaluation of renal function. There are many ways to test the GFR clinically, such as serum creatinine concentration, blood urea nitrogen and SPECT renography, however, they’re all not a good standard to evaluate the early damage of renal function. In recent years, the improvement of MRI hardware and software makes it possible to reveal physiological characteristics such as renal blood flow or GFR by dynamic contrast enhancement magnetic resonance perfusion renography (DEC MRPR). MRPR is a method used to monitor the transit of contrast material, typically a gadolinium chelate, through the renal cortex, the medulla, and the collecting system. This review outlines the basics of DCE MRPR included acquisition of dynamic MR perfusion imaging, calculation of the contrast concentration from signal intensity and compartment models, and some challenges of MRPR method faced in prospective clinical application.

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

International Nuclear Information System (INIS)

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

1981-01-01

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

Determination of kidney function with 99mTc-DTPA renography using a dual-head camera

DEFF Research Database (Denmark)

Madsen, Claus J; Møller, Michael L; Zerahn, Bo

2013-01-01

Single-head gamma camera renography has been used for decades to estimate kidney function. An estimate of the glomerular filtration rate (GFR) can be obtained using Tc-diethylenetriaminepentaacetic acid (Tc-DTPA). However, because of differing attenuation, an error is introduced when the kidney...

Radiohippuran renography in chronic alcoholics with acute alcohol withdrawal syndromes

International Nuclear Information System (INIS)

Dobrzanski, T.

1975-01-01

Functional changes found in radiohippuran renography in chronic alcoholics with acute alcohol withdrawal syndromes (n=82; AAWS) regressed to normal values with recovery from AAWS (during 4 days on the average) with the exception of the secretory value which increased to a maximum on the 7th day of observation, remaining approximately unchanged for the following 3 days and decreasing more gradually to a normal value on the 23rd day of observation. In various forms of AAWS the same functional changes in the radiohippuran renogram were observed. (author)

Quantitative Assessment of Obstructive Uropathy with Diuretic Renography in children

International Nuclear Information System (INIS)

Kim, Jong Ho; Lee, Dong Soo; Kwark, Cheol Eun; Lee, Kyung Han; Choi, Chang Woon; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Choi, Yong; Choi, Hwang

1993-01-01

Differentiating the various causes of hydronephrosis from that of obstruction can be very difficult. The decision-marking process for those instances of urinary tract dilatation that require surgical correction and those that do not is based in part on the findings of diuresis renography. The methodology for performing this test has differed among nuclear medicine practitioners and the surgical findings are occasionally discrepant from the diuretic renogram interpretation. Consequently we made an automatic computer software program that calculates the slope of the response curve. The quantitative indices, such as the injection and response t1/2 by linear-fitting and monoexponential-fitting, were compared with the visual assessment of the diuretic cinerenography and clinical outcome in 50 children (62 kidneys) with ureteropelvic junction obstruction. Pooled diuresis renogram data indicated that: (1) Visual evaluation of the diuretic cinerenography is a sensitive (87%, 54/62) tool to differentiate obstruction in suspected ureteropelvic junction obstruction. (2) The cut-off value (maximum washout t1/2 with non-obstruction) of injection and response t1/2 by linear-fitting were 40 min. (3) The sensitivity and specificity using injection and response t1/2 by linear-fitting for obstruction were 89%(23/26) and 100%(30/30), respectively. (4) Response t1/2 as well as injection t1/2 by monoexponential-fitting do not stratify children with possible ureteropelivic junction obstruction. In conclusion, quantitative assessment of diuretic renography as well as visual assessment of diuretic cinerenography correlate well with surgical and clinical outcome of suspected ureteropelvic junction obstruction.

Clinical significance of gamma camera renography in chronic renal insufficiency

International Nuclear Information System (INIS)

Dudczak, R.; Frischauf, H.; Kletter, K.

1980-01-01

Gamma camera renography allows, together with renal imaging, an evaluation of individual renal function. For these examinations, I 123 orthoiodohippurate is preferred and most widely used. The results on patients with chronic renal insufficiency, including urologic and posttransplantation patients, are reported. Whereas the method is of clinical significance in evaluating posttransplantation complications and in assessing individual kidney function preoperatively in urology, as well as in monitoring therapeutic effects in the early period of renal disease, it is of limited diagnostic value in chronic renal insufficiency. In this latter regard, clinical and laboratory examinations are of primary importance. (author)

F + 0 diuresis renography in infants and children

International Nuclear Information System (INIS)

Wong, D.C.; Rossleigh, M.A.; Farnsworth, R.H.

1999-01-01

Full text: The purpose of the study was to evaluate the results of modifying diuretic renography in the investigation of hydronephrosis and hydroureteronephrosis by the simultaneous administration of 99 Tc m -MAG3 and frusemide. Two parameters were assessed: (1) the diuretic response in normal kidneys and (2) the ability to differentiate renal obstruction from non-obstruction. A prospective study was performed in infants and children in whom venous access was deemed to be difficult. Seventy-two patients were involved in the 3-year study. There were 48 males and 24 females with ages ranging from 2 days to 7 years (median age of 6 weeks). Following the intravenous administration of 99 Tc m -MAG3 and frusemide simultaneously, 20-min dynamic studies of the kidneys and bladder were obtained. Post-gravity-assisted drainage images were also obtained. The patients were then followed up for 6-12 months and the results of the F+0 study were compared to the final diagnoses, based on either surgical findings or conservative management with repeat ultrasound and 99 Tc m -MAG3 studies. There were 151 renal units in 72 patients with 55 normal non-obstructed renal units and 96 abnormal renal units. All 55 normal renal units showed excellent diuretic responses with clearance half-times of 1.3-6.3 min (mean 3.8 min). Fifty-three abnormal renal units were classified as non-obstructed and 43 renal units as obstructed. Of the 53 non-obstructed renal units, there were 48 true-negatives and five false-negatives; of the 43 obstructed renal units, there were 40 true-positives and 3 false-positives. The sensitivity was 88.9%, specificity 94.1 % and accuracy 91.7%. In conclusion, F+0 diuresis renography shows an excellent diuretic response in normal kidneys and is a valid method for the investigation of hydronephrosis or hydroureteronephrosis in infants and children

Negative captopril renography on patients with renin mediated hypertension due to page kidney and reninoma

International Nuclear Information System (INIS)

Yung, B.C.K.; Wong, K.W.; Fan, W.C.; Chan, J.C.S.; Lo, S.S.S.

1999-01-01

Through a mechanism similar to renal artery stenosis, patients with reninoma and page kidney also suffered from renin mediated hypertension. Captopril renograms performed on our patients with the latter two conditions, however, did not yield diagnostic findings. Therefore, equivocal or negative captopril renography cannot serve to rule out conditions with elevated renin other than renal artery stenosis

Diuresis renography; A simultaneous comparison between sup 131 I-hippuran and sup 99 Tc sup m -MAG sub 3

Energy Technology Data Exchange (ETDEWEB)

Hvid-Jacobsen, K.; Thomsen, H.S.; Nielsen, S.L. (Koebenhavns Amts Sygehus, Herlev (Denmark). Dept. of Nuclear Medicine)

1990-01-01

In 20 patients investigated for unilateral upper urinary tract obstruction diuresis renography was performed simultaneously with {sup 131}I-hippuran and {sup 99}Tc{sup m}-MAG{sub 3} using a gamma camera with dual isotope facilities. Furosemide was administered routinely 20 min after radionuclide injection. No significant differences were found in fractional share between the two kidneys, time to maximal activity, residual activity at 20 and 30 min, or rate of emptying after furosemide administration. The MAG{sub 3} curves showed, however, better counting statistics and on scintigrams with MAG{sub 3} more anatomic details (extent of dilation and site of obstruction) could be seen. It is concluded, that MAG{sub 3} is superior to hippuran in the evaluation of patients with possible unilateral upper urinary tract obstruction by diuresis renography. (orig.).

Furosemide-131I-hippuran renography after angiotensin-converting enzyme inhibition for the diagnosis of renovascular hypertension

International Nuclear Information System (INIS)

Erbsloeh-Moeller, B.Du.; Dumas, A.; Roth, D.; Sfakianakis, G.N.; Bourgoignie, J.J.

1991-01-01

We have previously demonstrated the greater sensitivity of 131I-hippuran renography than 99mTC-DTPA scintigraphy to diagnose renovascular hypertension (RVH). This study assesses the predictive diagnostic value of furosemide-131I-hippuran renography after angiotensin-converting enzyme (ACE) inhibition in patients with and without RVH. All patients were investigated at the University of Miami/Jackson Memorial Medical Center. Twenty-eight patients had RVH and 22 did not. Twenty-eight patients had normal or minimally decreased renal function and 22 had renal insufficiency. Renography was performed 60 minutes after oral administration of 50 mg captopril or 10 minutes after intravenous injection of 40 micrograms/kg enalaprilat. Forty milligrams of furosemide were administered intravenously 2 minutes after injection of 131I-hippuran. The residual cortical activity (RCA) of 131I-hippuran was measured at 20 minutes. RVH was unlikely when RCA after ACE inhibition was less than 30% of peak cortical activity. Conversely, RVH was present when 131I-hippuran cortical activity steadily increased throughout the test to reach 100% at 20 minutes. In azotemic patients with RCA between 31% and 100%, RVH was differentiated from intrinsic renal disease by obtaining a baseline renogram without ACE inhibition and comparing RCA in that study and RCA after ACE inhibition. If RCA increased (indicating worsening renal function) after ACE inhibition, RVH was likely; whereas, intrinsic renal disease was more likely if RCA remained unchanged or decreased (indicating improved renal function) with ACE inhibition. The test had a specificity of 95% and a sensitivity of 96% in this population. There was a direct correlation between the results of angioplasty or surgery on high blood pressure and the changes in RCA before and after intervention (n = 20)

99mTc-DTPA candesartan renography in the diagnosis of renovascular hypertension

International Nuclear Information System (INIS)

Alonso, O.; Moreira, E.; Galvalisi, M.E.; Alvarez, G.; Andruskevicius, P.; Guisoli, P.; Lago, G.; Beretta, M.

2002-01-01

Aim: Captopril renography (CPR) has been proved to be highly accurate in the diagnosis of patients with renovascular hypertension (RVH). However, a false-negative rate up to 20% has been described. Candesartan, a new angiotensin II AT1-receptor antagonist (ARA), has proved to be more effective to lower blood pressure in hypertensive patients than losartan, the most widely used drug of the group. The aim of this study was to evaluate the feasibility and the potential clinical value of candesartan renography (CSR) in the diagnosis of RVH and to compare on a head-to-head basis, the results of CPR and CSR. Material and Methods: A total of 39 studies were performed on 14 patients (9 female, 5 male, median age 45.5 yr, range: 35-74 yr) with moderate-to-high risk of RVH, using a three-day protocol (1: CPR, 2: CSR, 3: baseline). If the CPR and CSR studies were normal, no further studies were done. A dose of 296 MBq of 99m Tc-DTPA was i.v. injected one hour after captopril (50 mg), and three hours after candesartan (8 mg) interventions. Patients were imaged supine with a LFOV camera equipped with a LEHR collimator. Renogram curves were generated and split kidney uptake was also calculated during tracer uptake interval (2 to 3 min), using the area method. A study was considered of high probability for RVH (positive) when an unilateral change ≥2 in the renogram grade and/or a reduction in the relative kidney uptake greater than 10% was seen in the CPR/CSR study compared with the baseline acquisition. Patients underwent angiography (n=10) or colour doppler (n=4) within 2 weeks of nuclear studies. Results: Six patients were diagnosed by correlative imaging with unilateral (n=5) or bilateral (n=1) renal artery stenosis (RAS). In this group CPR was positive in 2/7 (29%) renal units whereas CSR was positive in 6/7 (86%). No evidence of significant RAS was demonstrated in the remaining group of patients (n=8) in whom CPR and CSR studies were negative for RVH. Conclusion: These

A multiple regression analysis for accurate background subtraction in 99Tcm-DTPA renography

International Nuclear Information System (INIS)

Middleton, G.W.; Thomson, W.H.; Davies, I.H.; Morgan, A.

1989-01-01

A technique for accurate background subtraction in 99 Tc m -DTPA renography is described. The technique is based on a multiple regression analysis of the renal curves and separate heart and soft tissue curves which together represent background activity. It is compared, in over 100 renograms, with a previously described linear regression technique. Results show that the method provides accurate background subtraction, even in very poorly functioning kidneys, thus enabling relative renal filtration and excretion to be accurately estimated. (author)

99Tcm-DTPA renography in evaluating the function of duplex kidneys in pediatric patients

International Nuclear Information System (INIS)

Zhang Lixia; Wang Xiaoming; Chen Jinyan; Su Junmei

2013-01-01

Objective: To study the value of 99 Tc m -DTPA dynamic renography in evaluating the function of duplex kidneys in pediatric patients. Methods: Twenty-five pediatric patients with duplex kidneys diagnosed by ultrasound or MR urography (MRU) were included (9 males, 16 females; mean age:(23.80 ± 20.97) months, range: 2-72 months). Twenty patients (9 males,11 females; mean age: (32.95 ± 23.58) months, range: 2-72 months) with urinary tract infection but without duplex kidneys confirmed by ultrasound or MRU were chosen as control group during the same period of this study. All patients and controls were divided into two subgroups according to their ages (group Ⅰ, 0-24 months; group Ⅱ, 25-72 months). The research was approved by the ethics committee, and all patients' parents (or guardians) signed informed consents. The time-activity curve was generated on the dynamic imaging data automatically with GFR calculated. The uptake rates of the upper and lower moieties were measured by drawing the corresponding ROIs in the duplex kidney. Dunnett-t test was used for statistical analysis. Results: There were 25 patients with 26 duplex kidneys (1 case bilateral), 16 on the left and 10 on the right. The time-activity curve of 6 cases was normal, 9 with continuously upward type, 4 with high level plateau type, 2 with parabolic type and 5 with low level plateau type. There were 19 abnormal kidneys in group Ⅰ and 7 in group Ⅱ, and 20 kidneys in each control subgroup. The GFR of patients with normal renography was (78.81 ± 15.97) ml/min (group Ⅰ) and (64.68 ± 11.15) ml/min (group Ⅱ), continuously upward type was (72.11 ±22.76) ml/min (group Ⅰ) and (63.41 ± 16.42) ml/min (group Ⅱ), high level plateau and parabolic types were (68.74 ± 16.17) ml/min and (65.26 ± 15.27) ml/min in group Ⅰ, respectively. There was no statistically significant difference between the GFR of different renography type groups and that of the controls (group Ⅰ: (79.35 ±13.31) ml

Furosemide- sup 131 I-hippuran renography after angiotensin-converting enzyme inhibition for the diagnosis of renovascular hypertension

Energy Technology Data Exchange (ETDEWEB)

Erbsloeh-Moeller, B.Du.; Dumas, A.; Roth, D.; Sfakianakis, G.N.; Bourgoignie, J.J. (Univ. of Miami/Jackson Memorial Medical Center, FL (USA))

1991-01-01

We have previously demonstrated the greater sensitivity of 131I-hippuran renography than 99mTC-DTPA scintigraphy to diagnose renovascular hypertension (RVH). This study assesses the predictive diagnostic value of furosemide-131I-hippuran renography after angiotensin-converting enzyme (ACE) inhibition in patients with and without RVH. All patients were investigated at the University of Miami/Jackson Memorial Medical Center. Twenty-eight patients had RVH and 22 did not. Twenty-eight patients had normal or minimally decreased renal function and 22 had renal insufficiency. Renography was performed 60 minutes after oral administration of 50 mg captopril or 10 minutes after intravenous injection of 40 micrograms/kg enalaprilat. Forty milligrams of furosemide were administered intravenously 2 minutes after injection of 131I-hippuran. The residual cortical activity (RCA) of 131I-hippuran was measured at 20 minutes. RVH was unlikely when RCA after ACE inhibition was less than 30% of peak cortical activity. Conversely, RVH was present when 131I-hippuran cortical activity steadily increased throughout the test to reach 100% at 20 minutes. In azotemic patients with RCA between 31% and 100%, RVH was differentiated from intrinsic renal disease by obtaining a baseline renogram without ACE inhibition and comparing RCA in that study and RCA after ACE inhibition. If RCA increased (indicating worsening renal function) after ACE inhibition, RVH was likely; whereas, intrinsic renal disease was more likely if RCA remained unchanged or decreased (indicating improved renal function) with ACE inhibition. The test had a specificity of 95% and a sensitivity of 96% in this population. There was a direct correlation between the results of angioplasty or surgery on high blood pressure and the changes in RCA before and after intervention (n = 20).

Estimation in adults of the glomerular filtration rate in [99mTc] DTPA renography - the rate constant method

International Nuclear Information System (INIS)

Carlsen, Ove

2004-01-01

The purpose of this study was to design an alternative and robust method for estimation of glomerular filtration rate (GFR) in [ 99 mTc]-diethylenetriaminepentaacetic acid ([ 99 mTc] -DTPA renography with a reliability not significantly lower than that of the conventional Gates' method. Methods: The method is based on renographies lasting 40 min in which regions of interest (ROIs) are manually created over selected parts of certain blood pools (e.g. heart, lungs, spleen, and liver). For each ROI the corresponding time-activity curve (TAC) was generated, decay corrected and exposed to a monoexponential fit in the time interval 10 to 40 min postinjection. The rate constant in min-1 of the monoexponential fit was denoted BETA. Following an iterative procedure comprising usually 5-10 manually created ROIs, the monoexponential fit with the maximum rate constant (BETA max ) was used for estimation of GFR. Results: In a patient material of 54 adult subjects in whom GFR was determined with multiple or one sample techniques with [ 51 Cr]-ethylenediaminetetraacetic acid ([ 51 Cr]-EDTA) the regression curve of standard GFR (GFR std ) (i.e. GFR adjusted to 1.73 m 2 body surface area) showed a close, non-linear relationship with BETA max with a correlation coefficient of 95%. The standard errors of estimate (SEE) were 6.6, 10.6 and 16.8 for GFR std equal to 30, 60, and 120 ml/(min .73 m 2 ), respectively. The corresponding SEE values for almost the same patient material using Gates' method were 8.4, 11.9, and 16.8 ml/(min 1.73 m 2 ). Conclusions: The alternative rate constant method yields estimates of GFR std with SEE values equal to or slightly smaller than in Gates' method. The two methods provide statistically uncorrelated estimates of GFR std . Therefore, pooled estimates of GFR std can be calculated with SEE values approximately 1.41 times smaller than those mentioned above. The reliabilities of the pooled estimate of GFR std separately and of the multiple samples method

A motion correction algorithm for an image realignment programme useful for sequential radionuclide renography

International Nuclear Information System (INIS)

De Agostini, A.; Moretti, R.; Belletti, S.; Maira, G.; Magri, G.C.; Bestagno, M.

1992-01-01

The correction of organ movements in sequential radionuclide renography was done using an iterative algorithm that, by means of a set of rectangular regions of interest (ROIs), did not require any anatomical marker or manual elaboration of frames. The realignment programme here proposed is quite independent of the spatial and temporal distribution of activity and analyses the rotational movement in a simplified but reliable way. The position of the object inside a frame is evaluated by choosing the best ROI in a set of ROIs shifted 1 pixel around the central one. Statistical tests have to be fulfilled by the algorithm in order to activate the realignment procedure. Validation of the algorithm was done for different acquisition set-ups and organ movements. Results, summarized in Table 1, show that in about 90% of the stimulated experiments the algorithm is able to correct the movements of the object with a maximum error less of equal to 1 pixel limit. The usefulness of the realignment programme was demonstrated with sequential radionuclide renography as a typical clinical application. The algorithm-corrected curves of a 1-year-old patient were completely different from those obtained without a motion correction procedure. The algorithm may be applicable also to other types of scintigraphic examinations, besides functional imaging in which the realignment of frames of the dynamic sequence was an intrinsic demand. (orig.)

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

International Nuclear Information System (INIS)

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

1992-01-01

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

Valutazione morfo-funzionale in pazienti ipertesi con stenosi dell'arteria renale; Correlazioni tra angiografia e scintigrafia dinamica. Morpho-functional evaluation in hypertensive patients with renal artery stenosis; Correlations between angiography and radionuclide renography

Energy Technology Data Exchange (ETDEWEB)

Cuocolo, A; Celentano, L; Nappi, A [Naples Univ. (Italy). Ist. di Scienze Radiologiche; Neumann, R D; Salvatore, M [Naples Univ. (Italy). Cattedra di Medicina Nucleare

1991-01-01

Renovascula hypertension is the most important and common cause of secondary hypertension. We studied 10 patients with arterial hypertension and different degrees of renal artery stenosis to assess the usefulness of dynamic radionuclide renography in evaluating renal perfusion and funcion, and to compare funcional radionuclide results to the morphological findings of renal angiography. Computer-assisted dynamic renal with {sup 00m}Tc diethylenetriaminepentaacetic acid (DTPA) and {sup 131}I orthoiodohippurate (OIH), and renal artheriography were also employed in all patients. In all patients, radionuclide results matched angiography findings in quality. In particular, 3 patients with hemodynamical insignificant renal artery stenosis exhibited normal perfusion and function at dynamic radionuclide renography. Seven patients had significant renal artery stenosis and associated functional changes at dynamic radionuclide renography. Quantitative comparison of all patients showed a significant correlation (r=0.866, p<0.001) between the degree of renal artery stenosis, quantified as the percentage of narrowing as compared to adjacent/contralateral normal vessel diameter, and the results of split renal function, as assessed during OIH studies and expressed per kidney as a percentage of the net total counts of both kidneys. In conclusion, our results demonstrated dynamic radionuclide renography to be a valuable secondary to renal artery stenosis in hypertensive patients, providing complementary results to arteriography.

Diuretic 99mTc DTPA renography in assessment of renal function and drainage in infants with antenatally detected hydronephrosis.

Science.gov (United States)

Radulović, Marija; Pucar, Dragan; Jauković, Ljiljana; Sisić, Marija; Krstić, Zoran; Ajdinović, Boris

2015-12-01

The controversy over the postnatal management of infants with antenataly detected hydronephrosis (ANH) still exists. We presented the results of diuretic 99mTc diethylenetriamine pentaacetic acid (DTPA) renography in 30 infants with the antenatal diagnosis of unilateral renal pelvic dilatation. The aim of this study was to assess the renal function determined by the pattern of drainage and split renal function (SRF) on diuretic renography and to correlate these findings with anteroposterior pelvic diameter (APD) estimated by ultrasonography. A total of 30 infants with 60 renal units (RU) (25 boys and 5 girls, median age 6.0 months, range 2-24) presented with unilateral hydronephrosis on ultrasound in the newborn period, underwent DTPA diuretic renal scintigraphy (F+15 protocol). The median APD evaluated on perinatal ultrasound was 15 mm (range 5-30). The postnatal associated clinical diagnosis were pelviureteric junction obstruction (PUJ), simple hydronephrosis, megaureter, vesicoureteral reflux (VUR) and posterior urethral valves in 11, 10, 6, 2 and 1 infant, respectively. Images and Tmax/2 after diuretic stimulation on the background subtracted renographic curves were used as the criteria for classifying the drainage as good, partial, and poor or no drainage. The SRF was calculated with the integral method. Good drainage was shown in 36/60, partial drainage in 13/60 and poor or no drainage in 11/60 RU. The SRF > 40% was observed in 55/60 RU, with no RU showing SRF lower than 23.5%. In infants with severe ANH the obstruction was not excluded in 94.1%. Diuretic renography in antenatally detected hydronephrosis should be a useful tool in postnatal follow up, especially in differentiating nonobstructive hydronephrosis from obstructive. It is also importanat to assess and monitor the SRF. Our results suggest that even in the presence of partial or no drainage, SRF may not be significantly impaired.

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

Energy Technology Data Exchange (ETDEWEB)

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

1992-11-01

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

Assessment of renal impairment by non-contrast-enhanced conventional magnetic resonance imaging. Comparison with 99mTc-DTPA renography

International Nuclear Information System (INIS)

Hidaka, Fumitaka; Amano, Yasuo; Takahama, Katsuya; Takagi, Ryo; Murakami, Ryusuke; Onozawa, Shiro; Kumita, Shinichiro

2011-01-01

The aim of this study was to determine whether non-contrast-enhanced magnetic resonance imaging (MRI) can detect three levels of renal impairment by evaluating the differences and agreement with 99m Tc-diethylenetriamine pentaacetic acid (DTPA) renography. A total of 28 patients with kidney disease were enrolled in the study. MRI findings, including visual corticomedullary differentiation (CMD) on T1- and T2-weighted imaging (T1WI, T2WI), cortical irregularity, the number of renal cysts, and the volume of the kidney, were evaluated for individual kidneys and pairs of kidneys. The differences and agreement between MRI findings and the three levels of renal impairment based on the glomerular filtration rate (GFR) measured using 99m Tc-DTPA renography were analyzed. All MRI findings except the number of renal cysts in pairs of kidneys were consistent with the patient's classification. The agreement between the patient's classifications based on GFR and that based on the visual CMD on T1WI and T2WI was almost perfect or substantial in both individual kidneys and pairs of kidneys. Non-contrast-enhanced MRI was capable of distinguishing three levels of renal function, including serious renal impairment. (author)

Renal parenchymal function evaluated by scintillation camera renography before and after pyeloplasty for hydronephrosis

International Nuclear Information System (INIS)

Ahlgren, G.; Maansson, W.; White, T.

1992-01-01

Scintillation camera renography with Tc-DTPA was performed before and after pyeloplasty on 16 kidneys with urographic signs of pelviureteric obstruction causing hydronephrosis. Regional parenchymal renograms were generated, and the passage of Tc-DTPA through the parenchyma was measured and correlated to the change in separate glomerular filtration rate. Preoperative parenchymal passage of DTPA was significantly slower in kidneys with improved glomerular filtration rate after pyeloplasty than in those without such improvement. Postoperative passage of DTPA in parenchyma was almost identical with that in a reference series. This method seems to be clinically useful for evaluating cases of hydronephrosis and for predicting the outcome of pyeloplasty. (au)

Angiotensin converting enzyme inhibition induces alterations to hippuran renography despite unchanged ipsilateral renal blood flow in conscious two-kidney, one clip Goldblatt hypertensive dogs

NARCIS (Netherlands)

Jonker, G J; de Zeeuw, D; Huisman, R M; van der Hem, G K

1988-01-01

We performed experiments in the two-kidney, one clip Goldblatt hypertensive dog to see whether angiotensin converting enzyme (ACE) inhibition could improve the sensitivity of hippurate renography in detecting renal artery stenosis. Ten dogs on a sodium-restricted diet were studied before and after

The Test of Inaccurate Position of Renography Detector to Relative UptakeFigure and Individual Excretion

International Nuclear Information System (INIS)

Bambang-Supardiyono; Prayitno

2000-01-01

Accuracy of detector position toward the kidney location (preciseposition) in renography will resulting the maximum count figure, detectorposition change from the precise point (inaccurate) will decreasing the countrate. Therefore for it had been simulated the influence of count figure ofright kidney (fixed left kidney count) ± 5 % to ± 20 % to relativeuptake figure and individual excretion. Based on the calculation it was foundthat the relation of detector position ± 0.5 cm to ± 2 cm from theprecise point will have effect to relative uptake figure ± (1.25 % to 5.00%), the fixed individual excretion figure. The change is still can beaccepted because the qualitative information with 10 % accuracy is stillacceptable. (author)

Effect of time in the evaluation of F+20 and F0 diuretic renography

International Nuclear Information System (INIS)

Donoso, G.; Piepsz, A.; Ham, H.

2002-01-01

F0 diuretic renography starts gaining popularity especially because of the practical convenient of avoiding one intravenous injection. Using F0 however, the most adequate parameters for evaluating renal output are still to be determined. Aim: to evaluate which parameter of F0 and F+20 procedures gives rise to the best possible renal drainage. Methods: In this retrospective study we compared F0 and F20 quantitative parameters obtained in 36 clinically stable children, aged 10 days to 17 years, with unilateral (25) or bilateral (11)hydronephrosis, in whom both tests were performed. The mean time interval between the two tests was 17 months. F0 and F+20 Tc-99m MAG3 diuretic renography were carried out using the usual procedure. In all cases, a late image (PM) was acquired after micturition and after changing the position of the patient. The mean time at which this image was acquired was 80 min(SD : 33) for the F+20 test and 48 min(SD : 30) for the F0 test. Following parameters were calculated : Time to the maximum of the basic renogram (Tmax); normalized residual activity (NORA) and output efficiency (OE) at the end of the 20- min renogram, at the end of furosemide test (35 min) and on the post micturition image (NORA 20, NORA 35, NORA PM, OE 20, OE35 and OE PM). On the basis of all available parameters, each of the 47 hydronephrotic kidneys were classified either as 'good drainage' or as 'partial or bad drainage'. All parameters were then evaluated according to this reference. Conclusions: For both the F+20 and the F0 tests, the PM image had obviously a higher performance rate than all the other parameters, underlying the mandatory character of this acquisition. The higher performance of the PM image on F+20 is clearly related to the significantly different time at which the PM image was acquired, underlying the need of standardization of the acquisition time

Computer assisted diagnosis in renal nuclear medicine: rationale, methodology and interpretative criteria for diuretic renography

Science.gov (United States)

Taylor, Andrew T; Garcia, Ernest V

2014-01-01

The goal of artificial intelligence, expert systems, decision support systems and computer assisted diagnosis (CAD) in imaging is the development and implementation of software to assist in the detection and evaluation of abnormalities, to alert physicians to cognitive biases, to reduce intra and inter-observer variability and to facilitate the interpretation of studies at a faster rate and with a higher level of accuracy. These developments are needed to meet the challenges resulting from a rapid increase in the volume of diagnostic imaging studies coupled with a concurrent increase in the number and complexity of images in each patient data. The convergence of an expanding knowledge base and escalating time constraints increases the likelihood of physician errors. Errors are even more likely when physicians interpret low volume studies such as 99mTc-MAG3 diuretic scans where imagers may have had limited training or experience. Decision support systems include neural networks, case-based reasoning, expert systems and statistical systems. iRENEX (renal expert) is an expert system for diuretic renography that uses a set of rules obtained from human experts to analyze a knowledge base of both clinical parameters and quantitative parameters derived from the renogram. Initial studies have shown that the interpretations provided by iRENEX are comparable to the interpretations of a panel of experts. iRENEX provides immediate patient specific feedback at the time of scan interpretation, can be queried to provide the reasons for its conclusions and can be used as an educational tool to teach trainees to better interpret renal scans. iRENEX also has the capacity to populate a structured reporting module and generate a clear and concise impression based on the elements contained in the report; adherence to the procedural and data entry components of the structured reporting module assures and documents procedural competency. Finally, although the focus is CAD applied to

Clinical evaluation of diuretic renography in infants and children with congenital urinary abnormality

International Nuclear Information System (INIS)

Li Jingsong; Li Jianing; Fu Hongliang; Zou Renjian; Wu Jingchuan

2006-01-01

Objective: The clinical application of furosemide plus 15-minute diuretic renography (F+15 DR) was evaluated in infants and children with congenital urinary abnormalities. Methods: In 163 patients with different congenital urinary abnormalities undergoing F+15 DR, 97 were operated and followed by F+15 DR reexamination. The DR imaging characteristics were analyzed and, based on those analyses, hydronephrosis was classified into five degrees. Follow-up data were analyzed both quantitatively and qualitatively. Results: Each renal abnormality (kidney duplication 60, horseshoe kidney 6, multiple cysts of kidney 5, hypoplasia 35, ureterocele 20, displacement of ureter opening 13, megaloureter 20, valve of ureter 26) exhibited its unique characteristics on DR imaging. Renal functions of those patients were improved dur- ing the follow-up after surgical operations. Patients with duplex kidney and ureter abnormalities had better prognosis than those with urethral valve. Conclusion: F + 15 DR imaging may reveal characteristic changes of congenital urinary abnormalities and helps in the qualitative or quantitative evaluation of the treatments. (authors)

Clinical usefulness of physiological components obtained by factor analysis. Application to /sup 99m/Tc-DTPA renography

Energy Technology Data Exchange (ETDEWEB)

Ohtake, Eiji; Murata, Hajime; Matsuda, Hirofumi; Yokoyama, Masao; Toyama, Hinako; Satoh, Tomohiko.

1989-01-01

The clinical usefulness of physiological components obtained by factor analysis was assessed in /sup 99m/Tc-DTPA renography. Using definite physiological components, another dynamic data could be analyzed. In this paper, the dynamic renal function after ESWL (Extracorporeal Shock Wave Lithotripsy) treatment was examined using physiological components in the kidney before ESWL and/or a normal kidney. We could easily evaluate the change of renal functions by this method. The usefulness of a new analysis using physiological components was summarized as follows: (1) The change of a dynamic function could be assessed in quantity as that of the contribution ratio. (2) The change of a sick condition could be morphologically evaluated as that of the functional image.

99mTc-DTPA renography before and after extracorporeal shock wave lithotripsy for renal calculi

International Nuclear Information System (INIS)

Ohtake, Eiji; Murata, Hajime; Kanemura, Mikio; Yokoyama, Masao

1988-01-01

This study was undertaken to evaluate 99m Tc-DTPA renography before and after extracorporeal shock wave lithotripsy (ESWL). Twelve patients with renal calculi were examined in this study. In three patients, bilateral kidneys were treated with ESWL. Sequential renal images of the vascular phase, and the functional and excretory phases were taken using a gamma camera (ZLC 7500, Siemens), after intravenous injection of 555 MBq of 99m Tc-DTPA. Renograms were generated using data stored every 10 seconds for a period of 30 minutes by computer (Scintipac-2400, Shimadzu). Some treated kidneys were enlarged and/or showed uniform retention of radioactivity on sequential images, within a week after ESWL. Renogram patterns after ESWL were varied in each patient. The renogram findings after ESWL seemed to be affected by the presence or absence of stone fragments in the urinary tract. (author)

Quantitative analysis of infantile ureteropelvic junction obstruction by diuretic renography

Energy Technology Data Exchange (ETDEWEB)

Ueno, Shigeru; Suzuki, Yutaka; Murakami, Takeshi; Yokoyama, Seishichi; Hirakawa, Hitoshi; Tajima, Tomoo; Makuuchi, Hiroyasu [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

2001-04-01

Infantile hydronephrosis detected by ultrasonography poses a clinical dilemma on how to treat the condition. This article reports a retrospective study to evaluate infantile hydronephrosis due to suspected ureteropelvic junction (UPJ) obstruction by means of standardized diuretic renography and to speculate its usefulness for quantitative assessment and management of this condition. Between November 1992 and July 1999, 43 patients who had the disease detected in their fetal or infantile period were submitted to this study. Standardized diuretic renograms were obtained with {sup 99m}Tc-labeled diethylene-triaminepenta-acetate (Tc-99m-DTPA) or {sup 99m}Tc-labeled mercaptoacetyl triglycine (Tc-99m-MAG3) as radiopharmaceuticals. Drainage half-time clearance (T 1/2) of the activity at each region of interest set to encompass the entire kidney and the dilated pelvis was used as an index of quantitative analysis of UPJ obstruction. Initial T 1/2s of 32 kidneys with suspected UPJ obstruction were significantly longer than those of 37 without obstruction. T 1/2s of kidneys which had undergone pyeloplasty decreased promptly after surgery whereas those of units followed up without surgery decreased more sluggishly. These findings demonstrate that a standardized diuretic renographic analysis with T 1/2 can reliably assess infantile hydronephrosis with UPJ obstruction and be helpful in making a decision on surgical intervention. (author)

Quantitative analysis of infantile ureteropelvic junction obstruction by diuretic renography

International Nuclear Information System (INIS)

Ueno, Shigeru; Suzuki, Yutaka; Murakami, Takeshi; Yokoyama, Seishichi; Hirakawa, Hitoshi; Tajima, Tomoo; Makuuchi, Hiroyasu

2001-01-01

Infantile hydronephrosis detected by ultrasonography poses a clinical dilemma on how to treat the condition. This article reports a retrospective study to evaluate infantile hydronephrosis due to suspected ureteropelvic junction (UPJ) obstruction by means of standardized diuretic renography and to speculate its usefulness for quantitative assessment and management of this condition. Between November 1992 and July 1999, 43 patients who had the disease detected in their fetal or infantile period were submitted to this study. Standardized diuretic renograms were obtained with 99m Tc-labeled diethylene-triaminepenta-acetate (Tc-99m-DTPA) or 99m Tc-labeled mercaptoacetyl triglycine (Tc-99m-MAG3) as radiopharmaceuticals. Drainage half-time clearance (T 1/2) of the activity at each region of interest set to encompass the entire kidney and the dilated pelvis was used as an index of quantitative analysis of UPJ obstruction. Initial T 1/2s of 32 kidneys with suspected UPJ obstruction were significantly longer than those of 37 without obstruction. T 1/2s of kidneys which had undergone pyeloplasty decreased promptly after surgery whereas those of units followed up without surgery decreased more sluggishly. These findings demonstrate that a standardized diuretic renographic analysis with T 1/2 can reliably assess infantile hydronephrosis with UPJ obstruction and be helpful in making a decision on surgical intervention. (author)

Assessment of effectiveness of Anderson-Hynes operation in patients with unilateral hydronephrosis according to the data of radionuclide renography and clearance-tests

International Nuclear Information System (INIS)

Khripta, F.P.; Kogut, Yu.Ya.

1988-01-01

The function of injured and contralateral kidneys is studied according to the data of radionuclide renography, effective kidney plasma flow and glomerular filtration in 35 patients with unilateral hydronephrosis after the Andersen-Heinz operation. The comparative estimate of the data obtained before and after operation (in different periods) is carried out. The improvement of functions of the hydronephrotic kidney is found both 1-5 years and 0.5 year after the operation. It is shown that radionuclide clearance tests are objective methods of studying remote results of surgical treatment of hydronephrosis. 8 refs

/sup 99m/Tc-DTPA renography before and after extracorporeal shock wave lithotripsy for renal calculi

Energy Technology Data Exchange (ETDEWEB)

Ohtake, Eiji; Murata, Hajime; Kanemura, Mikio; Yokoyama, Masao

1988-09-01

This study was undertaken to evaluate /sup 99m/Tc-DTPA renography before and after extracorporeal shock wave lithotripsy (ESWL). Twelve patients with renal calculi were examined in this study. In three patients, bilateral kidneys were treated with ESWL. Sequential renal images of the vascular phase, and the functional and excretory phases were taken using a gamma camera (ZLC 7500, Siemens), after intravenous injection of 555 MBq of /sup 99m/Tc-DTPA. Renograms were generated using data stored every 10 seconds for a period of 30 minutes by computer (Scintipac-2400, Shimadzu). Some treated kidneys were enlarged and/or showed uniform retention of radioactivity on sequential images, within a week after ESWL. Renogram patterns after ESWL were varied in each patient. The renogram findings after ESWL seemed to be affected by the presence or absence of stone fragments in the urinary tract.

Clinical evaluation of diuretic renography in obstructive uropathy

International Nuclear Information System (INIS)

Itoh, Kazuo; Imanaka, Kaori; Nonomura, Katsuya; Koyanagi, Tomohiko

1982-01-01

Diuretic renography assisted with Lasix was performed in 44 cases with obstructive uropathy. The procedure was done in four steps, (1) hydration with an intake of water 10 to 20 minutes before the examination, (2) non-diuretic (regular) dynamic renal scan with sup(99m)Tc-DTPA for 20 minutes. (3) Voiding and (4) post-voiding diuretic dynamic renal scan followed an i.v. injection of Lasix (0.4-0.5 mg/kg, Max 20 mg) at 2 minutes for 15 minutes. Quantitative analysis of the time-activity curves which were obtained from data stored as 64 x 64 matrix per frame of 10 seconds during imaging was simultanously performed on a computer system. Most of kidneys showed a prompt linear, mono-compartnental excretion in a semi-logarithmic scale after the administration of diuretics. Mean half time (D-Tl/2) and S.D. of diuretic excretion in normal Kidneys was 4.41 +- 2.73 minutes and reactive duration 2.04 +- 1.23. The excretion pattern of these diuretic renograms showed four different groups, (I) linear decrease with D-Tl/2 under 10 min., (II) linear with D-Tl/2 between 10 to 20 min. (III) linear with D-Tl/2 over 20 Min. and non-linear and (IV) flat or elevated excretion. All of preoperative obstructive kidneys urologically indicated of the operation showed excretion pattern of I, III and IV with decrease in a blood perfusion on non-diuretic dynamic images. This finding is appreciated of significance evaluating the indication of an operation to the affected kidney. However, many of the postoperative kidneys showed such decrease persisted. In those kidneys, diuretic Tl/2 and excretion patterns were useful for following-up the urodynamic change after the reconstration performed in urinary tracts (author)

Dynamic 99mTc-MAG3 renography: images for quality control obtained by combining pharmacokinetic modelling, an anthropomorphic computer phantom and Monte Carlo simulated scintillation camera imaging

Science.gov (United States)

Brolin, Gustav; Sjögreen Gleisner, Katarina; Ljungberg, Michael

2013-05-01

In dynamic renal scintigraphy, the main interest is the radiopharmaceutical redistribution as a function of time. Quality control (QC) of renal procedures often relies on phantom experiments to compare image-based results with the measurement setup. A phantom with a realistic anatomy and time-varying activity distribution is therefore desirable. This work describes a pharmacokinetic (PK) compartment model for 99mTc-MAG3, used for defining a dynamic whole-body activity distribution within a digital phantom (XCAT) for accurate Monte Carlo (MC)-based images for QC. Each phantom structure is assigned a time-activity curve provided by the PK model, employing parameter values consistent with MAG3 pharmacokinetics. This approach ensures that the total amount of tracer in the phantom is preserved between time points, and it allows for modifications of the pharmacokinetics in a controlled fashion. By adjusting parameter values in the PK model, different clinically realistic scenarios can be mimicked, regarding, e.g., the relative renal uptake and renal transit time. Using the MC code SIMIND, a complete set of renography images including effects of photon attenuation, scattering, limited spatial resolution and noise, are simulated. The obtained image data can be used to evaluate quantitative techniques and computer software in clinical renography.

Methods and results of diuresis renography in infants and children. Methodik und Ergebnisse der Diurese-Nephrographie im Kindesalter

Energy Technology Data Exchange (ETDEWEB)

Kleinhans, E. (Klinik fuer Nuklearmedizin, RWTH Aachen (Germany)); Rohrmann, D. (Urologische Klinik, RWTH Aachen (Germany)); Stollbrink, C. (Paediatrische Klinik, RWTH Aachen (Germany)); Mertens, R. (Paediatrische Klinik, RWTH Aachen (Germany)); Jakse, G. (Urologische Klinik, RWTH Aachen (Germany)); Buell, U. (Klinik fuer Nuklearmedizin, RWTH Aachen (Germany))

1994-02-01

In infants and children with hydronephrosis, the decision-making process for those instances of urinary tract dilatation that require surgical correction and those that do not is based in part on the findings of diuresis renography. Quantitative analysis of renogram curve pattern is a well established tool which, in addition, provides comparable results in follow-up studies. However, standardization of the method including data analysis does not yet exist. In this study, three parameters obtained by mathematical curve analysis were examined: clearance half-time for diuretic response, clearance within 5 minutes and clearance within 16 minutes. As a result, 16 minutes clearance revealed superior results in discriminating obstructive impairments of urine drainage from not obstructive ones. Compared to the clearance halftime, the markedly shorter duration of the examination (16 minutes) is an additional benefit. (orig.)

Clinical impact of renography in antenatally discovered pelviureteric stenosis: a short review of the literature; Zur klinischen Wertigkeit der Nierenfunktionsszintigraphie bei praenatal diagnostizierten renalen Abflussstoerungen

Energy Technology Data Exchange (ETDEWEB)

Froekiaer, J.; Eskild-Jensen, A. [Dept. of Clinical Physiology and Nuclear Medicine, Aarhus Univ. Hospital, Skejby, Aarhus (Denmark)

2003-09-01

Congenital unilateral hydronephrosis is a relatively frequent and often asymptomatic condition diagnosed in utero. The natural history and significance of congenital hydronephrosis on the development and long-term consequences on renal function is not sufficiently known. The present diagnostic methods do not provide prediction of the functional consequences of a potential presence of an obstruction. However, renography is an important method affecting the clinical treatment of children with prenatal unilateral hydronephrosis, and is the only method that satisfactory can provide serial accurate measurements of differential renal function. The present review briefly summarizes the clinical impact of renography in neonatally discovered hydronephrosis in relation to the pathophysiological characteristics of congenital unilateral hydronephrosis. (orig.) [German] Bei der einseitigen angeborenen Hydronephrose handelt es sich um ein relativ haeufiges Krankheitsbild, das in der Regel durch Sonographie bereits im Uterus diagnostiziert wird. Die Ursache dieser Erkrankung und ihre Bedeutung fuer die Entwicklung der Nierenfunktion im weiteren Verlauf sind nicht ausreichend bekannt. Die heute zur Verfuegung stehenden Untersuchungsmethoden koennen keine Aussage ueber die funktionellen Konsequenzen einer moeglichen Obstruktion erbringen. Die Nierenfunktionsszintigraphie ist jedoch eine sehr wichtige Methode fuer die klinische Behandlung der Kinder mit einer einseitigen praenatal diagnostizierten Hydronephrose und sie ist die einzige Methode, die wiederholte Messungen der seitengetrennten Nierenfunktion mit einer hohen Genauigkeit ermoeglicht. Die vorliegende Arbeit fasst kurz die klinische Bedeutung der Nierensequenzszintigraphie bei praenatalen Hydronephrosen zusammen und stellt einen Zusammenhang zu den pathophysiologischen Charakteristiken dieser Erkrankung her. (orig.)

The results of isotope renography and intravenous pyelography in 420 patients with carcinoma of the uterine cervix

International Nuclear Information System (INIS)

Leodolter, S.; Philipp, K.; Szalay, S.

1979-01-01

A group of women with carcinoma of the cervix was studied by renography and i.v. pyelography. The incidence of renal and urinary tract disorders detected by these tests increased as did the stage of the disease, being 17.1% with Stage I carcinoma of the cervix, 27.8% with Stage II carcinoma of the cervix, 47% with Stage III carcinoma of the cervix, and 83.3% in Stage IV carcinoma of the cervix. In patients with Stage I and Stage II carcinoma of the cervix, those selected for radiotherapy had twice the incidence of abnormal renograms as those selected for surgery. This difference probably reflected a higher incidence of medical disorders affecting renal and urinary tract function in those considered unfit for surgery. We believe that renograms should be used routinely as a screening test in patients with carcinoma of the cervix. (orig.) [de

Role of diuretic radionuclide renography in the evaluation of unilateral ureteropelvic junction obstruction after pyeloplasty

International Nuclear Information System (INIS)

Arun, S.; Chakraborthy, D.; Senthil, R.; Kamaleshwaran, K.K.; Bhattacharya, A.; Singh, B.; Mittal, B.R.

2010-01-01

The incidence of ureteropelvic junction obstruction (UPJO) is about 1 in 1000 newborns with a left sided predominance. UPJO is the most common cause of urinary tract obstruction in children. Boys outnumber girls in a ratio of 2:1. Diuretic renography has proved to be a reliable non invasive test for assessing obstruction and differential function of the kidneys and assessing improvement after surgical intervention. Objectives: To assess the improvement in function and drainage in post operative cases of UPJO after pyeloplasty using DRR. Materials and Methods: Retrospective analysis of diuretic renograms for the past 8 years were reviewed. Among 156 patients with UPJO, 33 patients had pre and post pyeloplasty renography. Study included 13 females and 20 males in the age group range of 3 months to 56 yrs with an average age of 16.1 yrs. 23 (69.7%) patients had left side UPJO. The median time at which post pyeloplasty scintigraphy was done was 2.5 months. Scintigraphy was done as per predefined protocol using 99m Tc-EC with measurement of relative function (RF) of each kidney. Diuretic was given at 10 min of study. Improvement in relative function of the diseased kidney was taken as an increase in ≥5% in relative function of that kidney post operatively, and deterioration in relative function taken as a decrease in relative function by ≥ 5% post operatively. An increase or decrease in renal function of less than 5% is considered to be a non significant change in renal function. Results: Hydronephrosis is noted in all the patients. 22 cases had evidence of obstruction at PUJ in the pre op renogram, of whom 19(86%) showed relieved obstruction post op study. Remaining 3 cases showed persistent obstruction of which 2 showed deterioration in function. 11 cases had no evidence of obstruction, underwent pyeloplasty in which 2 showed improvement in function, 2 showed deterioration and remaining stable function. Among the 33 cases only 6 (18%) patients showed improvement

Prognosis of renal transplant function by renography with radioactive hippuran

International Nuclear Information System (INIS)

Riccabona, G.; Fill, H.; Hilty, E.; Leidlmair, K.

1986-01-01

The relation of the functional prognosis of a kidney graft to the results of renography with radioactive hippuran (OIH-RG) was assessed in 96 patients after renal allograft transplantation in 1982. By October 1, 1984 26 of these kidneys had lost their function. The curves obtained from the gamma-camera OIH-RG are classified into six different curve patterns (curve types 1 to 6) as published earlier. For the evaluation of the long-term prognosis, the survival times of the kidneys were related to the curve types. The distribution of the curve types obtained in patients with a kidney survival longer than 144 weeks differs significantly from the curve type distribution when the kidney survival is shorter than 144 weeks. The individual survival times in the collective 26 lost kidneys show a relation to the different curve types. All kidneys with curve type 4 in the last examination before hospital discharge are lost within the first 20 weeks while curve types 1 and 2 promise a functional survival up to 144 weeks. Serum creatinine time courses and their relation to the OIH-RG curve patterns are analyzed by analyses of variance and covariance with repeated measurement. These statistical analyses reveal significant differences between the creatinine courses in the single curve types and, in addition, a significant interaction of the curve types with the creatinine courses. In curve type 1, a rapid normalization of an elevated creatinine level can be predicted, while in curve type 4 no improvement of the creatinine level and thus of kidney function can be expected at least within the five days following discharge

Diuretic renography in neonates and infants with congenital obstructive hydronephrosis for evaluating post-operative renal function

International Nuclear Information System (INIS)

Li Jianing; Yang Shurong; Fu Hongliang; Gu Zhenhui; Chen Fang; Xie Hua; Zou Renjian; Wu Jingchuan

2003-01-01

Objective: To study the value of diuretic renography (DR) in evaluation of renal function after operation in congenital obstructive hydronephrosis (HN) in neonates and infants. Methods: Thirty-two patients with the disease detected in their neonatal or infantile period were submitted to this study. DR was performed 1 to 4 times on all patients during follow-up. The qualitative evaluation of renal function after operation was combined with renal morphology, renogram curve and several other renal function indexes. The major index of quantitative evaluation of renal function is the change of renal blood perfusion rate (BPR). Results: The results of qualitative evaluation with 67 DR in the affected kidney (AK): 6 totally recovered, 35 significantly improved, 7 improved, 9 unchanged, 10 deteriorated. The changes of BPR of the groups with qualitative evaluation differed from each other significantly (F=7.77, P 0.05 and r=0.166, P>0.05, respectively). Conclusion: The change of BPR is a good index of renal function after operation, but only the quantitative evaluation being combined with qualitative evaluation can be considered a complete evaluation

Kidney Scanning with Hippuran: A Necessary Complement for Correct Interpretation of Renography in the Transplanted Kidney

Energy Technology Data Exchange (ETDEWEB)

Lubin, E.; Lewitus, Z.; Rosenfeld, J.; Levi, M. [Beilinson Medical Centre, University of Tel Aviv School of Medicine (Israel)

1969-05-15

Every impairment of the kidneys' blood supply, and the production or excretion of urine, is reflected by abnormal renograms that are not specific enough in the information they provide. The subsequent performance of renal scans with Hippuran {sup 131}I adds information to the topographical distribution of the Hippuran {sup 131}I in the renal parenchyma, and to the dynamics of its transport through the urinary system. The information thus obtained is valuable in itself and is necessary for the correct interpretation of renography. We have found this specially useful in the follow-up of the transplanted kidneys. In cases of anuria following renal transplantation, the renogram is useful for indicating that renal circulation is present in the transplanted kidney but is inadequate as a method to differentiate between other renal and post-renal causes of anuria. The anuric transplanted kidney should be scanned thirty minutes after the injection of Hippuran {sup 131}I. Patterns of complementary results of renograms and renal scannings are presented that correspond to prerenal, renal and postrenal causes of anuria, with all the important therapeutic implications this differential diagnosis has. (author)

Significance of normalized residual activity value (Nora) - the new parameter of isotopic renography - for the diagnosis of patients with obstructive uropathy

International Nuclear Information System (INIS)

Juszczyk-Gontaszewska, M.; Gontaszewski, W.; Rogowski, F.

2005-01-01

The aim of this research was to establish NORA values typical of patients with compensated and uncompensated obstructive uropathy. 147 results of renoscintigraphies carried out after the application of Tc-99m DTPA with furosemide diuretic test were analyzed. The patients were divided into three groups: the group with compensated obstructive uropathy, the group with uncompensated obstructive uropathy, and the controlled group. NORA-1 and NORA-2 values were calculated in each patient, for each kidney separately. It was established that the mean NORA-1 values in the three groups (the controlled group, the compensated uropathy group, and the uncompensated uropathy group) were significantly different, thus enabling differentiation between them. Based on the examination described above, the following conclusions wee drawn: 1. NORA is an effective differentiation index for compensated and uncompensated uropathy. 2. NORA values should be routinely calculated in every case of isotopic diuretic renography. (author)

MAG3 diuresis renography and output efficiency measurement in renal transplant patients

International Nuclear Information System (INIS)

Spicer, T.; Gruenewald, S.; Chi, K.K.; Larcos, G.; Farlow, D.; Choong, K.; Chapman, J.

1997-01-01

Full text: Urinary tract obstruction following renal transplantation often presents a diagnostic dilemma, as some patients with equivocal investigations subsequently show improvement following stenting. The purposes of this study were to (1) establish a normal range of renal output efficiency (ROE) in transplants, and (2) assess the usefulness of MAG3 diuresis renography and ROE in suspected allograft obstruction. Twenty-two renal transplant patients with stable function and no evidence of hydronephrosis on serial ultrasound had a diuretic MAG3 scan with calculation of ROE. Three patients with proven graft obstruction underwent the same scanning procedure. Methodology was as follows: (1) 60 MBq of 99m Tc-DTPA GFR was performed (single injection-dual blood sample method); (2) patients were then prehydrated with either oral or IV fluid; (3) 10 min prior to scanning, intravenous Frusemide 20-80 mg (dose depending on renal function) was injected, and then (4) 200 MBq of MAG3 for a 20 min scan. The studies were then qualitatively and quantitatively reviewed to assess uptake and excretion, and the ROE was calculated. The mean ROE for the twenty-two normal renal transplant patients was 85.7% ± 4.1% (range 78 - 90%). Technetium-99m-DTPA GFR was 55.5 mL/min/1.73m 2 (range 27 to 83). The MAG3 scans in the three obstructed patients were equivocal for obstruction but the ROE values of 59%, 68% and 75% were more than 2.5 standard deviations below our calculated normal mean. The 99m Tc-DTPA GFRs were 61,17 and 57 mL/min/1.73m 2 , respectively. Thus, in normal grafts the ROE should exceed 78 per cent. Our data suggest that ROE may be a useful addition to standard scintigraphic parameters in diagnosis of graft obstruction

Assessment of 99Tcm-ethylenedicysteine diuretic renography in pre-and post-operative pediatric congenital hydronephrosis

International Nuclear Information System (INIS)

Ye Zhiyi; Wang Hui; Li Jianing; Fu Hongliang; Wu Jingchuan

2010-01-01

Objective: To investigate the clinical value of 99 Tc m -ethylenedicysteine (EC) diuretic renography (DR) in pre-and post-operative pediatric congenital hydronephrosis. Methods: The DR with injection of Furosemide at 15 min of forty children with hydronephrosis was retrospectively studied. The preoperative renal blood perfusion rate (BPR), effective renal plasma flow (ERPF), grade of hydronephrosis,renogram and renal dynamic imaging of pre- and post-operative kidneys were compared. The t-test and Mann-Whitney test were used for data analysis. Results: (1) Of 40 pathological kidneys, the BPR increased 5.99% (t=-5.13, P<0.01) from pre-operative to post-operative: (34.05 ± 11.07)% to (40.04 ± 8.56)%. The ERPF increased 12.48 ml/min (t=-4.35, P<0.01) from pre-operative to post-operative: (57.81 ± 34.32) ml/min to (70.29 ± 5.37) ml/min. (2) The grade of hydronephrosis of 40 pathological kidneys improved significantly(Z=-2.64, P<0.01) with the mean sum of ranks of 47.21 pre-operatively to 33.79 post-operatively.(3) As the hydronephrosis worsened, the collecting system became bigger, the renal parenchyma became thinner, the extent of intrarenal parenchymal photopenia became larger and the response to diuretic challenge in pathological kidneys decreased or became totally irresponsive. (4)Thirty-seven cases of obstruction at ureteropelvic junction (UPJO) and 3 cases at ureterovesical junction (UVJO) were diagnosed by DR, which were all confirmed by surgery. Conclusions: DR is a reliable method to evaluate pediatric congenital hydronephrosis.It can accurately reflect the grade and (or) severity of the disease, guide therapy and assess the therapeutic success of operation. (authors)

Clinical analysis of 131I-orthoiodohippurate renogram in diagnosis of urinary system diseases

International Nuclear Information System (INIS)

Zha Jin Shun; Shang Daohui; Jiang Yan

2012-01-01

Objective: To investigate the characteristics of the 131 I-orthoiodohippurate renography in patients with a variety of urinary system disease. Methods: Retrospectively analyzed 190 unilateral 131 I-orthoiodohippurate renography in 95 cases with urologic system disease. Disease group included the cases with unilateral or bilateral renal or ureter, bladder and prostate gland disease. The cases with normal unilateral renal or ureter were classified as normal group. The incidence of abnormal renography and the clinical features of a variety of abnormal renography were analyzed. The SPSS.16 software was used to statistical analysis. Results: The incidence of abnormal renography in disease group was significantly higher than normal group(81.34% vs.19.64% , χ 2 =64.617, P<0.005). The renographies of urethra obstruction, such as calculus and mild degree hydronephrosis, always showed steep and steadily rising curves or high flat lines. Severe hydronephrosis,renal insufficiency renographies and renal parenchymal disease showed low flat lines or straight line of low level falls gradually. The nephrograms were presenting with delayed drop of the excretory segments and stairs-like in sharp to descent in the halves or functional obstruction. Nephrogram pattern were mostly normal in the renal space-occupying lesion and adrenal glands disease. Conclusion: The 131 I-orthoiodohippurate renography has a higher sensitivity in assessing the hydronephrosis and renal function, it should be combined with clinical situation for lack of specificity. (authors)

Comparison of aspirin renogram and captopril renogram in the diagnosis of renovascular hypertension

International Nuclear Information System (INIS)

Dabiri Oskoie, S.; Argani, H.

2002-01-01

Renal artery stenosis is the most common cause of secondary hypertension. Preliminary data indicate that aspirin renography with hippurate may be more sensitive for detection renal artery stenosis. In this study 20 patients with known or suspected renal artery stenosis underwent aspirin renography (20 mg/kg orally 1 hour before injection of radiotracer) and captopril renography (50 mg orally) with 99 Tc-DTPA. Renal angiography was performed in all patients. Of the 20 patients enrolled, 11 had unilateral renal artery stenosis on angiography. Captopril renography was positive in 10 patients (915 sensitivity and 90% specificity). Aspirin renogram showed 9 patients with renal artery stenosis correctly (81.85 sensitivity and 100% specificity). Our data suggest that aspirin renography with 99 Tc-DTPA has comparable sensitivity with captopril in detection of unilateral renal artery stenosis

Supranormal differential renal function in an obstructed kidney demonstrated on 99MTc-mercaptoacetyltriglycine (MAG3) diuresis renography - is it real or an artifact?

International Nuclear Information System (INIS)

Wegner, E.A.; Eagle, B.; Mitchell, G.; Rossleigh, M.A.

2003-01-01

Full text: Diuresis renography has been used extensively as a noninvasive method of estimating differential renal function (DRF), which may determine patient management. There has been controversy as to whether the phenomenon of supranormal DRF (>55%) in an obstructed kidney exists and the significance of this finding. A case study of a child with supranormal renal function is presented and the impact of different background regions on DRF calculations is demonstrated. Serial MAG3 studies were performed at ages 3 weeks, 2 and 10 months on a male with an antenatal diagnosis of right hydronephrosis. A weight adjusted dose of MAG3 was given simultaneously with frusemide (1mg/kg). DRF was calculated at 1.5-2.5 minutes following tracer administration. Background correction regions were drawn at the lower pole of each kidney. Supranormal DRF (61%) of the hydronephrotic kidney was demonstrated on the baseline study. There was deterioration in scan appearances and persistent supranormal DRF (64%) on the follow up study and the patient proceeded to pyeloplasty. The post-operative study demonstrated an improvement in scan findings and DRF returned to normal (55%). When suprarenal and perirenal background regions were used, supranormal DFR values were not obtained. Suprarenal background - 47%, 50%, 55% and perirenal background - 55%, 57% and 54% DRF on sequential studies. Review of the literature provides conflicting evidence as to the significance and even existence of this phenomenon. The location of background correction regions appears to influence DRF results. This occurs particularly when MAG3 is used, because of physiological uptake in the liver. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

Diuretic ultrasound - noninvasive method for assessment of congenital hydronephrosis in children

International Nuclear Information System (INIS)

Bueva, A.; Gaidarova, M.; Zlatanova, G.

2012-01-01

Ureteropelvic junction obstruction is the most common congenital abnormality of the urinary tract. Its incidence is 5 cases per 100 000 population annually. Several functional methods are available: diuretic renography, diuretic ultrasound and diuretic urography. The aim of this study is to compare the sensitivity and the specificity of the diuretic ultrasound and renography in the evaluation of upper urinary tract obstruction. (authors)

Delayed parenchymal transit during Tc-99m MAG3 renography is a valuable sign in diagnosing urinary obstruction in patients with early hydronephrosis

Energy Technology Data Exchange (ETDEWEB)

Lee, Won Woo; Moon, Dae Hyuk; Kim, Jae Seung; Ryu, Jin Sook; Lee, Hee Kyung [Ulsan University College of Medicine, Seoul (Korea, Republic of)

2002-10-01

Diuretic renography (DR) can be false negative with upper urinary tract obstruction due to low compliance of the renal pelvis. Delayed parenchymal transit (DPT) may be a valuable sign in case of false negative DR. We compared the diagnostic values of DR and DPT during Tc-99m MAG3 diuretic scan in adults with suspected unilateral obstructive uropathy. Fifty-four patients (male:female=30:24, age: 40.7{+-}15.5 yrs) who underwent Tc-99m MAG3 diuretic scan due to suspicious unilateral obstructive uropathy were analyzed. DR with a T{sub 1/2} of > 15 min was considered as positive for obstruction. DPT was considered to be present when there was delayed appearance of radioactivity in the renal pelvis and prolonged retention of radioactivity in the renal pelvis and prolonged retention of radioactivity in the renal parenchyma. The renal area ratio was defined as the ratio of pixel number of hydronephrotic after intervention, or aggravated hydronephrosis without intervention. Non-obstruction was defined as unchanged hydronephrosis over 6 months. Twenty-six renal units had obstruction and 28 no obstruction. The sensitivities of DR and DPT were 69% (18/26) and 50% (13/26) respectively. Two renal units with DPT but negative DR showed DPT had lower renal area ratio than 7 renal units without DPT (0.97{+-}0.20 vs 1.30{+-}0.41, p<0.05). Differential renal function was not significantly different between these groups. DPT correctly diagnosed all renal units with non-obstruction (specificity 100%), while the specificity of DR was 89% (25/28). DPT during Tc-99m MAG3 diuretic scan may be a valuable sign in diagnosing urinary obstruction especially in patients with false negative DR and early HN.

Delayed parenchymal transit during Tc-99m MAG3 renography is a valuable sign in diagnosing urinary obstruction in patients with early hydronephrosis

International Nuclear Information System (INIS)

Lee, Won Woo; Moon, Dae Hyuk; Kim, Jae Seung; Ryu, Jin Sook; Lee, Hee Kyung

2002-01-01

Diuretic renography (DR) can be false negative with upper urinary tract obstruction due to low compliance of the renal pelvis. Delayed parenchymal transit (DPT) may be a valuable sign in case of false negative DR. We compared the diagnostic values of DR and DPT during Tc-99m MAG3 diuretic scan in adults with suspected unilateral obstructive uropathy. Fifty-four patients (male:female=30:24, age: 40.7±15.5 yrs) who underwent Tc-99m MAG3 diuretic scan due to suspicious unilateral obstructive uropathy were analyzed. DR with a T 1/2 of > 15 min was considered as positive for obstruction. DPT was considered to be present when there was delayed appearance of radioactivity in the renal pelvis and prolonged retention of radioactivity in the renal pelvis and prolonged retention of radioactivity in the renal parenchyma. The renal area ratio was defined as the ratio of pixel number of hydronephrotic after intervention, or aggravated hydronephrosis without intervention. Non-obstruction was defined as unchanged hydronephrosis over 6 months. Twenty-six renal units had obstruction and 28 no obstruction. The sensitivities of DR and DPT were 69% (18/26) and 50% (13/26) respectively. Two renal units with DPT but negative DR showed DPT had lower renal area ratio than 7 renal units without DPT (0.97±0.20 vs 1.30±0.41, p<0.05). Differential renal function was not significantly different between these groups. DPT correctly diagnosed all renal units with non-obstruction (specificity 100%), while the specificity of DR was 89% (25/28). DPT during Tc-99m MAG3 diuretic scan may be a valuable sign in diagnosing urinary obstruction especially in patients with false negative DR and early HN

Valutazione morfo-funzionale in pazienti ipertesi con stenosi dell'arteria renale

International Nuclear Information System (INIS)

Cuocolo, A.; Celentano, L.; Nappi, A.; Neumann, R.D.; Salvatore, M.

1991-01-01

Renovascula hypertension is the most important and common cause of secondary hypertension. We studied 10 patients with arterial hypertension and different degrees of renal artery stenosis to assess the usefulness of dynamic radionuclide renography in evaluating renal perfusion and funcion, and to compare funcional radionuclide results to the morphological findings of renal angiography. Computer-assisted dynamic renal with 00m Tc diethylenetriaminepentaacetic acid (DTPA) and 131 I orthoiodohippurate (OIH), and renal artheriography were also employed in all patients. In all patients, radionuclide results matched angiography findings in quality. In particular, 3 patients with hemodynamical insignificant renal artery stenosis exhibited normal perfusion and function at dynamic radionuclide renography. Seven patients had significant renal artery stenosis and associated functional changes at dynamic radionuclide renography. Quantitative comparison of all patients showed a significant correlation (r=0.866, p<0.001) between the degree of renal artery stenosis, quantified as the percentage of narrowing as compared to adjacent/contralateral normal vessel diameter, and the results of split renal function, as assessed during OIH studies and expressed per kidney as a percentage of the net total counts of both kidneys. In conclusion, our results demonstrated dynamic radionuclide renography to be a valuable secondary to renal artery stenosis in hypertensive patients, providing complementary results to arteriography

Assessment of Hydroureteronephrosis in Children Using Diuretic Radionuclide Ureterography

International Nuclear Information System (INIS)

Kim, Jong Ho; Lee, Dong Soo; Kwark, Cheol Eun

1994-01-01

The need for assessment of ureteric function in the patient with an obviously dilated ureter has increased particularly with the added spectrum of asymptomatic patients presenting with hydronephrosis and hydroureter on antenatal and perinatal ultrasound. To assess the influence of ureteral status on kidney washout during 99m Tc-DTPA diuretic renography, ureteral images were reviewed in 80 children referred for hydronephrosis. A scintigraphically abnormal ureter was defined as an intense and continuous image of > 10 min during diuretic renography. Out of them, a total of 16 nephroureteral systems in 12 children with scintigraphically abnormal ureter were analyzed. A diuretic washout index using response half time (t1/2) by linear fitting after lasix injection, was determined on renal (Ktl/2) and ureteral (Utl/2) curves (diuretic renogram vs. diuretic ureterogram). Diuretic ureterogram curve patterns corresponding to normal (type I), obstructive (II) and non-obstructive (III) cases were described. Compared with X-ray data, diuretic renography was highly sensitive (88%) and specific (99%) for detecting any ureteral abnormality. Despite an obstructive Ktl/2 (> 20 min), no patient with an abnormal ureter underwent therapy at the ureteropeivic junction because (he hydronephrosis regressed after surgery at the lower level. Our data indicate that the abnormal ureter findings during diuretic renography have to be recognized before therapy for children with hydeonephrosis.

Significance of renal scintigraphy with 99mTc-DTPA for the diagnosis of diabetic nephropathy

International Nuclear Information System (INIS)

Lin Jun; Zhao Shuhao; Guo Rong; Lin Haoxue; Xie Zhichun

1995-01-01

99m Tc-DTPA renography was performed in 64 cases of type II diabetes mellitus and 20 control subjects. The value of GFR in the controls was 113 +-11.7 ml/min. The value of GFR in 15 of 43 patients with negative proteinuria was more than 140 ml/min, but GFR in the 21 diabetes with positive proteinuria was 76 +- 32.9 ml/min. These data indicated that 99m Tc-DTPA renography is an accurate and sensitive method for evaluation of hyperfiltration in early diabetes mellitus

Compensatory renal hypertrophia in patients undergoing unilateral nephrectomy

DEFF Research Database (Denmark)

Mogensen, P; Munck, O; Tonnesen, K H

1977-01-01

Estimations of the residual glomerular filtration rate (GFR) were made from renography and GFR measurements before unilateral nephrectomy in 28 patients aged 42-77 years. The GFR was measured one week and three months after the operation and comparisons were made between the function of the remai......Estimations of the residual glomerular filtration rate (GFR) were made from renography and GFR measurements before unilateral nephrectomy in 28 patients aged 42-77 years. The GFR was measured one week and three months after the operation and comparisons were made between the function...

Usefulness of captopril enhanced renogram in renovascular hypertension

International Nuclear Information System (INIS)

Enkhtuya, B.; Onkhuudai, P.; Sereegotov, E.; Tamir, J.; Monkhjargal, B.; Khishigjargal, Z.

2007-01-01

Full text: Arterial hypertension is caused mainly by renal disease. Conventional angiography which is the gold standard has been used to diagnose renal artery stenosis in adults. However, due to its invasiveness, it can not be utilized as a screening test in all patients suspected to have renal artery stenosis. The aim of the study was to identify the role of captopril renography in hypertensive patients suspected of having renovascular hypertension. We retrospectively evaluated 124 patients (74 males, 50 females between 19- 45 ages) all of them presented with blood pressure readings of 190/120. All patients underwent baseline radionuclide renography and captopril interventional renography. 110- 145 MBq (3-5 mCi) Tc-99m DTPA was injected intravenously. The interval of first 60 seconds of acquisition time is 2 seconds per frame, then every 30 seconds / frame for 25 minutes with multi SPECT. ACE (captopril enapril) inhibitor were withheld for 3-5 days prior to imaging, also withheld were losartan (an angiotensin II receptor blocker ) and diuretics for 2 days prior to the study. A baseline and a captopril (after administering 25 mg oral captopril) renogram were performed on two consecutive days by following standard protocol. In comparison with basal renography captopril was considered as positive following these criteria: The size of ischemic kidney was decreased, the clearance rate at 20 min decreased more than 10%, and the peak time of ischemic kidney was significantly delayed. In 9 patients, there were moderate to high probability of renovascular hypertension. All 9 patients underwent renal angiography to complete scintigraphic findings and renal artery stenosis was revealed in 7 patients. Conclusion: Our study shows low incidence of renovascular disease among hypertensive patients. However, the above study is important in identifying differences between renovascular and essential hypertension. Significance of the captopril renography is that, it is relatively

Robustness of estimation of differential renal function in infants and children with unilateral prenatal diagnosis of a hydronephrotic kidney on dynamic renography: How real is the supranormal kidney?

Energy Technology Data Exchange (ETDEWEB)

Ozcan, Zehra [University Faculty of Medicine, Nuclear Medicine Department of Ege, Bornova, Izmir (Turkey); Anderson, Peter J.; Gordon, Isky [Great Ormond Street Hospital For Children, Department of Radiology, London (United Kingdom)

2006-06-15

The two methods recommended for estimation of differential renal function (DRF) in the renography guidelines published by the European Association of Nuclear Medicine are the area under the background-subtracted time-activity curves (AUCs) (often called the integral method) and the regression slope of the background-subtracted Rutland/Patlak plot analysis. The current study investigated the agreement/disagreement of DRF estimations obtained using these two techniques. This report also focusses on the occurrence of supranormal function of the affected kidney (defined as DRF >55%) and reviews the related technical and physiological factors. A total of 394 renographic studies in 101 children with a prenatal diagnosis of unilateral renal pelvic dilatation confirmed on postnatal studies were retrieved from optical disc and reprocessed by one author. DRF was calculated using the Rutland/Patlak plot and the AUC over the time period 40-120 s following an injection of{sup 99m}Tc-mercaptoacetyltriglycine. The difference in DRF between the methods (Rutland/Patlak minus AUC) and 95% limits of agreement were calculated. The age distribution of the difference between the methods was also analysed. For all 394 measurements the mean difference was -0.8% (range -21.0% to 16.9%, SD 3.9%). The 95% limits of agreement were -7.0% to 8.6%. Analysis of the data revealed that greater spread of DRF between the techniques was seen in studies performed at a younger age: a discrepancy of >5% DRF was significantly more common in those <1 year of age than in those >1 year old (25.3% vs 9.9%; chi-square, p<0.0005). Supranormal function was found less frequently using the Rutland/Patlak method than with the AUC method (8.4% vs 11.2%; chi-square, p<0.0005). The frequency of this diagnosis was reduced to 4.6% when both methods were required to be in agreement. (orig.)

New trends in radioisotope renal function studies: Improved diagnostic potential by pharmacological intervention and by quantitative analysis

International Nuclear Information System (INIS)

Kletter, K.

1988-01-01

Tc99m mercaptoacetyltriglycine (Tc99m MAG3) was tested as replacement for I123 orthoiodohippuric acid (I123 oIH) both in the form of a HPLC purified substance and as an impure kit preparation. The influence of angiotensin converting enzyme (ACE) inhibitors (captopril) leads to characteristic changes in the renograms of patients with Goldblatt hypertension. Quantitative criteria for the evidence of haemodynamically significant renal artery stenosis were derived from investigations without and with captopril (25 mg) (I123 oIH and Tc99m DTPA) in 21 patients with essential hypertension. Diuresis renography is used for the assessment of urinary outflow obstruction. Up till now mainly qualitative criteria have been used for the evaluation of the washout curves. The introduction of the quantitative parameter of peak elimination rate for washout curve analysis yielded a significantly better concordance between diuresis renography and the invasive Whitaker test. The parameter of peak elimination (E max ) is mathematically clearly defined and is closely related to the peak urinary flow after frusemide. The dependence of the diuresis renogram on renal function and the degree of hydronephrosis was investigated in 80 ureterorenal units. Diuresis renography was tested and found to be a useful method for the assessment of hydronephrosis in newborn children. Follow up investigations of 7 children during the first weeks and months post partum revealed valuable diagnostic results in all cases. There was no sign that the diagnostic potential of diuresis renography was in any way restricted by as yet incompletely developed renal function during the first months of life. (Author, shortened by Quittner)

Diuretic renal function scintigraphy in the follow-up of pyeloplasty

International Nuclear Information System (INIS)

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

1982-01-01

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

A rational approach to imaging the upper urinary tract in children with pyelonephritis

International Nuclear Information System (INIS)

Merrick, M.V.; Glass, J.; Uttley, W.S.

1982-01-01

At least seven techniques of imaging the urinary tract are commonly used for the investigation of children in whom infection is suspected or proven, namely Excretion Urography (EU), Micturating Cysto-Urethrography (MCU), Isotope Renography (IR), Indirect Radionucleide Voiding Cysto-Urethrography (IRVC), Renal Scintigraphy (RS), Direct Radionucleide Voiding Cysto-Urethrography (DRVC) and Ultrasonography (US). There is at the present time no single investigation which is clearly suitable for use as a stand-alone screening test for predicting risk of progressive renal damage in children with upper tract infections. Radioisotope renography, associated with indirect radionuclide voiding cysto-urethrography, and supplemented by ultrasound may be the combination of tests which give the maximum information for the lowest radiation dose

Nuclear medicine

International Nuclear Information System (INIS)

Taylor, A. Jr.

1996-01-01

Renovascular hypertension is estimated to affect 1-3% of the unselected hypertension population and from 15-45% of patients referred to a subspecialty center because of refractory hypertension. A large body of literature exists which supports the use of angiotensin converting enzyme (ACE) inhibitors in conjunction with radionuclide renography to enhance the sensitivity and specificity for the detection of renovascular hypertension. The goals of ACE inhibitor renography ar two-fold: (1) detect those patients with hypertension who have renal artery stenosis as the cause of their hypertension and would benefit from revascularization and (2) determine which hypertensive patients do not have renovascular hypertension and thereby obviate the necessity of angiography or revascularization. (EG) 22 refs

The effect of diclofenac (Voltarol) and pethidine on ureteric peristalsis and the isotope renogram

International Nuclear Information System (INIS)

Brough, R.J.; Lancashire, M.J.R.; Prince, J.R.; Rose, M.R.; Prescott, M.C.; Testa, H.J.; Payne, S.R.

1998-01-01

Diclofenac (a non-steroidal anti-inflammatory drug) and pethidine (a synthetic opiate) are the two analgesics most commonly used to relieve the pain of ureteric colic. Fast frame renography is a non-invasive means of imaging ureteric peristalsis and renal drainage. The aim of this study was to determine the effects of each of these drugs on the drainage pattern of the upper tracts. Twelve normal male volunteers were studied. All underwent a standard fast frame renogram using 75 MBq of technetium-99m-mercaptoacetyltriglycine, and were then administered either 100 mg pethidine or 75 mg diclofenac by intramuscular injection. Fast frame renography was then repeated. Peristalsis was determined from the condensed image of each ureter and the renogram curves were analysed to obtain standard parameters and deconvolution analysis. Diclofenac caused a profound disruption to both ureteric peristalsis and the renogram curve. This effect was not seen after the administration of pethidine. Deconvolution analysis suggests the effects of diclofenac are mediated via a direct effect on drainage rather than by any alteration of blood flow to the kidney. This study suggests that pethidine is the analgesic of choice prior to renography and that inferences about alterations of drainage in the presence of diclofenac should be interpreted with care. (orig.)

Renal scintigraphy with captopril for the investigation of arterial hypertension. Captopril-Nierenfunktionsszintigraphie (C-NFSZ) bei der Abklaerung der arteriellen Hypertonie

Energy Technology Data Exchange (ETDEWEB)

Nitzsche, E; Strauss, E; Moser, E [Freiburg Univ. (Germany, F.R.). Abt. Klinische Nuklearmedizin; Grosser, G [Freiburg Univ. (Germany, F.R.). Abt. Roentgendiagnostik Sankt Marienkrankenhaus, Frankfurt am Main (Germany, F.R.). Radiologische Abt.; Rump, C; Keller, E [Freiburg Univ. (Germany, F.R.). Abt. Nephrologie; Meyer, E [Freiburg Univ. (Germany, F.R.). Abt. Roentgendiagnostik

1991-03-01

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

Renal scintigraphy with captopril for the investigation of arterial hypertension

International Nuclear Information System (INIS)

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

1991-01-01

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

Nuclear medicine in the nephrourinary tract

International Nuclear Information System (INIS)

Jofre M, M.Josefina; Sierralta C, Paulina

2002-01-01

Nuclear medicine images play an important role in the evaluation of urinary tract pathologies. Radionuclide imaging studies (DMSA scan, DTPA/MAG3 renography, radionuclide cistography) are reviewed, analyzing their indications (au)

Nuclear medicine in the nephrourinary tract; Medicina nuclear en el tracto refrourinario

Energy Technology Data Exchange (ETDEWEB)

Jofre M, M Josefina; Sierralta C, Paulina [Hospital Militar de Santiago, Servicio de Medicina Nuclear, Santiago (Chile)

2002-07-01

Nuclear medicine images play an important role in the evaluation of urinary tract pathologies. Radionuclide imaging studies (DMSA scan, DTPA/MAG3 renography, radionuclide cistography) are reviewed, analyzing their indications (au)

The effect of diclofenac (Voltarol) and pethidine on ureteric peristalsis and the isotope renogram

Energy Technology Data Exchange (ETDEWEB)

Brough, R.J. [Department of Urology, Withington Hospital, Manchester (United Kingdom); Lancashire, M.J.R. [Department of Virology, The Alexandra Hospital, Redditch (United Kingdom); Prince, J.R. [Department of Medical Physics, Christie Hospital, Manchester (United Kingdom); Rose, M.R.; Prescott, M.C.; Testa, H.J. [Department of Nuclear Medicine, Manchester Royal Infirmary, Manchester (United Kingdom); Payne, S.R. [Department of Urology, Manchester Royal Infirmary, Manchester (United Kingdom)

1998-11-01

Diclofenac (a non-steroidal anti-inflammatory drug) and pethidine (a synthetic opiate) are the two analgesics most commonly used to relieve the pain of ureteric colic. Fast frame renography is a non-invasive means of imaging ureteric peristalsis and renal drainage. The aim of this study was to determine the effects of each of these drugs on the drainage pattern of the upper tracts. Twelve normal male volunteers were studied. All underwent a standard fast frame renogram using 75 MBq of technetium-99m-mercaptoacetyltriglycine, and were then administered either 100 mg pethidine or 75 mg diclofenac by intramuscular injection. Fast frame renography was then repeated. Peristalsis was determined from the condensed image of each ureter and the renogram curves were analysed to obtain standard parameters and deconvolution analysis. Diclofenac caused a profound disruption to both ureteric peristalsis and the renogram curve. This effect was not seen after the administration of pethidine. Deconvolution analysis suggests the effects of diclofenac are mediated via a direct effect on drainage rather than by any alteration of blood flow to the kidney. This study suggests that pethidine is the analgesic of choice prior to renography and that inferences about alterations of drainage in the presence of diclofenac should be interpreted with care. (orig.) With 5 figs., 2 tabs., 15 refs.

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

International Nuclear Information System (INIS)

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

1995-01-01

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

Renovascular hypertension

Science.gov (United States)

... have narrowed. They include: Angiotensin converting enzyme (ACE) inhibition renography Doppler ultrasound of the renal arteries Magnetic ... Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow us ...

BOOKS I BOEKE

African Journals Online (AJOL)

artery catheterisation, and the scant attention paid to catheter sepsis. .... give a convincing picture of medicine as it has developed through the ages, but also ..... selective renography instead of venography for localising the impalpable testis) ...

Morphological and functional outcome of dismembered pyeloplasty ...

African Journals Online (AJOL)

Preoperative radiological assessment included renal ultrasonography, magnetic resonance urography (MRU) and diuretic renography for all patients. All cases showed hydronephrosis with an obstructive renal pattern. Dismembered pyeloplasty (Andersen-Hynes) was performed via an open or laparoscopic approach.

Is deconvolution applicable to renography?

NARCIS (Netherlands)

Kuyvenhoven, JD; Ham, H; Piepsz, A

The feasibility of deconvolution depends on many factors, but the technique cannot provide accurate results if the maximal transit time (MaxTT) is longer than the duration of the acquisition. This study evaluated whether, on the basis of a 20 min renogram, it is possible to predict in which cases

Diuresis renography in hydrouretero-nephrosis

International Nuclear Information System (INIS)

Thrall, J.H.

1985-01-01

The diuretic renogram has become a useful clinical procedure during the past five years. The major strength of the study is its ability to noninvasively place the majority of patients into unequivocally nonobstructed or obstructed categories. The technique remains limited in the face of marked hydronephrosis or impaired renal function. Future improvements in the technique will be forthcoming if more knowledge can be developed regarding the interrelationship between murine flow rate, volume of the collecting system, and pressure within the collecting system

Transitional neonatal hydronephrosis: fact or fantasy

International Nuclear Information System (INIS)

Homsy, Y.L.; Williot, P.; Danais, S.

1986-01-01

Hydronephrosis secondary to an anomalous ureteropelvic junction was detected antenatally in more than 60 neonatal renal units Those 21 units that exhibited partial obstruction or dilatation without obstruction were selected for this study. They were assessed and followed by serial diuretic isotope renography (99mtechnetium-diethylenetriaminepentaacetic acid augmented with furosemide) and ultrasonography. Excretory urography was used selectively. Of the 17 renal units that could be assessed 88 per cent demonstrated labile ureteropelvic junctions. Indeed, in 3 to 6 months, when the definitive status seemed to be attained, 41 per cent (7 units) had deteriorated, 12 per cent (2 units) remained stable and 47 per cent (8 units) underwent spontaneous improvement. We recommend a 3 to 6-month observation period for patients with hydronephrosis secondary to ureteropelvic junction anomalies when definite obstruction cannot be confirmed by isotope renography

CHANGES IN RENAL-FUNCTION INDUCED BY ACE-INHIBITION IN THE CONSCIOUS 2-KIDNEY, ONE-CLIP GOLDBLATT HYPERTENSIVE DOG

NARCIS (Netherlands)

JONKER, GJ; VISSCHER, CA; DEZEEUW, D; HUISMAN, RM; PIERS, DA; BEEKHUIS, H; VANDERHEM, GK

In order to study why the diagnostic sensitivity of I-123-hippurate renography for a renal artery stenosis is improved by angiotensin converting enzyme (ACE-) inhibition we used the model of the conscious chronically instrumented two-kidney, one-clip Goldblatt hypertensive dog. Urine flow (UV),

NONINVASIVE MEASUREMENT OF INTRARENAL BLOOD-FLOW DISTRIBUTION - KINETIC-MODEL OF RENAL I-123 HIPPURAN HANDLING

NARCIS (Netherlands)

JANSSEN, WMT; BEEKHUIS, H; DEBRUIN, R; DEJONG, PE; DEZEEUW, D

1995-01-01

A new technique for noninvasive measurement of intrarenal blood flow distribution over cortex and medulla is proposed. The tech nique involves analysis of I-123-labeled hippuran renography, according to a kinetic model that describes the flow of I-123- hippuran from the heart (input) through the

Robotic repair of retrocaval ureter: A case series | Nayak | African ...

African Journals Online (AJOL)

Subjects and methods: This is a prospective case series of five consecutive patients who underwent robotic retrocaval ureter repair at our institute from August 2006 to September 2009. Pre-operative imaging included intravenous urogram, contrast enhanced CT scan and diuretic renography. All cases were done through a ...

Improved split renal function after percutaneous nephrostomy in young adults with severe hydronephrosis due to ureteropelvic junction obstruction.

Science.gov (United States)

Zhang, Shiwei; Zhang, Qing; Ji, Changwei; Zhao, Xiaozhi; Liu, Guangxiang; Zhang, Shun; Li, Xiaogong; Lian, Huibo; Zhang, Gutian; Guo, Hongqian

2015-01-01

We evaluated percutaneous nephrostomy for adult kidneys with severe hydronephrosis due to ureteropelvic junction obstruction and less than 10% split renal function. In this retrospective analysis we included patients who underwent percutaneous nephrostomy for unilateral ureteropelvic junction obstruction of the kidneys with hydronephrosis and less than 10% split renal function at our hospital between May 2009 and January 2012. Adults (age 18 years or greater) were divided into those 35 years or younger (young adults) and older than 35 years (older adults). The percutaneous nephrostomy remained in situ a mean ± SD of 6.62 ± 2.55 weeks and patients underwent repeat renography before pyeloplasty. When there was no significant improvement in split renal function (10% or greater) and drainage (greater than 400 ml per day), nephrectomy was performed. Otherwise pyeloplasty was performed. Patients were followed by renography, ultrasound and contrast computerized tomography at 3 and 6 months, at 1 year and annually thereafter. Of 53 patients 30 (56.6%) showed improvement after percutaneous nephrostomy drainage and urine output greater than 400 ml per day with percutaneous nephrostomy. Pyeloplasty was then performed. Of 29 young adults 24 (82.8%) showed improved split renal function vs 6 of 24 older adults (25%). Nephrectomy of the other 23 kidneys was performed. At a mean followup of 19.27 ± 7.82 months (range 12 to 36), no patient showed hypertension or urinary tract infection. Split renal function detected by renography may not accurately predict recovered, poorly functioning kidneys, especially in young adults. First observing the recoverability of hydronephrotic kidneys by percutaneous nephrostomy drainage and then preserving select kidneys may be an effective method to manage poorly functioning kidneys due to ureteropelvic junction obstruction. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights

Renal dynamic functional scintigraphy in children with congenital urinary tract anomalies

International Nuclear Information System (INIS)

Cui Ruixue; Zhou Qian

2000-01-01

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

Correlates of diuretic renography in experimental hydronephrosis

Energy Technology Data Exchange (ETDEWEB)

Kekomaeki, M.R.; Rikalainen, H.; Ruotsalainen, P.; Bertenyi, C.

1989-02-01

We studied the correlations between diuretic renographs and kidney function in experimental hydronephrosis in rabbits. Features of furosemide-stimulated /sup 99m/Tc-diethylenetriamine-pentaacetic acid renographs were compared to the growth rate, thirst test and endogenous creatinine clearance rate in a chronic solitary-kidney animal model. Intravenous pyelograms, done four weeks after laparotomy, left nephrectomy, bladder resection and constriction of the right pyeloureteric junction, showed signs of obstruction in all the 12 animals of the experimental group. An absent tracer washout after intravenous furosemide, found in five animals, was associated with retarded growth, isosthenuria and an abnormal creatinine clearance. In all of the other seven animals, a distinct tracer washout after intravenous furosemide was accompanied with a normal growth rate and creatinine clearance. However, no one of these seven animals had a normal ability to retain water and concentrate urine in the thirst test. We conclude that, in this experimental model, a furosemide-induced tracer washout from the kidney pelvis cannot be taken as a proof of the absence of any upper urinary tract obstruction.

Correlates of diuretic renography in experimental hydronephrosis

International Nuclear Information System (INIS)

Kekomaeki, M.R.; Rikalainen, H.; Ruotsalainen, P.; Bertenyi, C.

1989-01-01

We studied the correlations between diuretic renographs and kidney function in experimental hydronephrosis in rabbits. Features of furosemide-stimulated /sup 99m/Tc-diethylenetriamine-pentaacetic acid renographs were compared to the growth rate, thirst test and endogenous creatinine clearance rate in a chronic solitary-kidney animal model. Intravenous pyelograms, done four weeks after laparotomy, left nephrectomy, bladder resection and constriction of the right pyeloureteric junction, showed signs of obstruction in all the 12 animals of the experimental group. An absent tracer washout after intravenous furosemide, found in five animals, was associated with retarded growth, isosthenuria and an abnormal creatinine clearance. In all of the other seven animals, a distinct tracer washout after intravenous furosemide was accompanied with a normal growth rate and creatinine clearance. However, no one of these seven animals had a normal ability to retain water and concentrate urine in the thirst test. We conclude that, in this experimental model, a furosemide-induced tracer washout from the kidney pelvis cannot be taken as a proof of the absence of any upper urinary tract obstruction

Difficulties in the interpretation of the Diuretic Renogram in Children

International Nuclear Information System (INIS)

Morales Klinkert, Barbara

2005-01-01

Diuretic renal scintigraphy was developed in the 1970s as a non invasive method to diagnose and follow up patients with hydronephrosis and obstructive uropathy and remains the noninvasive functional study of choice in these patients. Over the years, a wide variety of protocols and techniques have been developed. Unfortunately, this has contributed to increase the variability in the interpretive criteria among the different nuclear medicine departments. For an appropriate interpretation of the diuretic renography and to avoid and minimize the number of in determined studies it is essential a meticulous attention to details such as hydration of the child, radiopharmaceutical selection, dosage and time of Furosemide administration, bladder status and effect of gravity and an awareness of the potential pitfalls of the technique. For most patients the F+20 protocol is sufficient, however the F-15 protocol allows clarification in some equivocal baseline F+20 studies. Invasive techniques such as the Whittaker test are best reserved for the group in whom the diagnosis remains equivocal after diuretic renography. The new guidelines published and the protocols recommended by the recent international consensus panels have contributed to increase the reproducibility of the technique (au)

Extraperitoneal urine leak after renal transplantation: the role of radionuclide imaging and the value of accompanying SPECT/CT - a case report

International Nuclear Information System (INIS)

Son, Hongju; Heiba, Sherif; Kostakoglu, Lale; Machac, Josef

2010-01-01

The differentiation of the nature of a fluid collection as a complication of kidney transplantation is important for management and treatment planning. Early and delayed radionuclide renography can play an important role in the evaluation of a urine leak. However, it is sometimes limited in the evaluation of the exact location and extent of a urine leak. A 71-year-old male who had sudden anuria, scrotal swelling and elevated creatinine level after cadaveric renal transplantation performed Tc-99 m MAG3 renography to evaluate the renal function, followed by an ultrasound which was unremarkable. An extensive urine leak was evident on the planar images. However, an exact location of the urine leak was unknown. Accompanying SPECT/CT images confirmed a urine leak extending from the lower aspect of the transplant kidney to the floor of the pelvic cavity, presacral region and the scrotum via right inguinal canal as well as to the right abdominal wall. Renal scintigraphy is very useful to detect a urine leak after renal transplantation. However, planar imaging is sometimes limited in evaluating the anatomical location and extent of a urine leak accurately. In that case accompanying SPECT/CT images are very helpful and valuable to evaluate the anatomical relationships exactly

Kronisk monstrøs urinretention

DEFF Research Database (Denmark)

Thomsen, Frederik Gustav; Holm, Mette Lind

2015-01-01

to suspect urinary retention. His creatinine level was normal and he had no hydronephrosis. A renography showed equal func-tion, but prolonged bilateral outflow. The volume extracted by urethral catheter passed 15 l. Absence of hydronephrosis and normal S-creatinine level has not been described in chronic...... urinary retention of this extent. Hydronephrosis is seen, but in much smaller volume of retention. Infrequent voiding is easily diagnosed. Urinary retention should be suspected when finding median cystic processes....

[Diagnosis and treatment of symptomatic hydronephrosis in pregnancy].

Science.gov (United States)

Simonsen, Jane Angel; Graumann, Ole; Toft, Anja; Henriques, Carsten Ulrik; Walter, Steen

2015-09-14

Hydronephrosis in pregnancy is common in the second and third trimester. Only a few cases are symptomatic, caused by a ureteric stone or by the pregnancy itself. The clinical dilemma is when to treat and when not to treat. We propose a multidisciplinary management based on renal ultrasonography to verify hydronephrosis and renography to diagnose obstructive hydronephrosis. Obstruction with a high intra-renal pressure must be treated to avoid kidney dysfunction. Patients with pyonephrosis need immediate treatment.

The incidence of ureteral obstruction secondary to aorto-femoral bypass surgery. A prospective study

DEFF Research Database (Denmark)

Henriksen, L O; Mejdahl, Steen; Petersen, F

1988-01-01

Hydronephrosis is reported to be an infrequent complication of aorto-femoral bypass operations. To define the true incidence of this complication, renography (131I-Hippuran) and renal scintigraphy (99 Technetium) were performed both pre- and postoperatively on 56 asymptomatic patients following...... successful aortic reconstruction. No patient developed signs of ureteral obstruction. It is concluded that hydronephrosis is a rare complication to aorto-femoral bypass surgery and postoperative control is only indicated in patients with symptoms from the urinary tract....

International urinary tract imaging basic spinal cord injury data set

DEFF Research Database (Denmark)

Biering-Sørensen, F; Craggs, M; Kennelly, M

2008-01-01

OBJECTIVE: To create an International Urinary Tract Imaging Basic Spinal Cord Injury (SCI) Data Set within the framework of the International SCI Data Sets. SETTING: An international working group. METHODS: The draft of the Data Set was developed by a working group comprising members appointed...... of comparable minimal data. RESULTS: The variables included in the International Urinary Tract Imaging Basic SCI Data Set are the results obtained using the following investigations: intravenous pyelography or computer tomography urogram or ultrasound, X-ray, renography, clearance, cystogram, voiding cystogram...

Renal parenchyma thickness: a rapid estimation of renal function on computed tomography

International Nuclear Information System (INIS)

Kaplon, Daniel M.; Lasser, Michael S.; Sigman, Mark; Haleblian, George E.; Pareek, Gyan

2009-01-01

Purpose: To define the relationship between renal parenchyma thickness (RPT) on computed tomography and renal function on nuclear renography in chronically obstructed renal units (ORUs) and to define a minimal thickness ratio associated with adequate function. Materials and Methods: Twenty-eight consecutive patients undergoing both nuclear renography and CT during a six-month period between 2004 and 2006 were included. All patients that had a diagnosis of unilateral obstruction were included for analysis. RPT was measured in the following manner: The parenchyma thickness at three discrete levels of each kidney was measured using calipers on a CT workstation. The mean of these three measurements was defined as RPT. The renal parenchyma thickness ratio of the ORUs and non-obstructed renal unit (NORUs) was calculated and this was compared to the observed function on Mag-3 lasix Renogram. Results: A total of 28 patients were evaluated. Mean parenchyma thickness was 1.82 cm and 2.25 cm in the ORUs and NORUs, respectively. The mean relative renal function of ORUs was 39%. Linear regression analysis comparing renogram function to RPT ratio revealed a correlation coefficient of 0.48 (p * RPT ratio. A thickness ratio of 0.68 correlated with 20% renal function. Conclusion: RPT on computed tomography appears to be a powerful predictor of relative renal function in ORUs. Assessment of RPT is a useful and readily available clinical tool for surgical decision making (renal salvage therapy versus nephrectomy) in patients with ORUs. (author)

Quantitative Ultrasound for Measuring Obstructive Severity in Children with Hydronephrosis.

Science.gov (United States)

Cerrolaza, Juan J; Peters, Craig A; Martin, Aaron D; Myers, Emmarie; Safdar, Nabile; Linguraru, Marius George

2016-04-01

We define sonographic biomarkers for hydronephrotic renal units that can predict the necessity of diuretic nuclear renography. We selected a cohort of 50 consecutive patients with hydronephrosis of varying severity in whom 2-dimensional sonography and diuretic mercaptoacetyltriglycine renography had been performed. A total of 131 morphological parameters were computed using quantitative image analysis algorithms. Machine learning techniques were then applied to identify ultrasound based safety thresholds that agreed with the t½ for washout. A best fit model was then derived for each threshold level of t½ that would be clinically relevant at 20, 30 and 40 minutes. Receiver operating characteristic curve analysis was performed. Sensitivity, specificity and area under the receiver operating characteristic curve were determined. Improvement obtained by the quantitative imaging method compared to the Society for Fetal Urology grading system and the hydronephrosis index was statistically verified. For the 3 thresholds considered and at 100% sensitivity the specificities of the quantitative imaging method were 94%, 70% and 74%, respectively. Corresponding area under the receiver operating characteristic curve values were 0.98, 0.94 and 0.94, respectively. Improvement obtained by the quantitative imaging method over the Society for Fetal Urology grade and hydronephrosis index was statistically significant (p hydronephrosis can identify thresholds of clinically significant washout times with 100% sensitivity to decrease the number of diuretic renograms in up to 62% of children. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

2001 Venezuela: 2. Ibero-Latin American and Caribbean Congress of Medical Physics

International Nuclear Information System (INIS)

2001-01-01

The subjects covered are the following: Low energy X rays qualities, medical physicist, simulation of irradiation X, dosimetry, radiotherapy, calibration, digital mammography, management of radioactive specimens, radio-surgery, genetic algorithm for the ventricular volume mensuration, SPECT systems, electronic paramagnetic resonance, radio-diagnose service, bra qui-therapy, radio sensibility, mammographic systems, thermoluminescent dosimetry, magnetic resonance, radiological protection, radiological safety, Venezuelan legislation, tomographic images, linear energy transfer (LET), regional master in physics medicine, heart function in nuclear medicine, renography, protons beam, nuclear medicine equipment. Individual papers have been analysed and submitted to INIS separately [es

The investigation of in-vivo measurement of individual renal blood perfusion, effective renal plasma flow and quantitation of renogram and 15 min bladder collection percentage

International Nuclear Information System (INIS)

Huang Kangchu

1991-01-01

25 normals and 43 renal diseases were examined by the RBF-I multifunctioning renography. The result showed that the determination of ERPF has no difference between blood sampling and noin-blood sampling method, and actually the lattrer can replace the former one. Above method can be also used for the measurement of the individual renal blood perfusion, the quantitation of renogram and the 15 min bladder coolection percentage at the same time. Thereby it provides more complete diagnostic information for the renal vascular diseases, renal pancren chymations and other urologic diseases

Age-related features of renal function (on radiorenographic data)

International Nuclear Information System (INIS)

Korkushko, O.V.; Frajfel'd, V.Eh.; Belyj, A.A.

1986-01-01

Renal function of 91 healthy subjects aged 18-91 has been evaluated at radionuclide renography with the use of 131 I-Hippuran. Renal excretory function, effective renal plasma and blood flows were found to decrease annually by 0.09 ml/kg in ageing men and by 0.08 ml/kg in women. The use of new indices may be useful for evaluation of renal blood circulation, especially during hypo- or hypervolaemia is proposed. These are the index of renal circulation efficiency and the mean time of circulating blood volume transfer through renal blood vessels

Forty-five-year follow-up on the renal function after spinal cord injury

DEFF Research Database (Denmark)

Elmelund, M; Oturai, P S; Toson, B

2016-01-01

rate (GFR) ⩽75% of expected according to age and gender) was 58%. The cumulative risk of severe renal deterioration (functional distribution outside 30-70% on renography or relative GFR⩽51%) was 29% after 45 years postinjury. Only dilatation of UUT and renal/ureter stone requiring removal significantly...... increased the risk of moderate and severe renal deterioration. CONCLUSION: Renal deterioration occurs at any time after injury, suggesting that lifelong follow-up examinations of the renal function are important, especially in patients with dilatation of UUT and/or renal/ureter stones....

A single injection technique for subtraction of blood background in 131I-hippuran renograms

International Nuclear Information System (INIS)

Rutland, M.D.

1979-01-01

A method of subtracting blood background during probe-renography is presented which does not require a prior injection of RIHSA and which produces results approximately 11% higher than the RIHSA method. The new method treats the renogram up to two-and-a-half minutes as a combination of a fraction of the blood curve and a fraction of the integral of the blood curve. Analysis of the data, using either a computer or a programmed calculator, enables these two fractions to be calculated, hence producing the 'background subtraction factor' and the 'uptake constant'. (author)

Dosimetric substantiation of the use of radionuclide methods in obstetrics

International Nuclear Information System (INIS)

Volobuev, A.I.; Filatov, V.I.; Turaev, R.N.

1987-01-01

The problem of a possible use of radionuclide methods of investigation (placentography and renography) in obstetrics was considered. Doses and permissibles activities in pregnant women of the AP category belonging to groups at high risk of obstetric and perinated pathology were worked out on the basis of the ''Rules and standards of open radiopharmaceuticals in diagnostic purposes'' (1984). The above investigations using the administration of short-lived radionuclides with total activity of 7.4 MBq ( 99m Tc-albumin and DTPA) were shown to be safe for mother and fetus

Recent advances and future projections in clinical radionuclide imaging

International Nuclear Information System (INIS)

Peters, A.M.

1990-01-01

This outline review of recent advances in radionuclide imaging draws attention to developments in nuclear medicine of the urinary tract such as Captopril renography and the introduction of MAG-3, the technetium-99m labelled mimic of hippuran, the use of radionuclides for infection diagnosis, advances in lung perfusion scanning, new radiopharmaceuticals for cardiac imaging, and developments in radiopharmaceuticals for imaging tumours, including gallium-67, thallium-201, and the development of radiolabelled monoclonal antibodies. Attention is drawn to the wider use of nuclear medicine in child care. (author)

Behandling af renovaskulær hypertension med transluminal angioplastik--13 års erfaring--sekundærpublikation

DEFF Research Database (Denmark)

Øvrehus, Kristian Altern; Andersen, Poul Erik; Jacobsen, Ib Abildgaard

2008-01-01

angioplasty. A total of 124 patients were treated; 31% were normotensive immediately after angioplasty, 59% had improved blood pressure control and 10% had unchanged hypertension. The corresponding figures after six months and at the latest follow-up were 13, 72 and 15%. Udgivelsesdato: 2008-Jan-21......The result of treatment of renovascular hypertension by renal angioplasty over a period of 13 years was analysed. Patients with a positive diagnostic work-up with renography or renal vein renin measurement had renal angiography performed and in cases of renal artery stenosis, transluminal...

Treatment of renovascular hypertension by transluminal angioplasty

DEFF Research Database (Denmark)

Øvrehus, Kristian A; Andersen, Poul E; Jacobsen, Ib A

2007-01-01

: with improved control of blood pressure; group III: unchanged blood pressure control. Grouping was performed immediately after treatment, at 1 month, 6 months and at the latest follow-up. One hundred-and-twenty-two patients (124 atherosclerotic and 12 fibromuscular lesions) were treated during 13 years......OBJECTIVE: The study is a follow-up on treatment of renovascular hypertension (RVH) with percutaneous transluminal renal angioplasty (PTRA). METHODS: Patients were screened on the basis of clinical criteria of increased probability of RVH with renography and in selected cases with renal vein renin...

Application of computer-generated functional (parametric) maps in radionuclide renography

International Nuclear Information System (INIS)

Agress, H. Jr.; Levenson, S.M.; Gelfand, M.J.; Green, M.V.; Bailey, J.J.; Johnston, G.S.

1975-01-01

A functional (parametric) map is a single visual display of regional dynamic phenomena which facilitates interpretation of the nature of focal abnormalities in renal function. Methods for producing several kinds of functional maps based on computer calculations of radionuclide scan data are briefly described. Three abnormal cases are presented to illustrate the use of functional maps to separate focal lesions and to specify the dynamic nature of the abnormalities in a way which is difficult to achieve with conventional sequential renal scans and renograms alone

Renal perfusion in chronic liver diseases: Evaluation by radiotechnetium renography

International Nuclear Information System (INIS)

Fanfani, G.; Fratello, A.; Mele, M.; Conte, E.; D'Addabbo, A.; Greco, L.

1985-01-01

Twenty-four patients with chronic liver diseases and seven normal controls were studied using renal and hepatic radiotechnetium angiography. The time-activity histograms generated were employed to calculate both the renal perfusion index (RPI) and the hepatic perfusion index (HPI). Renal perfusion proved to be reduced not only in cirrhotic patients but also in patients with aggressive chronic hepatitis, as well as in those with persistent chronic hepatitis. The HPI, which is to be considered as being strictly dependent on portal flow, only fell significantly in the group of cirrhotic patients. In all patient groups, the correlation coefficient between the HPI and RPI (mean of the two kidneys) was low (r=0.275) and not significant (P>0.05). After Warren's splenorenal derivation, renal perfusion did not improve but worsened, particularly in the left kidney where derivation anastomosis probably caused a venous overload. (orig.)

[131I] Hippuran renography in the detection of orthostatic hypertension

International Nuclear Information System (INIS)

Clorius, J.H.; Kjelle-Schweigler, M.; Ostertag, H.; Moehring, K.

1978-01-01

Scintigrams in prone and standing positions were done in 11 hypertensive women. All had nephroptosis with ventral rotation. On the basis of the renograms, seven patients were identified as suffering from orthostatic hypertension. Nephropexy resulted in normalization of blood pressure in six of the seven patients and normalization of the renograms of all seven. We believe that sequence scintigrams in prone and standing positions offer a simple method of identifying patients with orthostatic hypertension

Diuretic renography in evaluating dilated upper urinary tract in children

International Nuclear Information System (INIS)

Ireton, R.C.; Parker, R.M.; Hayden, P.

1987-01-01

The diuretic renogram provides a previously unavailable noninvasive method for assessing and following urinary tract dilation of diverse cause, and defining true obstruction in children. Technetium-99m-DTPA (diethylenetriaminepentaacetic acid) is injected intravenously and a posteriorly placed gamma scintillation camera used to image the kidneys, ureters, and bladder. Furosemide is subsequently injected to stimulate a diuresis, and the washout pattern of isotope is monitored (time-activity histogram). Nonobstructive, obstructive, and poor renal function patterns were seen. Forty patients with varying degrees of hydroureteronephrosis were evaluated. Tracings were performed serially and compared with the clinical course in time, as well as with pressure flow studies and operative findings. All patients with a nonobstructed diuretic renogram did well, except for 1 boy in whom ureteropelvic obstruction developed later. Difficulty in evaluating the obstructive renogram pattern occurred only in some children with severe (grade V) hydronephrosis. Further standardization of the diuretic renogram with regard to time of diuretic injection, state of patient hydration, and regions of imaging may improve diagnostic accuracy

Studies on renal function in the elderly by analysis of radioisotope renal images

International Nuclear Information System (INIS)

Ohishi, Yukihiko

1990-01-01

This study was carried out to evaluate the potential of radionuclide renal imagings for examining senile renal function in a total of 178 subjects. Single photon emission computed tomography (SPECT) with Tc-99m-dimercaptosuccinic acid (Tc-DMSA) was performed in the senile group (60-87 years) and in the adult group to determine renal uptake rate of Tc-DMSA and renal volume. Renography studies with I-131 hippuran (n=100) and Tc-99m diethylentriaminepentaacetic acid (Tc-DTPA) (n=20) were also performed for deconvolution analysis. Mean transit time (MTT) was mainly assessed as one of the retention function parameters. Blood residual rates (R15%) at fifteen minutes were also investigated. Renal volume and renal uptake rate for healthy persons were significantly lower in the senile group (n=17) than the adult group (n=24), 205±50 ml vs 225±27 ml; and 22±5% vs 26±2%. I-133 hippuran renography in healthy persons (n=35) showed a tendency toward higher MTT values with aging; however, there was no significant difference among age groups. R15%, obtained by I-133 hippuran renograms, tended to be higher with aging in age groups of persons younger than 70 years. A decreased number of effective nephrons was considered to result in higher R15% values even when aged persons had normal MTT values of I-131 hippuran. Split renal function values for healthy persons, calculated by the two radionuclide imagings, were lower in the senile group than the adult group, suggesting the usefulness of radionuclide imagings in renal function examination. (N.K.)

Impact of operator on determining functional parameters of nuclear medicine procedures.

Science.gov (United States)

Mohammed, A M; Naddaf, S Y; Mahdi, F S; Al-Mutawa, Q I; Al-Dossary, H A; Elgazzar, A H

2006-01-01

The study was designed to assess the significance of the interoperator variability in the estimation of functional parameters for four nuclear medicine procedures. Three nuclear medicine technologists with varying years of experience processed the following randomly selected 20 cases with diverse functions of each study type: renography, renal cortical scans, myocardial perfusion gated single-photon emission computed tomography (MP-GSPECT) and gated blood pool ventriculography (GBPV). The technologists used the same standard processing routines and were blinded to the results of each other. The means of the values and the means of differences calculated case by case were statistically analyzed by one-way ANOVA. The values were further analyzed using Pearson correlation. The range of the mean values and standard deviation of relative renal function obtained by the three technologists were 50.65 +/- 3.9 to 50.92 +/- 4.4% for renography, 51.43 +/- 8.4 to 51.55 +/- 8.8% for renal cortical scans, 57.40 +/- 14.3 to 58.30 +/- 14.9% for left ventricular ejection fraction from MP-GSPECT and 54.80 +/- 12.8 to 55.10 +/- 13.1% for GBPV. The difference was not statistically significant, p > 0.9. The values showed a high correlation of more than 0.95. Calculated case by case, the mean of differences +/- SD was found to range from 0.42 +/- 0.36% in renal cortical scans to 1.35 +/- 0.87% in MP-GSPECT with a maximum difference of 4.00%. The difference was not statistically significant, p > 0.19. The estimated functional parameters were reproducible and operator independent as long as the standard processing instructions were followed. Copyright 2006 S. Karger AG, Basel.

Assessment of paediatric hydronephrosis using output efficiency

International Nuclear Information System (INIS)

Saundres, C.A.B.; Choong, K.K.L.; Gruenewald, S.M.

1998-01-01

Full text: Diuretic renography is an important tool in the evaluation of paediatric hydronephrosis. Recently a newly developed parameter, output efficiency (OE) has allowed normalisation of washout according to renal function. We retrospectively reviewed the diagnostic accuracy of OE in 56 children (70 hydronephrotic kidneys). There were 16 females and 41 males (mean age 1.4 years, range 3 weeks-12 years). Diuretic renography ( 99m Tc-MAG3) was performed using i.v. volume expansion (15 mL/kg), frusemide diuresis (1mg/kg) and urethral catheterisation if VUR was present. Final diagnosis was made using surgery (n = 15) or clinical outcome (n = 42). Clinical follow up exceeded one year and included repeat MAG3 scan (n = 20), resolving hydronephrosis on ultrasound (n = 15) or percutaneous antegrade pyelogram (n = 1). Initial scans were classified as obstructed (n 13), indeterminate (n = 13) or non obstructed (n = 30) based on standard qualitative and quantitative criteria. Using a normal range of >84%, OE correctly predicted 12/13 (92%) obstructed kidneys and 44/44 non-obstructed kidneys (100%). In the indeterminate group, three kidneys developed obstruction at follow -up and 10 became non obstructed. Initial OE predicted outcome in two and four kidneys respectively. Overall, OE sensitivity and specificity were 88% and 89%. In the subgroup of patients (n = 19) with reduced differential function (<40%) the sensitivity of OE was 100% and specificity was 75%. This compares to 83% and 66% for Tl/2 in this subgroup. Therefore OE is a useful marker of renal outflow tract obstruction and maybe superior to other parameters such as Tl/2 particularly when renal function is reduced

Renographic curve of persons exposed to mercury

International Nuclear Information System (INIS)

Kolenic, J.; Jurgova, T.; Zimacek, J.; Petrovicova, J.; Bilicky, J.

1995-01-01

In the group of 72 workers which were exposed to fumes of metallic mercury we evaluated possible nephrotoxic effect of Hg 0 . We also used nuclear renography for evaluation of kidney. Nephrotoxic effect of Hg 0 was proved by increased proteinuria and relatively frequent findings of pathological renogram. In the group with pathological renogram, elimination of Hg 0 in urine (1822.8 nmol.dm -3 ) was increased. In the group with normal finding the value was 883.7 nmol.dm -3 . These findings pointed at toxic effect of Hg 0 on kidney and suitability of radionuclide examination for disclosing of subclinical pathological changes. (authors)

Decreased renal function and hypertension are long-term complications of extracorporeal shock wave lithotripsy

International Nuclear Information System (INIS)

Williams, C.M.; Kaude, J.V.; Newman, R.C.; Peterson, J.C.; Thomas, W.C.

1987-01-01

Quantitative radionuclide renography performed in 21 patients 17-21 months after extracorporeal shock wave lithotripsy showed a significant decrease in the percentage of effective renal plasma flow (%ERPF) of the treated kidney; in five (24%) patients the %ERPF had decreased by more than 5 percentage units. In seven (8%) of 91 patients sustained hypertension developed that required pharmacologic treatment after lithotripsy. Decreased %ERPF of a treated kidney and hypertension may be related to a Page kidney or similar process resulting from renal trauma and hemorrhage occurring as a side effect of lithotripsy. Hypertension is an important complication of lithotripsy in about 8% of patients

Role of radionuclide studies in cases of enlarged prostate

International Nuclear Information System (INIS)

Singhvi, S.D.; Shrimali, R.; Singhal, N.C.

1985-01-01

The present study of radionuclide 131 I hyppuran in 30 positive cases of enlarged prostate and 10 normal subjects has been found effective in giving information about functional status of the kidneys and presence of obstructive unropathy by renography, enlargement of the prostate causing bladder base contour deformity in bladder scan and the presence of residual urine by external counting method over bladder. It is a non-invasive method of investigation and can be undertaken safely in cases sensitive iodine-containing contrast medium. It is also cheap, easy to perform and does not require any pre-examination preparation and can be repeated frequently. (author)

MR renography by semiautomated image analysis : Performance in renal transplant recipients

NARCIS (Netherlands)

de Priester, JA; Kessels, AGH; Giele, ELW; den Boer, J.A.; Christiaans, MHL; Hasman, A; van Engelshoven, JMA

We evaluated a method of semiautomated analysis of dynamic MR image series in renal transplants. Nine patients were studied twice, with an average time interval of 7 days. MR examination consisted of a run of 256 T1-weighted coronal scans (GE; TR/TE/flip: = 11/3.4/60 degrees; slice thickness = 6 mm;

Mercaptoacetyltriglycine diuretic renography and output efficiency measurement in renal transplant patients

International Nuclear Information System (INIS)

Spicer, S.T.; Chi, Ka-Kit; Larcos, G.; Farlow, D.C.; Choong, K.K.L.; Gruenewald, S.M.; Nankivell, B.J.; Chapman, J.R.

1999-01-01

Suspected urinary tract obstruction following renal transplantation presents a diagnostic dilemma. The purposes of this study were: (1) to establish a normal range of measurement of output efficiency (OE) in the renal transplant population, and (2) to assess prospectively the usefulness of OE in the setting of allograft obstruction. Twenty-two renal transplant patients with stable renal function and no evidence of hydronephrosis on serial ultrasound examination had a diuretic mercaptoacetyltriglycine scan with calculation of OE. Three renal transplant patients with confirmed graft obstruction were also studied. Standard qualitative and quantitative parameters as well as OE were calculated. The mean OE for the 22 normal renal transplant patients was 86.3%±3.7% (range: 77%-91%). OE values in the three obstructed patients were 59%, 68% and 75% respectively. It is concluded that OE should normally exceed 77% in renal graft recipients. OE is a promising means of diagnosing functional obstruction in these patients. (orig.)

Live Donor Renal Anatomic Asymmetry and Post-Transplant Renal Function

Science.gov (United States)

Tanriover, Bekir; Fernandez, Sonalis; Campenot, Eric S.; Newhouse, Jeffrey H.; Oyfe, Irina; Mohan, Prince; Sandikci, Burhaneddin; Radhakrishnan, Jai; Wexler, Jennifer J.; Carroll, Maureen A.; Sharif, Sairah; Cohen, David J.; Ratner, Lloyd E.; Hardy, Mark A.

2014-01-01

Background Relationship between live donor renal anatomic asymmetry and post-transplant recipient function has not been studied extensively. Methods We analyzed 96 live-kidney donors, who had anatomical asymmetry (>10% renal length and/or volume difference calculated from CT angiograms) and their matching recipients. Split function differences (SFD) were quantified with 99mTc-DMSA renography. Implantation biopsies at time-zero were semi-quantitatively scored. A comprehensive model utilizing donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at one-year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60ml/min/1.73 m2 at one-year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the CKD-EPI formula), and a Monte Carlo simulation based on the linear regression model (N=10,000 iterations). Results In the study cohort, the mean Vol/Wgt and eGFR at one-year were 2.04 ml/kg and 60.4 ml/min/1.73m2, respectively. Volume and split ratios between two donor kidneys were strongly correlated (r=0.79, p-value10%) were not different (p=0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR>60ml/min/1.73 m2 (OR=8.94, 95% CI 2.47–32.25, p=0.001) and had a strong discriminatory power in predicting the risk of eGFRrenal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at one-year post-transplantation. Renography can be replaced with CT volume calculation in estimating split renal function. PMID:25719258

Transverse comparisons between ultrasound and radionuclide parameters in children with presumed antenatally detected pelvi-ureteric junction obstruction

Energy Technology Data Exchange (ETDEWEB)

Duong, Hong Phuoc; Janssen, Francoise; Hall, Michelle; Ismaili, Khalid [Universite Libre de Bruxelles (ULB), Department of Pediatric Nephrology, Hopital Universitaire des Enfants Reine Fabiola, Brussels (Belgium); Piepsz, Amy [Hopital Universitaire Saint-Pierre, Department of Radioisotopes, Ghent (Belgium); Khelif, Karim; Collier, Frank [Universite Libre de Bruxelles (ULB), Department of Pediatric Urology, Hopital Universitaire des Enfants Reine Fabiola, Brussel (Belgium); Man, Kathia de [University Hospital Ghent, Department of Nuclear Medicine, Ghent (Belgium); Damry, Nash [Universite Libre de Bruxelles (ULB), Department of Pediatric Radiology, Hopital Universitaire des Enfants Reine Fabiola, Brussel (Belgium)

2015-05-01

The main criteria used for deciding on surgery in children with presumed antenatally detected pelviureteric junction obstruction (PPUJO) are the level of hydronephrosis (ultrasonography), the level of differential renal function (DRF) and the quality of renal drainage after a furosemide challenge (renography), the importance of each factor being far from generally agreed. Can we predict, on the basis of ultrasound parameters, the patient in whom radionuclide renography can be avoided? We retrospectively analysed the medical charts of 81 consecutive children with presumed unilateral PPUJO detected antenatally. Ultrasound and renographic studies performed at the same time were compared. Anteroposterior pelvic diameter (APD) and calyceal size were both divided into three levels of dilatation. Parenchymal thickness was considered either normal or significantly decreased. Acquisition of renograms under furosemide stimulation provided quantification of DRF, quality of renal drainage and cortical transit. The percentages of patients with low DRF and poor drainage were significantly higher among those with major hydronephrosis, severe calyceal dilatation or parenchymal thinning. Moreover, impaired cortical transit, which is a major risk factor for functional decline, was seen more frequently among those with very severe calyceal dilatation. However, none of the structural parameters obtained by ultrasound examination was able to predict whether the level of renal function or the quality of drainage was normal or abnormal. Alternatively, an APD <30 mm, a calyceal dilatation of <10 mm and a normal parenchymal thickness were associated with a low probability of decreased renal function or poor renal drainage. In the management strategy of patients with prenatally detected PPUJO, nuclear medicine examinations may be postponed in those with an APD <30 mm, a calyceal dilatation of <10 mm and a normal parenchymal thickness. On the contrary, precise estimation of DRF and renal

Dynamic {sup 18}F-fluoride small animal PET to noninvasively assess renal function in rats

Energy Technology Data Exchange (ETDEWEB)

Schnoeckel, Uta; Stegger, Lars; Schaefers, Klaus P.; Hermann, Sven; Schober, Otmar; Schaefers, Michael [Klinik und Poliklinik fuer Nuklearmedizin, Muenster (Germany); Reuter, Stefan; Schlatter, Eberhard; Gabriels, Gert [Universitaetsklinikum Muenster, Medizinische Klinik und Poliklinik D, Experimentelle Nephrologie, Muenster (Germany)

2008-12-15

Renal function can be quantified by both laboratory and scintigraphic methods. In the case of small animal diagnostics, scintigraphic image-based methods are ideal since they can assess split renal function, work noninvasively, and can be repeated. The aim of this study is to validate a {sup 18}F-PET-based method to quantify renal function in rats. Fluoride clearance was calculated from a dynamic whole body listmode acquisition of 60 min length in a small animal PET scanner following an i.v. injection of 15 MBq {sup 18}F-fluoride. Volumes of interest (VOIs) were placed in the left ventricle and the bladder as well as traced around the kidney contours. The respective time-activity curves (TAC) were calculated. The renal {sup 18}F-clearance was calculated by the ratio of the total renal excreted activity (bladder VOI) and the integral of the blood TAC. PET-derived renal function was validated by intraindividual measurements of creatinine clearance (n=23), urea clearance (n=23), and tubular excretion rate (TER-MAG3). The split renal function was derived from the injection of the clinically available radionuclide {sup 99m}Tc-mercaptotriglycine by blood sampling and planar renography (n=8). In all animals studied, PET revealed high-quality TACs. PET-derived renal fluoride clearance was linearly correlated with intraindividual laboratory measures (PET vs. creatinine: r=0.78; PET vs. urea: r=0.73; PET vs. TER-MAG3: r=0.73). Split function was comparable ({sup 18}F-PET vs. MAG3-renography: r=0.98). PET-derived measures were highly reproducible. {sup 18}F-PET is able to noninvasively assess renal function in rats and provides a significant potential for serial studies in different experimental scenarios. (orig.)

Uses and limitations of renal scintigraphy in renal transplantation monitoring

International Nuclear Information System (INIS)

Heaf, J.G.; Iversen, J.

2000-01-01

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

Surgical indications for unilateral neonatal hydronephrosis in considering ureteropelvic junction obstruction

Directory of Open Access Journals (Sweden)

Hong-Lin Cheng

2014-09-01

Full Text Available Prenatal hydronephrosis is one of the most common urological congenital abnormalities detected by ultrasound. The incidence ranges from 0.59% to 0.69%. Approximately 50% of these fetuses do not have hydronephrosis on postnatal examination, whereas 25–33% of the rest have persistent hydronephrosis leading to the diagnosis of ureteropelvic junction (UPJ obstruction. Renal ultrasonography and renal radionuclide scanning are the major modalities used for assessment and follow-up. Three main criteria used to determine the presence of obstruction are: (1 the magnitude of hydronephrosis present on ultrasound, (2 the relative renal function (RRF measured by renography, and (3 the response of radionuclide washout with furosemide. Unfortunately, it is not always easy to determine obstruction; different types of management have been developed. Without depending on the severity of renal pelvis dilation, percentage of RRF, and response of radionuclide washout in the initial presentation, early surgery to preserve renal function and aggressive observation to prevent unnecessary surgery are two extremes on the spectrum of management for neonatal UPJ obstruction. Relying on renal function in renography, <35–40% or 5–10% of a decrease in the percentage of RRF or on the enlarging of hydronephrosis, respectively, and parenchymal thinning on ultrasonography are the indications for the surgical management to recover renal function in time. In addition to renal function change and imaging progression, the follow-up protocol and family compliance are the other considerations in prevention of impaired renal function. Through more than 40 years of development in the field of UPJ obstruction in infants, there have been several advances in management but controversies remain to be resolved. In this review, we focus on the surgical indications for the UPJ obstruction in this cohort.

Dynamic 18F-fluoride small animal PET to noninvasively assess renal function in rats

International Nuclear Information System (INIS)

Schnoeckel, Uta; Stegger, Lars; Schaefers, Klaus P.; Hermann, Sven; Schober, Otmar; Schaefers, Michael; Reuter, Stefan; Schlatter, Eberhard; Gabriels, Gert

2008-01-01

Renal function can be quantified by both laboratory and scintigraphic methods. In the case of small animal diagnostics, scintigraphic image-based methods are ideal since they can assess split renal function, work noninvasively, and can be repeated. The aim of this study is to validate a 18 F-PET-based method to quantify renal function in rats. Fluoride clearance was calculated from a dynamic whole body listmode acquisition of 60 min length in a small animal PET scanner following an i.v. injection of 15 MBq 18 F-fluoride. Volumes of interest (VOIs) were placed in the left ventricle and the bladder as well as traced around the kidney contours. The respective time-activity curves (TAC) were calculated. The renal 18 F-clearance was calculated by the ratio of the total renal excreted activity (bladder VOI) and the integral of the blood TAC. PET-derived renal function was validated by intraindividual measurements of creatinine clearance (n=23), urea clearance (n=23), and tubular excretion rate (TER-MAG3). The split renal function was derived from the injection of the clinically available radionuclide 99m Tc-mercaptotriglycine by blood sampling and planar renography (n=8). In all animals studied, PET revealed high-quality TACs. PET-derived renal fluoride clearance was linearly correlated with intraindividual laboratory measures (PET vs. creatinine: r=0.78; PET vs. urea: r=0.73; PET vs. TER-MAG3: r=0.73). Split function was comparable ( 18 F-PET vs. MAG3-renography: r=0.98). PET-derived measures were highly reproducible. 18 F-PET is able to noninvasively assess renal function in rats and provides a significant potential for serial studies in different experimental scenarios. (orig.)

Investigation in uro-nephrology (1): diuretic renal scan in children; Enquete en uro-nephrologie (1): la scintigraphie renale dynamique avec test d'hyperdiurese chez l'enfant

Energy Technology Data Exchange (ETDEWEB)

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

2002-08-01

We present the results of a national investigation about the daily practice of diuretic renal scan in children and we compare these results to available international recommendations. Several questions were related to patient preparation, radiopharmaceutical injected activity, image acquisition, diuretic procedure, data processing and renal function quantification, and lastly hard copy output procedure. Diuretic renography is widely performed in children and national daily practice is in agreement with international recommendations about many aspects. However, some aspects should be improved such as hydration, standardisation of furosemide doses and post mobilization and post micturition images acquisition taking on account the effects of gravity and full bladder. Furthermore, a controversy does exist about interpretation of an impaired drainage. (authors)

Bilateral renal calculi

Science.gov (United States)

Sreenevasan, G

1974-01-01

Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968—May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V—Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed. ImagesFig. 1Fig. 4Fig. 6Fig. 7 PMID:4845653

Imaging of uretero-pelvic junction obstruction with stimulated diuresis

International Nuclear Information System (INIS)

Ebel, K.D.; Bliesener, J.A.; Gharib, M.

1988-01-01

Eighty-nine kidneys of 81 infants and children with uretero-pelvic junction obstruction were investigated using ultrasonography (US), diuretic urography (DUR) and diuretic renography (DREN). Results of the US were false-negative in 14%. This can be avoided by ensuring that the patients get an amount of fluid appropriate to their age before the examination or by performing diuretic ultrasonography with frusemide. False-positive results were found with US in 15%, but obstruction was excluded by using the DUR and/or the DREN. During post-operative follow-up the DUS is useful and after 6 months the clearance with 123-iodine hippurate combined with the DREN should be performed. The administration of the Whitaker-test is unnecessary. (orig.)

Investigation in uro-nephrology (1): diuretic renal scan in children

International Nuclear Information System (INIS)

Archambaud, F.; Olivier, P.; Guillet, J.; Wioland, M.; Bonnin, F.

2002-01-01

We present the results of a national investigation about the daily practice of diuretic renal scan in children and we compare these results to available international recommendations. Several questions were related to patient preparation, radiopharmaceutical injected activity, image acquisition, diuretic procedure, data processing and renal function quantification, and lastly hard copy output procedure. Diuretic renography is widely performed in children and national daily practice is in agreement with international recommendations about many aspects. However, some aspects should be improved such as hydration, standardisation of furosemide doses and post mobilization and post micturition images acquisition taking on account the effects of gravity and full bladder. Furthermore, a controversy does exist about interpretation of an impaired drainage. (authors)

Clinical usefulness of physiological components obtained by factor analysis

International Nuclear Information System (INIS)

Ohtake, Eiji; Murata, Hajime; Matsuda, Hirofumi; Yokoyama, Masao; Toyama, Hinako; Satoh, Tomohiko.

1989-01-01

The clinical usefulness of physiological components obtained by factor analysis was assessed in 99m Tc-DTPA renography. Using definite physiological components, another dynamic data could be analyzed. In this paper, the dynamic renal function after ESWL (Extracorporeal Shock Wave Lithotripsy) treatment was examined using physiological components in the kidney before ESWL and/or a normal kidney. We could easily evaluate the change of renal functions by this method. The usefulness of a new analysis using physiological components was summarized as follows: 1) The change of a dynamic function could be assessed in quantity as that of the contribution ratio. 2) The change of a sick condition could be morphologically evaluated as that of the functional image. (author)

The connection of hydronephrosis and microcirculation deterioration

Directory of Open Access Journals (Sweden)

Vorobets Dmytro

2016-09-01

Full Text Available In this study, we have analyzed the influence of hydronephrosis upon the microcirculation system, in situations of pyeloureteral junction obstruction. Herein, bulbar conjunctiva has been chosen as the object of this biomicroscopic study because of its simplicity and the method availability in clinic practice. In fulfilling this work, we ascertained the connections between extravascular, intravascular, vascular and general conjunctival indices of the patients before radical and paliatic correction of the pyeloureteral junction obstruction (i.e. by open and laparoscopic pyeloplasty, endopyelotomy, laser resection and balloon dilatation. We concluded that, apart from the proved deterioration of kidney function, systemic deteriorations of microcirculation may be observed in situations of clinically marked hydronephrosis, according to the results of radioisotope renography and excretory urography.

Blood and urine β2-microglobulin in pyelonephritic patients with diabetes mellituS

International Nuclear Information System (INIS)

Vasyukova, E.A.; Turiev, G.S.; Gerasimova, N.P.; Ametov, A.S.

1983-01-01

Blood and wine β 2 -microglobulin (B 2 MG) was determined in pyelonephritic patients with diabetes mellitus using the radioimmunoassay method. Different lesions of urogenital system such as pyelonephrit in 27 cases, isolated nephro microangiopathy in 25 cases, Urinary tracks infection in 13 cases Were revealed on the base of a complex examination (radioisotopic renography, dynamic nephroscintigraphy, extretory urography etc). No pathologic changes were discovered in 12 patients. It has been shown that simultaneous determination of blood and wine β 2 -MG allows one to specify a place of primary nephron damage. An increase of β 2 -MG concentration in blood serum is characteristic for violation of glomenular function of kidneys but an increase of its excretion with urine indicates a damage of proximal small channels

Association of congenital megacalycosis and ipsilateral segmental megaureter

International Nuclear Information System (INIS)

Mandell, G.A.; Keller, M.; Kaplan, J.M.

1987-01-01

Four cases of congenital megacalycosis associated with ipsilateral segmental megaureter in children are presented. This association has not been emphasized, although review of the English and French literature revealed eight such cases. In al cases, the concurrent entities are unilateral, with a left-sided predominance and a male prevalence. The diagnosis of megacalycosis is resumed in four of the cases by normal function and prompt emptying of the calyceal systems on diuretic renography and/or urography. The presence of normal caliber renal pelvis interposed between the dilated collecting system and the distal dilated ureter without evidence of vesicoureteral reflux implies the coexistence of ipsilateral idiopathic megaureter. The patients usually present because of urinary tract infection and/or calculus formation, but respond well to conservative therapy. (orig.)

Live Donor Renal Anatomic Asymmetry and Posttransplant Renal Function.

Science.gov (United States)

Tanriover, Bekir; Fernandez, Sonalis; Campenot, Eric S; Newhouse, Jeffrey H; Oyfe, Irina; Mohan, Prince; Sandikci, Burhaneddin; Radhakrishnan, Jai; Wexler, Jennifer J; Carroll, Maureen A; Sharif, Sairah; Cohen, David J; Ratner, Lloyd E; Hardy, Mark A

2015-08-01

Relationship between live donor renal anatomic asymmetry and posttransplant recipient function has not been studied extensively. We analyzed 96 live kidney donors, who had anatomical asymmetry (>10% renal length and/or volume difference calculated from computerized tomography angiograms) and their matching recipients. Split function differences (SFD) were quantified with technetium-dimercaptosuccinic acid renography. Implantation biopsies at time 0 were semiquantitatively scored. A comprehensive model using donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at 1 year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60 mL/min/1.73 m(2) at 1 year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the chronic kidney disease-epidemiology collaboration formula), and a Monte Carlo simulation based on the linear regression model (N=10,000 iterations). In the study cohort, the mean Vol/Wgt and eGFR at 1 year were 2.04 mL/kg and 60.4 mL/min/1.73 m(2), respectively. Volume and split ratios between 2 donor kidneys were strongly correlated (r = 0.79, P 10%) were not different (P = 0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR > 60 mL/min/1.73 m (odds ratio, 8.94, 95% CI 2.47-32.25, P = 0.001) and had a strong discriminatory power in predicting the risk of eGFR less than 60 mL/min/1.73 m(2) at 1 year [receiver operating curve (ROC curve), 0.78, 95% CI, 0.68-0.89]. In the presence of donor renal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at 1 year after transplantation. Renography can be replaced with CT volume calculation in estimating split renal function.

Renovascular hypertension in children with neurofibromatosis type 1

Directory of Open Access Journals (Sweden)

Peco-Antić Amira

2003-01-01

Full Text Available Arterial hypertension in pediatric patients with neurofibromatosis type 1 (NF 1 is usually due to renal artery stenosis (RAS mainly involving the proximal part of the vessel. The treatment modalities are highly individualized. In severe and/or bilateral RAS, antihypertensive drugs are either ineffective or have the potential risk for acute renal failure, while percutaneous transluminal angioplasty (PTA has limited success due to the ostial localization of RAS and the tough fibrotic tissue involved that is refractory to dilatation Renal autotransplantation has potential advantages when medical control and PTA/or bypass techniques failed. Here we report 5 year-old girl with NF 1 and hyponatremic hypertensive syndrome due to severe bilateral disease, occluded proximal part of the right artery and ostial stenosis (80% of the left one. Only left kidney was identified on 99 in Tc DTP A, but the right one was visualized on the renal ultrasonography and in the late phase of arterial renography due to well developed collateral circulation. Multiple antihyper-tensive drugs (nifedipine, labetolol and minoxidil in maximal doses and PTA failed to normalize BP while short term therapy with ACEIwith NF1 and hyponatremic hypertensive syndrome due to severe bilateral renovascular disease; occluded proximal part of the right renal artery and ostial stenosis (80% of the left one. Only left kidney was identified on 99m Tc DTPA, but the right one was visualized on the renal ultrasonography and in the late phase of arterial renography due to well developed collateral circulation. Multiple antyphypertensive drugs (nifedipine, labetolol and minoxidil in maximal doses and PTA failed to normalize BP while. short term therapy with ACEI, captopril induced transient acute renal failure. Autotransplantation of right kidney saved its function and improved BP control. Our current case Autotransplantation of right kidney saved its function and improved BP control. Our current

Renal deterioration after spinal cord injury is associated with length of detrusor contractions during cystometry

DEFF Research Database (Denmark)

Elmelund, Marlene; Klarskov, Niels; Bagi, Per

2017-01-01

AIMS: To investigate which urodynamic parameters are associated with renal deterioration over a median of 41 years follow-up after traumatic spinal cord injury. METHODS: Medical records of patients with a traumatic spinal cord injury sustained 1944-1975 were reviewed from time of injury until 2012....... Patients who attended regular renography and/or renal clearance examinations and had minimum one cystometry and pressure-flow study were included. Renal deterioration was diagnosed as split renal function ≤30% in one kidney or relative glomerular filtration rate ≤51% of expected according to age and gender....... Detrusor function, presence of detrusor sphincter dyssynergia, maximum detrusor pressure, post-void residual volume, and cystometric bladder capacity were obtained. In patients with detrusor overactivity, a detrusor overactivity/cystometry ratio was calculated using duration of detrusor contraction...

50 years follow-up on plasma creatinine levels after spinal cord injury

DEFF Research Database (Denmark)

Elmelund, Marlene; Oturai, P S; Biering-Sørensen, F

2014-01-01

STUDY DESIGN: Retrospective chart review. OBJECTIVES: To investigate the role of plasma creatinine (p-creatinine) in monitoring renal deterioration in patients up to 50 years after spinal cord injury (SCI). SETTING: The Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark. METHODS: A total...... of 119 patients with a traumatic SCI during the years 1944-1975 were included in the study. P-creatinine measurements, results from renography and glomerular filtration rate (GFR) measured with 51Cr-EDTA clearance were obtained from medical records and analyzed using a linear mixed model and linear...... regression analyses. RESULTS: When compared with median p-creatinine level in the first 5-year period after injury, the level of p-creatinine was stable throughout the first 30 years and decreased significantly after the 30th until 45th year post injury. Only patients with a functional distribution outside...

The value of diuretic renography for assessment of dilated upper urinary tract in children

International Nuclear Information System (INIS)

Yang, Ki Ra; Lim, Gye Yeon; Sohn, Hyung Sun; Hahn, Seong Tae; Lee, Jae Mun; Shin, Kyung Sub

1997-01-01

The use of perinatal ultrasonography has resulted in an increased recognition of hydronephrosis in neonates. The primary concern is differentiating obstructive from nonobstructive causes of hydronephrosis. The management varies from a conservative approach in nonobstructed kidneys to a different operative procedures for UPJ obstruction. To address these concerns, we reviewed the initial and follow-up diuretic renal scans of 14 patients (age range : 3days to 4 years) with unilateral hydronephrosis without ureterectasis diagnosed by ultrasonography and all had normal cystograms. The diuretic renal scans followed a standardized protocol including adequate hydration and continuous bladder drainage with urethral catheter in all patients. Six patients were diagnosed as having UPJ obstruction with surgical confirmation in all. However, initial nonobstructive diuretic renal scans performed within 1 week of age were converted to obstructive scans after 2-3 months in three neonates of these patients. Post-operative diuretic renal scan in 3-12 months after surgery showed nonobstructive pattern in 5 patients and nonfunction pattern in 1 patient. Eight were diagnosed as nonobstructed and seven of these were confirmed by serial imaging using ultrasonograms. None of these has subsequently developed deterioration of renal function or required surgery. In conclusion, diuretic renal scan was useful tools for assessing suspected UPJ obstruction in children as a initial or postoperative follow-up studies. Additionally, even nonobstrcuted or indeterminate result necessiates follow-up imaging to ensure obstruction does not develop, especially in the noenatal period, respectively

Measurement of Effective Renal Plasma Flow: Evaluation of Clinical Uses in Combination with Renography

Energy Technology Data Exchange (ETDEWEB)

Mahadev, V. [Department of Radiotherapy and Nuclear Medicine, General Hospital, Kuala Lumpur (Malaysia)

1971-02-15

A comparison of techniques for measuring the renal clearance of Hippuran using a single injection of {sup 131}I sodium orthoiodohippurate in 30 normal subjects and 49 patients showed that a simplified technique using limited samples of blood gave comparable results to more complicated blood and external monitoring techniques without significant loss of accuracy. The clearance value in normal subjects was 645 ml/1.73 m{sup 2} ({+-} 108 ml) and is comparable with results obtained elsewhere. Together with a renogram examination this measurement enables more information to be obtained and helps to distinguish vascular and parenchymal disorders from purely obstructive lesions. It may be useful in the problem of renal tuberculosis and in distinguishing benign kidney lesions from malignant. (author)

Reliability of single kidney glomerular filtration rate measured by a 99mTc-DTPA gamma camera technique

International Nuclear Information System (INIS)

Rehling, M.; Moller, M.L.; Jensen, J.J.; Thamdrup, B.; Lund, J.O.; Trap-Jensen, J.

1986-01-01

The reliability of a previously published method for determination of single kidney glomerular filtration rate (SKGFR) by means of technetium-99m-diethylenetriaminepenta-acetate (99mTc-DTPA) gamma camera renography was evaluated. The day-to-day variation in the calculated SKGFR values was earlier found to be 8.8%. The technique was compared to the simultaneously measured renal clearance of inulin in 19 unilaterally nephrectomized patients with GFR varying from 11 to 76 ml/min. The regression line (y = 1.04 X -2.5) did not differ significantly from the line of identity. The standard error of estimate was 4.3 ml/min. In 17 patients the inter- and intraobserver variation of the calculated SKGFR values was 1.2 ml/min and 1.3 ml/min, respectively. In 21 of 25 healthy subjects studied (age range 27-29 years), total GFR calculated from the renograms was within an established age-dependent normal range of GFR

Pediatric hypertension: An approach to imaging

International Nuclear Information System (INIS)

Diament, M.J.; Stanley, P.; Gilsanz, V.; Boechat, M.I.; Kangarloo, H.; Lieberman, E.R.

1986-01-01

Since 1981, we have made diagnoses of secondary hypertension using state of art imaging equipment in 18 pediatric patients. The most valuable tests were ultrasound identifying renal parenchymal disease, computed body tomography for adrenal tumors and intra-arterial renal angiography for renovascular disorders. Based on our experience, we have formulated an algorithm for the evaluation of the hypertensive pediatric patient. The initial step is careful clinical and laboratory screening to identify those patients that are likely to have essential hypertension and who should not undergo imaging tests. In the cases where there is a possible secondary etiology, renal ultrasound is usually performed first to identify parenchymal disease. If catecholamines are elevated, then abdominal computed tomography is the initial test. If no etiology is identified from these noninvasive studies, then direct intraarterial renal angiography is performed. The authors do not feel that excretory urography, radionuclide renography, intravenous digital subtraction angiography or selective renal vein sampling for renin are useful or practical screening tests for renovascular hypertension. (orig.)

The exercise renogram. A new approach documents renal involvement in systemic hypertension

International Nuclear Information System (INIS)

Clorius, J.H.; Schmidlin, P.

1983-01-01

Hippurate functional scintiscans were obtained in 51 hypertensive patients and in 15 controls. We investigated the influence that posture and exercise have on hippurate kinetics in patients with hypertension. A posture- or exercise-induced disturbance of renal hippurate transport was sought. All persons were examined in prone and standing positions, as well as during exercise. When prone and upright renograms were compared, 24% of the hypertensives demonstrated bilateral orthostatic renal dysfunction. Exercise caused the hippurate transport disturbance to increase. Fifty-seven percent of all hypertensives developed evidence of marked, bilateral, renal dysfunction during ergometric stress, so that exercise renography was shown to be a more sensitive test of the presence of transient tubular dysfunction in hypertension than the standing renogram. In normotensive controls the hippurate functional scintigram failed to be influenced by posture and exercise. The results suggest presence in hypertension of transient, posture- and exercise-mediated alterations of renal cortical blood flow

Pediatric hypertension: An approach to imaging

Energy Technology Data Exchange (ETDEWEB)

Diament, M J; Stanley, P; Gilsanz, V; Boechat, M I; Kangarloo, H; Lieberman, E R

1986-09-01

Since 1981, we have made diagnoses of secondary hypertension using state of art imaging equipment in 18 pediatric patients. The most valuable tests were ultrasound identifying renal parenchymal disease, computed body tomography for adrenal tumors and intra-arterial renal angiography for renovascular disorders. Based on our experience, we have formulated an algorithm for the evaluation of the hypertensive pediatric patient. The initial step is careful clinical and laboratory screening to identify those patients that are likely to have essential hypertension and who should not undergo imaging tests. In the cases where there is a possible secondary etiology, renal ultrasound is usually performed first to identify parenchymal disease. If catecholamines are elevated, then abdominal computed tomography is the initial test. If no etiology is identified from these noninvasive studies, then direct intraarterial renal angiography is performed. The authors do not feel that excretory urography, radionuclide renography, intravenous digital subtraction angiography or selective renal vein sampling for renin are useful or practical screening tests for renovascular hypertension.

Stability, protein binding and clearance studies of [99mTc]DTPA. Evaluation of a commercially available dry-kit

DEFF Research Database (Denmark)

Rehling, M

1988-01-01

[99mTc]DTPA has achieved widespread use for the measurement of glomerular filtration rate (GFR) with the single injection plasma clearance technique and for gamma-camera renography. However, the quality of the commercial preparations varies. The purpose of the present investigation was to study...... the quality of a commercial [99mTc]DTPA preparation (C.I.S., France) with reference to stability, protein binding and accuracy of the determined plasma clearance values as a measure of GFR. The stability of the preparations was studied by thin-layer chromatography, the in vitro protein binding by Sephadex.......7% and 1.1%, respectively. The plasma clearance of [99mTc]DTPA was on an average 3.7% higher than that of [51Cr]EDTA in 27 patients. It is concluded that the [99mTc]DTPA preparation is reliable for the measurement of GFR. The preparation is stable for at least six hours at room temperature...

Renal function and urine drainage after conservative or operative treatment of primary (obstructive) megaureter in infants and children.

Science.gov (United States)

Tröbs, R-B; Heinecke, K; Elouahidi, T; Nounla, J; Kluge, R

2006-01-01

We examined renal function and urinary drainage of children with primary megaureter (PMU) in dependence on conservative or operative treatment. The retrospective analysis covering the years 1994 to 2000 comprised children at an age of 0-7 years with 35 PMU. Sonography, dynamic MAG3 renography as well as endogenic creatinine clearance (GFR) were used to assess drainage and the renal function. Temporary urinary diversion was established in fourteen patients of both groups. In 14 children with 16 PMU a ureteroneocystostomy (UNC) was performed. The average observation period was 30 months (11-108). The children of the UNC group differed from the non-neoimplanted group in the age at diagnosis (10.5 vs. PMU with a reduced function of the kidneys and a significant impaired drainage pattern and/or symptoms, neoimplantation without temporary diversion has proved to be an efficient renoprotective method. Furthermore, data clearly justify a conservative approach without urinary diversion in infants with large asymptomatic PMU.

Renovascular hypertension

International Nuclear Information System (INIS)

Thomsen, H.S.; Sos, T.A.; Nielsen, S.L.; Koebenhavns Amts Sygehus, Herlev; Cornell Univ., New York

1989-01-01

Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin II blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty. (orig.)

Exercise renogram. A new approach documents renal involvement in systemic hypertension

International Nuclear Information System (INIS)

Clorius, J.H.; Schmidlin, P.

1983-01-01

Hippurate functional scintiscans were obtained in 51 hypertensive patients and in 15 controls. The authors investigated the influence that posture and exercise have on hippurate kinetics in patients with hypertension. A posture- or exercise-induced disturbance of renal hippurate transport was sought. All persons were examined in prone and standing positions, as well as during exercise. When prone and upright renograms were compared, 24% of the hypertensives demonstrated bilateral orthostatic renal dysfunction. Exercise caused the hippurate transport disturbance to increase. Fifty-seven percent of all hypertensives developed evidence of marked, bilateral, renal dysfunction during ergometric stress, so that exercise renography was shown to be a more sensitive test of the presence of transient tubular dysfunction in hypertension than the standing renogram. In normotensive controls the hippurate functional scintigram failed to be influenced by posture and exercise. The results suggest presence in hypertension of transient, posture- and exercise-mediated alterations of renal cortical blood flow

A Study on the Effectiveness of Diuretic Renal Scan on Functional and Pathologic Obstructive Uropathy

International Nuclear Information System (INIS)

Ahn, Cu Rie; Lee, Hun Yong; Kwon, In Sun

1983-01-01

Diuretic renal scan, a modified method of convectional radionuclide renography by administration of intravenous furosemide was performed in 54 patients with suspected urinary tract obstruction. Two showed normal responses, 41 showed increased washout patterns, and the remainder 15 revealed no changes in response to the furosemide administration. IVP was done in 34 patients. In comparison to the diuretic renal scan, the following results were obtained. 1) Patients with normal results by the scan, showed normal IVP findings also. 2) 10 patients who showed delayed excretory patterns not influenced by the diuretics administration. 9 patients revealed obstructive lesions and hydronephrotic changes, and CPN was diagnosed for the remainder one and the one patient without obstruction was diagnosed as chronic pyelonephritis. 3) 22 patients showed positive results to the diuretics. Among them 10 patients had positive results in IVP. but, were not related to the speed of decrement of the renal activity after the furosemide administration.

Technetium-99m DTPA renal flow studies in Goldblatt hypertension

International Nuclear Information System (INIS)

Nally, J.V.; Clarke, H.S.; Windham, J.P.; Grecos, G.P.; Gross, M.L.; Potvin, W.J.

1985-01-01

Computer-assisted dynamic renal studies were performed on a group of 14 mongrel dogs before and after the induction of unilateral renal artery stenosis. Ninety-second technetium-99m diethylenetriaminepentaacetic acid ([/sup 99m/Tc]DTPA), 15-min [/sup 99m/Tc]DTPA, and 30-min iodine-131 orthoiodohippurate ([ 131 I]hippuran) time-activity curves were analyzed and correlated with reduction of renal blood flow as measured by electromagnetic flow probe and PAH clearance techniques. For blood flow reductions greater than 33%, the [/sup 99m/Tc]DTPA studies were judged diagnostic of unilateral renal artery stenosis in all cases, whereas the [ 131 I]hippuran time-activity curves were indicative of stenosis in only six of ten studies. Thus, in this model we find the computer-assisted 90-sec [/sup 99m/Tc]DTPA renal flow study to be superior to conventional [ 131 I]hippuran renography in the diagnosis of moderate-to-serve unilateral renal artery stenosis

MR renography : An algorithm for calculation and correction of cortical volume averaging in medullary renographs

NARCIS (Netherlands)

de Priester, JA; den Boer, JA; Giele, ELW; Christiaans, MHL; Kessels, A; Hasman, A; van Engelshoven, JMA

We evaluated a mathematical algorithm for the generation of medullary signal from raw dynamic magnetic resonance (MR) data. Five healthy volunteers were studied. MR examination consisted of a run of 100 TI-weighted coronal scans (gradient echo: TR/TE 11/3.4 msec, flip angle 60 degrees; slice

A camera based calculation of 99m Tc-MAG-3 clearance using conjugate views method

International Nuclear Information System (INIS)

Hojabr, M.; Rajabi, H.; Eftekhari, M.

2004-01-01

Background: measurement of absolute or different renal function using radiotracers plays an important role in the clinical management of various renal diseases. Gamma camera quantitative methods is approximations of renal clearance may potentially be as accurate as plasma clearance methods. However some critical factors such as kidney depth and background counts are still troublesome in the use of this technique. In this study the conjugate-view method along with some background correction technique have been used for the measurement of renal activity in 99m Tc- MAG 3 renography. Transmission data were used for attenuation correction and the source volume was considered for accurate background subtraction. Materials and methods: the study was performed in 35 adult patients referred to our department for conventional renography and ERPF calculation. Depending on patients weight approximately 10-15 mCi 99 Tc-MAG 3 was injected in the form of a sharp bolus and 60 frames of 1 second followed by 174 frames of 10 seconds were acquired for each patient. Imaging was performed on a dual-head gamma camera(SOLUS; SunSpark10, ADAC Laboratories, Milpitas, CA) anterior and posterior views were acquired simultaneously. A LEHR collimator was used to correct the scatter for the emission and transmission images. Buijs factor was applied on background counts before background correction (Rutland-Patlak equation). gamma camera clearance was calculated using renal uptake in 1-2, 1.5-2.5, 2-3 min. The same procedure was repeated for both renograms obtained from posterior projection and conjugated views. The plasma clearance was also directly calculated by three blood samples obtained at 40, 80, 120 min after injection. Results: 99 Tc-MAG 3 clearance using direct sampling method were used as reference values and compared to the results obtained from the renograms. The maximum correlation was found between conjugate view clearance at 2-3 min (R=0.99, R 2 =0.98, SE=15). Conventional

Diuretic renography in hydronephrosis: renal tissue tracer transit predicts functional course and thereby need for surgery.

Science.gov (United States)

Schlotmann, Andreas; Clorius, John H; Clorius, Sandra N

2009-10-01

The recognition of those hydronephrotic kidneys which require therapy to preserve renal function remains difficult. We retrospectively compared the 'tissue tracer transit' (TTT) of (99m)Tc-mercaptoacetyltriglycine ((99m)Tc-MAG(3)) with 'response to furosemide stimulation' (RFS) and with 'single kidney function timely TTT maintained function. Without surgery 0 of 9 kidneys with timely TTT but obstructive RFS and only 1 of 16 kidneys with timely TTT but SKF timely TTT may exclude risk even in the presence of an obstructive RFS or SKF < 40%.

Diuretic renography in hydronephrosis: renal tissue tracer transit predicts functional course and thereby need for surgery

Energy Technology Data Exchange (ETDEWEB)

Schlotmann, Andreas [University Hospital Freiburg, Department of Nuclear Medicine and Department of Radiation Oncology, Freiburg (Germany); Clorius, John H. [German Cancer Research Center, Heidelberg (Germany); Clorius, Sandra N. [University Hospital Basel, Department of Internal Medicine, Basel (Switzerland)

2009-10-15

The recognition of those hydronephrotic kidneys which require therapy to preserve renal function remains difficult. We retrospectively compared the 'tissue tracer transit' (TTT) of {sup 99m}Tc-mercaptoacetyltriglycine ({sup 99m}Tc-MAG{sub 3}) with 'response to furosemide stimulation' (RFS) and with 'single kidney function < 40%' (SKF < 40%) to predict functional course and thereby need for surgery. Fifty patients with suspected unilateral obstruction and normal contralateral kidney had 115 paired (baseline/follow-up) {sup 99m}Tc-MAG{sub 3} scintirenographies. Three predictions of the functional development were derived from each baseline examination: the first based on TTT (visually assessed), the second on RFS and the third on SKF < 40%. Each prediction also considered whether the patient had surgery. Possible predictions were 'better', 'worse' or 'stable' function. A comparison of SKF at baseline and follow-up verified the predictions. The frequency of correct predictions for functional improvement following surgery was 8 of 10 kidneys with delayed TTT, 9 of 22 kidneys with obstructive RFS and 9 of 21 kidneys with SKF < 40%; for functional deterioration without surgery it was 2 of 3 kidneys with delayed TTT, 3 of 20 kidneys with obstructive RFS and 3 of 23 kidneys with SKF < 40%. Without surgery 67 of 70 kidneys with timely TTT maintained function. Without surgery 0 of 9 kidneys with timely TTT but obstructive RFS and only 1 of 16 kidneys with timely TTT but SKF < 40% lost function. Delayed TTT appears to identify the need for therapy to preserve function of hydronephrotic kidneys, while timely TTT may exclude risk even in the presence of an obstructive RFS or SKF < 40%. (orig.)

The renogram in renovascular hypertension

International Nuclear Information System (INIS)

Geyskes, G.G.

1987-01-01

This thesis comprises five reports on studies with renograms, radionuclide investigations of individual renal function in patients suspected of renovascular hypertension. The main question was to determine whether the renogram could trace functional changes in a kidney with a stenosed artery, before and after percutaneous transluminal angioplasty (PTA) treatment. In a given patient these functional changes could provide information on the significance of the artery stenosis as a cause of that patients' hypertension, and to some extent predict the blood pressure response after PTA treatment. An important issue in these studies is the registration of the renal effects created by captopril on the renogram. This drug with its specific inhibition of the conversion of angiotensine I to angiotensine II, amplifies the impairment of the glomerular filtration rate (GFR) in a kidney behind a stenosis. Captopril-induced deterioration of the GFR can be shown by renography, especially when it occurs in only one of two kidneys and for that reason does escape detection by overall renal function studies. 157 refs.; 16 figs.; 12 tabs

A method for subtraction of the extrarenal 'background' in dynamic 131I-hippurate renoscintigraphy

International Nuclear Information System (INIS)

Mlodkowska, E.; Liniecki, J.; Surma, M.

1979-01-01

Using a Toshiba GC-401 gamma camera with MDS computer Trinary a new method was developed for subtracting the extrarenal (extracanalicular) 'background' from the count rate recorded over the kidneys after intravenous administration of 131 I-hippurate. Mean subtraction factors of the 'blood' activity curve were calculated from a study of 27 patients who were given 51 Cr-HSA for purposes of conventional renography with 'background' subtraction. The values of the mean subtraction factors anti Fsub(R,L) for the right and left kidney, by which a blood count rate should be multiplied amounted to 0.86 +- 0.12 and 0.79 +- 0.13, respectively. A comparison of the coefficients of variation of the pure renal signal when mean vs. individually determined subtraction factors were used, and the verification of the method in unilaterally nephrectomized patients have demonstrated that determination of the factors, anti Fsub(R,L), for each patient individually is not required and sufficient precision can be obtained by using the method and factors reported in this study. (orig.) [de

Requirements for accurately diagnosing chronic partial upper urinary tract obstruction in children with hydronephrosis

International Nuclear Information System (INIS)

Koff, Stephen A.

2008-01-01

Successful management of hydronephrosis in the newborn requires early accurate diagnosis to identify or exclude ureteropelvic junction obstruction. However, the presence of hydronephrosis does not define obstruction and displays unique behavior in the newborn. The hydronephrotic kidney usually has nearly normal differential renal function at birth, has not been subjected to progressive dilation and except for pelvocaliectasis does not often show signs of high-grade obstruction. Furthermore, severe hydronephrosis resolves spontaneously in more than 65% of newborns with differential renal function stable or improving. The diagnosis of obstruction in newborn hydronephrosis is challenging because the currently available diagnostic tests, ultrasonography and diuretic renography have demonstrated inaccuracy in diagnosing obstruction and predicting which hydronephrotic kidney will undergo deterioration if untreated. Accurate diagnosis of obstruction is possible but it requires an understanding of the uniqueness of both the pathophysiology of obstruction and the biology of the kidney and renal collecting system in this age group. We examine here the requirements for making an accurate diagnosis of obstruction in the young child with hydronephrosis. (orig.)

Requirements for accurately diagnosing chronic partial upper urinary tract obstruction in children with hydronephrosis

Energy Technology Data Exchange (ETDEWEB)

Koff, Stephen A. [Ohio State University College of Medicine, Section of Pediatric Urology, Columbus Children' s Hospital, Columbus, OH (United States)

2008-01-15

Successful management of hydronephrosis in the newborn requires early accurate diagnosis to identify or exclude ureteropelvic junction obstruction. However, the presence of hydronephrosis does not define obstruction and displays unique behavior in the newborn. The hydronephrotic kidney usually has nearly normal differential renal function at birth, has not been subjected to progressive dilation and except for pelvocaliectasis does not often show signs of high-grade obstruction. Furthermore, severe hydronephrosis resolves spontaneously in more than 65% of newborns with differential renal function stable or improving. The diagnosis of obstruction in newborn hydronephrosis is challenging because the currently available diagnostic tests, ultrasonography and diuretic renography have demonstrated inaccuracy in diagnosing obstruction and predicting which hydronephrotic kidney will undergo deterioration if untreated. Accurate diagnosis of obstruction is possible but it requires an understanding of the uniqueness of both the pathophysiology of obstruction and the biology of the kidney and renal collecting system in this age group. We examine here the requirements for making an accurate diagnosis of obstruction in the young child with hydronephrosis. (orig.)

Radionuclide studies in paediatric nephro-urology

Energy Technology Data Exchange (ETDEWEB)

Piepsz, Amy E-mail: amypiepsz@yahoo.com

2002-08-01

The main tool of radionuclide techniques applied to paediatric uro-nephrology is the quantitation of function, which is an information not easily obtained by other diagnostic modalities. The radiation burden is low. Drug sedation is only rarely needed, whatever the age of the patient. Accurate determination of glomerular filtration rate can be obtained by means of an intravenous injection of Cr-51 EDTA and one or two blood samples. Tc-99m DMSA scintigraphy is an accurate method for evaluation of regional cortical impairment during acute pyelonephritis and later on, for detection of permanent scarring. Tc-99m MAG3 renography is nowadays a well-standardized method for accurate estimation of the split renal function and of renal drainage with or without furosemide challenge. This technique is particularly indicated in uni- or bilateral uropathies with or without renal and/or ureteral dilatation. Direct and indirect radionuclide cystography are two alternative modalities for X-ray MCUG. Their relative place in the strategy of management of vesicoureteral reflux is discussed.

Diagnostic nuclear medicine. 2. rev. ed.

International Nuclear Information System (INIS)

Schiepers, C.

2006-01-01

The field of nuclear medicine is undergoing rapid expansion, and is evolving into diagnostic molecular imaging. During recent years, dual-modality imaging with PET/CT has gained acceptance and this is currently the fastest-growing technique for oncological imaging applications. The glucose analogue FDG has held its place in diagnostic oncology, assessment of myocardial viability and diagnosis of neuro-degenerative disorders. Peptides have become even more important as imaging agents. The accuracy of hepatobiliary scintigraphy has been enhanced by cholecystokinin. The use of ACE inhibitors in the evaluation of renovascular hypertension has become the standard in renography. New instrumentation has led to faster scanners, and computer development to better image processing software. Automatic processing is more common, and standardization of protocols can be accomplished easily. The field of gene imaging has progressed, although routine clinical applications are not yet available. The present text, supplemented with many detailed and informative illustrations, represents an adjunct to the standard knowledge of diagnostic nuclear medicine and provides both the student and the professional with an overview of developments during the past decade. (orig.)

Renal morphology and function immediately after extracorporeal shock-wave lithotripsy

Energy Technology Data Exchange (ETDEWEB)

Kaude, J.V.; Williams, C.M.; Millner, M.R.; Scott, K.N.; Finlayson, B.

1985-08-01

The acute effects of extracorporeal shock-wave lithotripsy (ESWL) on morphology and function of the kidney were evaluated by excretory urography, quantitative radionuclide renography (QRR), and magnetic resonance imaging (MRI) in 33 consecutive patients. Excretory urograms demonstrated an enlarged kidney in seven (18%) of 41 treatments and partial or complete obstruction of the ureter by stone fragments after 15 (37%) of 41 treatments. Total effective renal plasma flow (ERPF) was not changed after ESWL, but the percentage ERPF of the treated kidney was decreased by more than 5% in 10 (30%) of 33 cases. QRR images showed partial parenchymal obstruction in 10 (25%) of 41 teated kidneys and total parenchymal obstruction in 9 (22%). MRI disclosed one or more abnormalities in 24 (63%) of 38 treated kidneys. Treated kidneys were normal by all three imaging methods in 26% and abnormal by one or more tests in 74% of cases. The morphologic and functional changes are attributed to renal contusion resulting in edema and extravasation of urine and blood into the interstitial, subcapsular, and perirenal spaces.

EFFECT OF CHRONIC ACE-INHIBITION ON THE DIAGNOSTIC-VALUE OF RENOGRAPHY FOR RENOVASCULAR HYPERTENSION - A PRELIMINARY-REPORT

NARCIS (Netherlands)

VISSCHER, CA; DEZEEUW, D; HUISMAN, RM

1995-01-01

We compared the effects of acute and chronic ACE inhibition (ACEi) on the I-123-hippurate in the stenotic kidney of two 2-kidney, 1-clip hypertensive dogs. In the period after clip implantation poststenotic renograms without ACEi of both dogs were normal. Acute ACEi always resulted in delayed

Isotope nephrography in the assessment of different methods of surgical repair of the kidney after blunt lesions of intermediate degree

International Nuclear Information System (INIS)

Hoeflin, F.G.; Schoenenberger, A.; Mettler, D.; Roesler, H.; Zimmermann, A.; Bilweis, J.; Zingg, E.

1986-01-01

Despite recent improvements in diagnostic facilities there are no clear guidelines for the management of intermediate degree blunt renal trauma. Sixteen experimentally induced blunt renal lesions in pigs were treated either with a new alloplastic renal capsule made to our specifications of semi-elastic Vicryl mesh or with homologous pig fibrin sealant of with through-and-through chromic catgut sutures. Postoperative renal function was repeatedly assessed in all animals by isotope renography using 123 I-hippuric acid. Results: At surgery the Vicryl mesh was easily and quickly applied. The two other procedures were technically more demanding and time-consuming. Full haemostasis was obtained with all three methods. Kidneys which had been repaired with the Vicryl mesh contained considerably less scar tissue at the site of parenchymal rupture and showed neither perirenal fibrosis nor atrophy of the parenchyma in the vicintiy of the capsule. In a first net version, where high initial tension was applied, final clearance was significantly lower than in the other groups, due to an initial transient ischemic period. A modified technique with a second, final net version allowing controlled expansion of the kidneys during the postoperative period resulted in optimal late results. (Author)

Clinical study of GFR and split renal GFR in evaluating the glomerular function in patients with type 2 diabetes

International Nuclear Information System (INIS)

Fu Hongliang; Li Jinsong; Li Jianing; Wu Jingchuan; Yang Shurong; Gu Zhenhui; Zou Renjian; Shi Haihong

2003-01-01

Objective: To assess glomerular filtration function in patients with type 2 diabetes by glomerular filtration rate (GFR) and split GFR, namely left GFR (LGFR) and right GFR (RGFR). Methods: Fifty-one patients with type 2 diabetes were classified by urine albumin analysis into three groups, normalalbuminuria group (NA), microalbuminuria group(MA) and macroalbuminuria group (MAA) . Twelve patients without diabetes were included into control group. 99 Tc m -DTPA renography was performed on all these cases. GFR and split GFR were calculated by Gates formula. Results: 1) GFR, LGFR and RGFR of NA group were lower than that of the control group. 2) GFR, LGFR and RGFR were significantly correlated with the urine albumin level (r=-0.457, -0.412, -0.424, respectively, P all < 0.01). 3) In all 51 cases, there were 5 cases whose GFR were normal while split GFR were abnormal. Conclusions: 1) GFR and split GFR measurement can detect the incipient damage of glomerular function more sensitively than urine albumin analysis and show the degree of the damage correctly. 2) Split GFR measurement can improve the evaluation of the glomerular function in type 2 diabetes patients

Radioisotope studies in the diagnosis of acute complications in the post-transplantation stage

International Nuclear Information System (INIS)

Lopatkin, N.A.; Gleizer, J.J.; Jarmolinskij, J.S.; Darenkov, A.F.

1980-01-01

Dynamic scintigraphy with computer renography ( 131 I-hippuran, 125 I-hippuran, sup(99m)Tc-DTPA), indirect angiography (sup(99m)Tc-albumin), static scintigraphy ( 197 Hg-promeran, sup(99m)Tc-citrate, sup(99m)Tc-calcium-gluconate, sup(99m)Tc-sulphuric colloid) and RIA determination of plasma renin activity were carried out in 105 patients with complications after renal transplantation. In the diagnosis of the specific complications the most valuable methods were the following: indirect angiography in the diagnosis of renal arterial thrombosis; dynamic scintigraphy in the case of ureteral occlusion; static scintigraphy ( 197 Hg-promeran) in infarction, carbuncle or abscess of the transplantatum. The methods applied provided ''good'' information in the following cases: indirect angiography in venous thrombosis and acute tubular necrosis; dynamic scintigraphy in venous and arterial thrombosis, ureteral occlusion, and acute renal failure; static scintigraphy with sup(99m)Tc-citrate in infarction and abscessus, with sup(99m)Tc-calcium-gluconate in ureteral occlusion, with sup(99m)Tc-sulphuric colloid in acute tubular necrosis; RIA determination of plasma renin activity in acute tubular necrosis. In the different pathological conditions the examinations not mentioned above gave poor or negative results. (L.E.)

Development of a relational database to capture and merge clinical history with the quantitative results of radionuclide renography.

Science.gov (United States)

Folks, Russell D; Savir-Baruch, Bital; Garcia, Ernest V; Verdes, Liudmila; Taylor, Andrew T

2012-12-01

Our objective was to design and implement a clinical history database capable of linking to our database of quantitative results from (99m)Tc-mercaptoacetyltriglycine (MAG3) renal scans and export a data summary for physicians or our software decision support system. For database development, we used a commercial program. Additional software was developed in Interactive Data Language. MAG3 studies were processed using an in-house enhancement of a commercial program. The relational database has 3 parts: a list of all renal scans (the RENAL database), a set of patients with quantitative processing results (the Q2 database), and a subset of patients from Q2 containing clinical data manually transcribed from the hospital information system (the CLINICAL database). To test interobserver variability, a second physician transcriber reviewed 50 randomly selected patients in the hospital information system and tabulated 2 clinical data items: hydronephrosis and presence of a current stent. The CLINICAL database was developed in stages and contains 342 fields comprising demographic information, clinical history, and findings from up to 11 radiologic procedures. A scripted algorithm is used to reliably match records present in both Q2 and CLINICAL. An Interactive Data Language program then combines data from the 2 databases into an XML (extensible markup language) file for use by the decision support system. A text file is constructed and saved for review by physicians. RENAL contains 2,222 records, Q2 contains 456 records, and CLINICAL contains 152 records. The interobserver variability testing found a 95% match between the 2 observers for presence or absence of ureteral stent (κ = 0.52), a 75% match for hydronephrosis based on narrative summaries of hospitalizations and clinical visits (κ = 0.41), and a 92% match for hydronephrosis based on the imaging report (κ = 0.84). We have developed a relational database system to integrate the quantitative results of MAG3 image processing with clinical records obtained from the hospital information system. We also have developed a methodology for formatting clinical history for review by physicians and export to a decision support system. We identified several pitfalls, including the fact that important textual information extracted from the hospital information system by knowledgeable transcribers can show substantial interobserver variation, particularly when record retrieval is based on the narrative clinical records.

The value of Tc-99m DTPA diuretic renography for assessment of dilated upper urinary tract in children

International Nuclear Information System (INIS)

Yang, Ki Ra; Lim, Gye Yeon; Sohn, Hyung Sun; Hahn, Seong Tae; Lee, Jae Mun

1999-01-01

The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children with dilated upper urinary tract. We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. Six patients required pyeloplasty and eight were managed conservatively. All 6 patients requiring pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonfunctioning pattern in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth, nonobstructive patterns of initial scan were converted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. Tc-99m DTPA diuretic renal scan with standardized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan results in the neonatal period requires follow-up scan to monitor development of the obstructive pattern

Surgical treatment reduces blood pressure in children with unilateral congenital hydronephrosis.

Science.gov (United States)

Al-Mashhadi, Ammar; Nevéus, Tryggve; Stenberg, Arne; Karanikas, Birgitta; Persson, A Erik G; Carlström, Mattias; Wåhlin, Nils

2015-04-01

Renal disorders can cause hypertension, but less is known about the influence of hydronephrosis on blood pressure. Hydronephrosis due to pelvo-ureteric junction obstruction (PUJO) is a fairly common condition (incidence in newborns of 0.5-1%). Although hypertensive effects of hydronephrosis have been suggested, this has not been substantiated by prospective studies in humans [1-3]. Experimental studies with PUJO have shown that animals with induced hydronephrosis develop salt-sensitive hypertension, which strongly correlate to the degree of obstruction [4-7]. Moreover, relief of the obstruction normalized blood pressure [8]. In this first prospective study our aim was to study the blood pressure pattern in pediatric patients with hydronephrosis before and after surgical correction of the ureteral obstruction. Specifically, we investigated if preoperative blood pressure is reduced after surgery and if split renal function and renographic excretion curves provide any prognostic information. Twelve patients with unilateral congenital hydronephrosis were included in this prospective study. Ambulatory blood pressure (24 h) was measured preoperatively and six months after surgery. Preoperative evaluations of bilateral renal function by Tc99m-MAG3 scintigraphy, and renography curves, classified according to O'Reilly, were also performed. As shown in the summary figure, postoperative systolic (103 ± 2 mmHg) and diastolic (62 ± 2 mmHg) blood pressure were significantly lower than those obtained preoperatively (110 ± 4 and 69 ± 2 mmHg, respectively), whereas no changes in circadian variation or pulse pressure were observed. Renal functional share of the hydronephrotic kidney ranged from 11 to 55%. There was no correlation between the degree of renal function impairment and the preoperative excretory pattern, or between the preoperative excretory pattern and the blood pressure reduction postoperatively. However, preoperative MAG3 function of the affected kidney correlated

Radioindication of hemodynamics and functional state of parenchyma of the kidneys in stenosis of renal arteries

International Nuclear Information System (INIS)

Efimov, O.N.; Gabuniya, R.I.; Kamynin, Yu.F.; Matveenko, E.G.; Buyuklyan, A.N.; Skoropad, L.S.; Syzgantseva, L.M.

1978-01-01

Hemodynamics and functional state of parenchyma of the kidney were studied in 39 patients with stenosis of the renal arteries by means of pertechnetate 99 Tc, hippuran 131 I and chlormerodrine 197 Hg. In patients with vasorenal hypertension the following changes in the stenosed kidney were revealed: a significant decrease in the renal blood flow, renal fraction, volume of maximal saturation, specific blood flow, systolic renal index; elevation of the intrarenal vascular resistance; and impairment of the functional state of the renal parenchyma. It was established that there was a direct dependence between the renal blood flow and the volume of maximal saturation and a reverse dependence between the renal blood flow and intrarenal vascular resistance. Hemodynamic changes in the stenosed kidney played an important role and led at first to a bias in renographic indices and then - to a decrease in accumulation of chlormerodrine 197 Hg in the kidneys. It was noted that changes in the functional state of the renal parenchyma tended to be dependent upon the level of the renal blood flow, and indices of the renal blood flow - upon the values of arterial pressure. From diagnostic point of view, methods of radioiangiography, as compared with renography and scintigraphy, were found to be the most informative

Chronic partial ureteral obstruction and the developing kidney

Energy Technology Data Exchange (ETDEWEB)

Chevalier, Robert L. [University of Virginia, Department of Pediatrics, Box 800386, Charlottesville, VA (United States)

2008-01-15

Although congenital urinary tract obstruction is a common disorder, its pathophysiology remains poorly understood and clinical practice is controversial. Animal models have been used to elucidate the mechanisms responsible for obstructive nephropathy, and the models reveal that renal growth and function are impaired in proportion to the severity and duration of obstruction. Ureteral obstruction in the neonatal rat or mouse leads to activation of the renin-angiotensin system, renal infiltration by macrophages, and tubular apoptosis. Nephrons are lost by glomerular sclerosis and the formation of atubular glomeruli, and progressive injury leads to tubular atrophy and interstitial fibrosis. Recovery following release of obstruction depends on the timing, severity, and duration of obstruction. Growth factors and cytokines are produced by the hydronephrotic kidney, including MCP-1 and TGF-{beta}1, which are excreted in urine and can serve as biomarkers of renal injury. Because MRI can be used to monitor renal morphology, blood flow, and filtration rate, its use might supplant current imaging modalities (ultrasonography and diuretic renography), which have significant drawbacks. Combined use of MRI and new urinary biomarkers should improve our understanding of human congenital obstructive nephropathy and should lead to new approaches to evaluation and management of this challenging group of patients. (orig.)

Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors

International Nuclear Information System (INIS)

Knox, Matthew K.; Rivers-Bowerman, Michael D.; Bardgett, Harry P.; Cowan, Nigel C.

2010-01-01

To evaluate multidetector computed tomography (MDCT) with a triple-bolus contrast administration protocol for preoperative anatomical and functional assessment of living renal donors. Fifty-five potential living renal donors underwent MDCT of which 27 proceeded to donor nephrectomy. A triple-bolus contrast administration protocol was used for simultaneous acquisition of arterial, nephrographic, and excretory phases. MDCT images were independently reviewed in random order by two radiologists blinded to surgical anatomy findings. Diagnostic accuracy for anatomical variants was quantified by sensitivity and specificity. Differential renal function (DRF) was derived from MDCT for 54 patients and compared with technetium-99 m dimercaptosuccinic acid renography (Tc-99 m DMSA). All triple-bolus MDCT examinations were technically adequate. Accessory renal arteries and veins were identified at surgery in 33% (n = 9/27) and 22% (n = 6/27) of donor kidneys. The mean difference between MDCT-derived DRF and DMSA was 0.8% (95% CI 0.1-1.6) with 95% limits of agreement of -4.6% (95% CI -3.3 to -5.9) to 6.3% (95% CI 5.0-7.6). MDCT delivered a mean (SD, range) radiation dose of 9.5 (3.6, 3.6-17.3) mSv. MDCT with a triple-bolus contrast administration provides accurate anatomical and functional evaluation of living renal donors. (orig.)

Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors

Energy Technology Data Exchange (ETDEWEB)

Knox, Matthew K. [University of Calgary, Faculty of Medicine, UME Office, Health Sciences Centre, Calgary, Alberta (Canada); Rivers-Bowerman, Michael D. [University of British Columbia, Faculty of Medicine, MD Undergraduate Program, Diamond Health Care Centre, Vancouver, British Columbia (Canada); Bardgett, Harry P. [Bradford Teaching Hospitals, Department of Radiology, Bradford (United Kingdom); Cowan, Nigel C. [The Churchill Hospital, Department of Radiology, Oxford (United Kingdom)

2010-11-15

To evaluate multidetector computed tomography (MDCT) with a triple-bolus contrast administration protocol for preoperative anatomical and functional assessment of living renal donors. Fifty-five potential living renal donors underwent MDCT of which 27 proceeded to donor nephrectomy. A triple-bolus contrast administration protocol was used for simultaneous acquisition of arterial, nephrographic, and excretory phases. MDCT images were independently reviewed in random order by two radiologists blinded to surgical anatomy findings. Diagnostic accuracy for anatomical variants was quantified by sensitivity and specificity. Differential renal function (DRF) was derived from MDCT for 54 patients and compared with technetium-99 m dimercaptosuccinic acid renography (Tc-99 m DMSA). All triple-bolus MDCT examinations were technically adequate. Accessory renal arteries and veins were identified at surgery in 33% (n = 9/27) and 22% (n = 6/27) of donor kidneys. The mean difference between MDCT-derived DRF and DMSA was 0.8% (95% CI 0.1-1.6) with 95% limits of agreement of -4.6% (95% CI -3.3 to -5.9) to 6.3% (95% CI 5.0-7.6). MDCT delivered a mean (SD, range) radiation dose of 9.5 (3.6, 3.6-17.3) mSv. MDCT with a triple-bolus contrast administration provides accurate anatomical and functional evaluation of living renal donors. (orig.)

Revised guidelines on management of antenatal hydronephrosis

Science.gov (United States)

Sinha, A.; Bagga, A.; Krishna, A; Bajpai, M.; Srinivas, M.; Uppal, R.; Agarwal, I.

2013-01-01

Widespread antenatal screening has resulted in increased detection of anomalies of the kidneys and urinary tract. The present guidelines update the recommendations published in 2000. Antenatal hydronephrosis (ANH) is transient and resolves by the third trimester in almost one-half cases. The presence of oligohydramnios and additional renal or extrarenal anomalies suggests significant pathology. All patients with ANH should undergo postnatal ultrasonography; the intensity of subsequent evaluation depends on anteroposterior diameter (APD) of the renal pelvis and/or Society for Fetal Urology (SFU) grading. Patients with postnatal APD exceeding 10 mm and/or SFU grade 3-4 should be screened for upper or lower urinary tract obstruction and vesicoureteric reflux (VUR). Infants with VUR should receive antibiotic prophylaxis through the first year of life, and their parents counseled regarding the risk of urinary tract infections. The management of patients with pelviureteric junction or vesicoureteric junction obstruction depends on clinical features and results of sequential ultrasonography and radionuclide renography. Surgery is considered in patients with increasing renal pelvic APD and/or an obstructed renogram with differential renal function <35-40% or its subsequent decline. Further studies are necessary to clarify the role of prenatal intervention, frequency of follow-up investigations and indications for surgery in these patients. PMID:23716913

Radioimmunologic analysis of the state of the renin-angiotensin-aldosterone system in arterial hypertension

International Nuclear Information System (INIS)

Slavnov, V.N.; Yakovlev, A.A.; Gandzha, T.I.; Yugrinov, O.G.

1986-01-01

For 110 patients having various forms of arterial hypertension (hypertension, aldersteronoma, phaeochromocytoma, corticosteroma) the parameters of the system renin-angiotensin-aldosterone (RAA) were measured. Basal values of aldosterone and renin activity in blood were determined as well as their concentration in blood taken from the vena cava inferior, renal and adrenal veins during selective renography. The 24-hours rhythm of the hormones in the blood, the reaction of the glomerular zone of the adrenal cortex and the juxtaglomerular renal system under acute lasix stress was evaluated. It was found, that the system RAA is disturbed in all patients with arterial hypertension. This is indicated by changes of aldosterone concentration, renin activity in peripheral blood and in the blood from the vena cava inferior, renal and adrenal veins, the 24-hour rhythm of their concentrations in serum and the reaction to acute lasix stress. The radioimmunoassays of quantitative parameters of the RAA system are decisive for the differential diagnostics of hypertension and suprarenomas connected with a hypertension syndrome. They facilitate a rational choice of the hypertension therapy and the daily distribution of the medicaments for patients with hypertension. The radioimmunoassays can be used for checking the efficiency of medicaments and surgery. (author)

Radioimmunologic analysis of the state of the renin-angiotensin-aldosterone-system in arterial hypertension

International Nuclear Information System (INIS)

Slavnov, V.N.; Yakovlev, A.A.; Gandzha, T.I.; Yugrinov, O.G.

1985-01-01

In 110 patients suffering from various forms of arterial hypertension (hypertension, aldosteronoma, phaeochromocytoma, corticosteroma) the parameters of the system renin-angiotensin-aldosterone were measured. Basal values of aldosterone, renin activity in blood as well as their concentration in blood taken from the vena cava inferior, renal and adrenal veins during selective renography were determined. The 24-hours rhythm of the hormones in the blood, the reaction of the glomerular zone of the adrenal cortex and the juxtaglomerular renal system under acute Lasix (furosemide) stress was evaluated. It was found, that the system renin-angiotensin-aldosterone is disturbed in all patients with arterial hypertension. This is indicated by changes of aldosterone concentration, renin activity in peripheral blood and in the blood from the vena cava inferior, renal and adrenal veins, the 24-hours rhythm of their concentrations in serum and the reaction to acute Lasix stress. The radioimmunoassays of quantitative parameters of the renin-angiotensin-aldosterone system are decisive for the differential diagnosis of hypertension and adrenal gland tumors connected with a hypertension syndrome. They facilitate a rational choice of the hypertension therapy and the daily distribution of the medicaments for patients with hypertension. The radioimmunoassays can be used for checking the efficiency of medicaments and surgery. (author)

IMRT limits nephrotoxicity after chemoradiotherapy for gastric cancer

International Nuclear Information System (INIS)

Trip, Anouk Kirsten; Nijkamp, Jasper; Tinteren, Harm van; Cats, Annemieke; Boot, Henk; Jansen, Edwin Petrus Marianus; Verheij, Marcel

2014-01-01

Objective: This observational study compares the effect of different radiotherapy techniques on late nephrotoxicity after postoperative chemoradiotherapy for gastric cancer. Patients and methods: Dosimetric parameters were compared between AP–PA, 3D-conformal and IMRT techniques. Renal function was measured by 99m Tc-MAG-3 renography, glomerular filtration rate (GFR) and the development of hypertension. Mixed effects models were used to compare renal function over time. Results: Eighty-seven patients treated between 2002 and 2010 were included, AP–PA (n = 31), 3D-conformal (n = 25) and IMRT (n = 31), all 45 Gy in 25 fractions. Concurrent chemotherapy: 5FU/leucovorin (n = 4), capecitabine (n = 37), and capecitabine/cisplatin (n = 46). Median follow-up time was 4.7 years (range 0.2–8). With IMRT, the mean dose to the left kidney was significantly lower. Left kidney function decreased progressively in the total study population, however with IMRT this occurred at a lower rate. A dose–effect relationship was present between mean dose to the left kidney and the left kidney function. GFR decreased only moderately in time, which was not different between techniques. Six patients developed hypertension, of whom none in the IMRT group. Conclusions: This study confirms progressive late nephrotoxicity in patients treated with postoperative chemoradiotherapy by different techniques for gastric cancer. Nephrotoxicity was less severe with IMRT and should be considered the preferred technique

IMRT limits nephrotoxicity after chemoradiotherapy for gastric cancer.

Science.gov (United States)

Trip, Anouk Kirsten; Nijkamp, Jasper; van Tinteren, Harm; Cats, Annemieke; Boot, Henk; Jansen, Edwin Petrus Marianus; Verheij, Marcel

2014-08-01

This observational study compares the effect of different radiotherapy techniques on late nephrotoxicity after postoperative chemoradiotherapy for gastric cancer. Dosimetric parameters were compared between AP-PA, 3D-conformal and IMRT techniques. Renal function was measured by (99m)Tc-MAG-3 renography, glomerular filtration rate (GFR) and the development of hypertension. Mixed effects models were used to compare renal function over time. Eighty-seven patients treated between 2002 and 2010 were included, AP-PA (n=31), 3D-conformal (n=25) and IMRT (n=31), all 45 Gy in 25 fractions. Concurrent chemotherapy: 5FU/leucovorin (n=4), capecitabine (n=37), and capecitabine/cisplatin (n=46). Median follow-up time was 4.7 years (range 0.2-8). With IMRT, the mean dose to the left kidney was significantly lower. Left kidney function decreased progressively in the total study population, however with IMRT this occurred at a lower rate. A dose-effect relationship was present between mean dose to the left kidney and the left kidney function. GFR decreased only moderately in time, which was not different between techniques. Six patients developed hypertension, of whom none in the IMRT group. This study confirms progressive late nephrotoxicity in patients treated with postoperative chemoradiotherapy by different techniques for gastric cancer. Nephrotoxicity was less severe with IMRT and should be considered the preferred technique. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

99mTc-MAG3: can it be a viable alternative to 99mTc-DTPA ?

International Nuclear Information System (INIS)

Bal, C.S.; Padhy, A.K.; Nair, R.; Gopinath, P.G.

1991-01-01

The purpose of this study was to assess the potentials of 99m Tc MAG 3 to replace universally used 99m Tc-DTPA as a routine renal agent. Five patients with different nephrological problems were first studied with 99m Tc MAG 3 and then reinvestigated with 99m Tc-DTPA two to seven days later. Renal MAG 3 gamma camera images were found to be almost identical with those of 99m Tc-DTPA images except high hepatic and splenic uptake of the former compound in four out of five patients (80%) irrespective of kidney function. MAG 3 and DTPA renograms showed identical differential renal uptake function (r=0.87) with slightly higher uptake in right kidneys. Time to reach the peak correlated well (r=0.91). Time to reach half maximum renal activity was also found to be almost identical (r=0.97) for MAG 3 and DTPA. It was felt that the age old 99m Tc-DTPA is as good a compound as 99m Tc MAG 3 with regard to imaging and assessment of renal uptake, drainage and differential renal functions. 99m Tc-DTPA is much cheaper, readily available in India and stable to suit the logistics in a busy nuclear medicine department for routine renography. (author). 10 refs., 2 figs., 3 tabs

Radioisotopes for diagnosis in urology

International Nuclear Information System (INIS)

Galvan, G.

1980-01-01

A lecture, held on the occasion of the meeting, organized by the Austrian Company for Urology and the Bavarian Union of Urologists. Kidney diagnosis with means of nuclear medicine technology, scintigraphy of skeleton and candula suprarenalis as well as radioimmunological hormone determination are characterized by a non-invasive, valuable extension of the convential nephrourological diagnosis under a relatively low rate of radioactive emission. In the field of kidney diagnosis the specification of the function of each kidney by means of renography, sequence-scintigraphy and clearance must be regarded as an important factor, especially for the measurement of the degree of kidney damages. Therefore, it is also of a great pre-operative value in context with the determination of the functional capacity of a kidney, the control of prae-, -intra - and postrenal diseases, urological emergencies and the period after kidney-transplantations. The Tc-perfusion can be used for the diagnosis of kidney arterio-stenosis. In the field of skeleton scintigraphy with Tc-marked phosphates a very sensitive method for the discovery of metastasis is available. It can be applied as a screeningstest to the determination of the stage and to the control of the progress concerning the prostata carcinoma. The candula suprarenalis scintigraphy guarantees the differentiation of hormon producing tumors of the adrenalin gland in context with the determination of ACTH, cortisol, aldosteron, estrogens and testosteron. (F.R.)

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

International Nuclear Information System (INIS)

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

1980-01-01

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

Impact of magnetic resonance urography and ultrasonography on diagnosis and management of hydronephrosis and megaureter in paediatric patients

Directory of Open Access Journals (Sweden)

Peer Wildbrett

2012-01-01

Full Text Available Background: (1 To evaluate the diagnostic value of magnetic resonance urography (MRU in comparison with ultrasonography (US to determine the extent of upper urinary tract dilation and (2 to evaluate the impact of MRU on therapy management. Materials and Methods: From January 2005 to December 2010, paediatric patients with hydronephrosis or megaureter who underwent MRU in addition to standard work-up imaging were included. Data were retrospectively collected and analysed in comparison with the data obtained from results by US. Results: Forty-five patients with upper urinary tract dilatation were included into the study. Twenty-six patients (58% had a hydronephrosis and 19 patients (42% presented with a megaureter. Diagnosis was established in all patients by multimodulary imaging work-up including micturating cysto-urethrography, MAG3 renography, US and MRU and could be confirmed in all patients who underwent surgery (n = 28. Hydronephrosis was detected in 26 of 26 patients by US (100% sensitivity and in 25 of 26 patients (96% by MRU (Not significant (n.s.. Megaureter was detected in 17 of 19 patients (sensitivity 89% by US and in 18 of 19 patients (sensitivity 95% by MRU (n.s.. In all 45 patients, MRU had no impact on surgical or conservative management of hydronephrosis or megaureter. Conclusion: In our experience, MRU was not superior to US in detecting hydronephrosis or megaureter and had no impact on the surgical or conservative management of upper urinary tract dilation.

Primary non-refluxive megaureter in children: single-center experience and follow-up of 212 patients.

Science.gov (United States)

Rubenwolf, P; Herrmann-Nuber, J; Schreckenberger, M; Stein, R; Beetz, R

2016-11-01

Primary non-refluxing megaureter (pMU) is a multifaceted and challenging congenital pathology of the urinary tract. We report our 23-year experience with this anomaly in terms of presentation, diagnostic work-up and management. We retrospectively reviewed the medical records of 212 children diagnosed with pMU between 1986 and 2009 at our institution. Mean follow-up was 45.17 (0-192) months. Of the total, 168 (79 %) children presented with upper urinary tract dilation on perinatal ultrasound screening. In 44 (21 %) patients, the diagnosis was made following diagnostic work-up of a urinary tract infection (UTI, 18 %) or flank pain (3 %). In total, 203 of 254 pMUs (79.9 %) were successfully treated conservatively during the 23-year observation period. Forty-eight children (23 %) underwent ureteric reimplantation. UTIs occurred in 91 of 212 children (43 %). Of these, 41 (45 %) occurred despite antibacterial infection prophylaxis. Within the past three decades, there has been a marked shift from surgical toward conservative therapy at our institution. Neonatal renal ultrasound is the method of choice to timely identify children with pMU and, alongside dynamic renography, to monitor the clinical course. Nowadays, only a minor subset of children with asymptomatic course requires surgical correction. Antibacterial prophylaxis has the potential to reduce the risk of febrile UTIs. Prospective randomized studies are warranted to provide evidence of the beneficial effect of antibacterial prophylaxis.

Use of Self-Expanding Metallic Ureteral Stents in the Secondary Treatment of Ureteral Stenosis Following Kidney Transplantation.

Science.gov (United States)

Xu, Guibin; Li, Xun; He, Yongzhong; Zhao, Haibo; Yang, Weiqing; Xie, Qingling

2015-10-01

To evaluate the safety and efficacy of self-expanding metal stents in the treatment of ureteral stenosis following kidney transplantation. Seven patients who developed benign stenosis after kidney transplantation were treated by a self-expanding metallic stent implantation from June 2007 to March 2014. All patients had undergone at least one open surgical procedure and one endourologic procedure for treatment of the stenosis. The extent of stenosis varied from 1.2 to 3.7 cm. Ultrasonography, urography, diuretic renography, and urine culture were performed every 3 months after stent insertion. Ureteroscopic examination was performed when needed. Stent placement was technically effective in all cases. The mean operative time was 37 minutes (range, 26-59 minutes). Lower urinary-tract symptoms and the ipsilateral flank pain were common early-stage complications and were greatly relieved after an average of 3 months. The mean follow-up duration was 38 months (range, 13-86 months), and no stent migration or fragmentation was observed. Urothelial hyperplasia occurred in only one patient and was effectively managed with a Double-J stent. Five patients had normal stable renal function; the remaining two had impaired renal function, including one patient with a preoperative renal failure who required dialysis at the end of the follow-up period (36 months). As an alternative to open surgery, implantation of a self-expanding metal stent is a safe and effective treatment for ureteral stenosis in patients who have undergone kidney transplantation.

Inter-observer reproducibility in reporting on renal drainage in children with hydronephrosis: a large collaborative study

International Nuclear Information System (INIS)

Tondeur, Marianne; Piepsz, Amy; De Palma, Diego; Roca, Isabel; Ham, Hamphrey

2008-01-01

The goal of this study was to evaluate the inter-observer reproducibility in reporting on renal drainage obtained during 99m Tc MAG3 renography in children, when already processed data are offered to the observers. Because web site facilities were used for communication, 57 observers from five continents participated in the study. Twenty-three renograms, including furosemide stimulation and posterect postmicturition views, covering various patterns of drainage, were submitted to the observers. Images, curves and quantitative parameters were provided. Good or almost good drainage, partial drainage and poor or no drainage were the three possible responses for each kidney. An important bias was observed among the observers, some of them more systematically reporting the drainage as being good, while others had a general tendency to consider the drainage as poor. This resulted in rather poor inter-observer reproducibility, as for more than half of the kidneys, less than 80% of the observers agreed on one of the three responses. Analysis of the individual cases identified some obvious causes of discrepancy: the absence of a clear limit between partial and good or almost good drainage, the fact of including or neglecting the effect of micturition and change of patient's position, the underestimation of drainage in the case of a flat renographic curve, and the difficulties of interpretation in the case of a small, not well functioning kidney. There is an urgent need for better standardisation in estimating the quality of drainage. (orig.)

Normal differential renal function does not indicate a normal kidney after partial ureteropelvic obstruction and subsequent relief in 2-week-old piglets

Energy Technology Data Exchange (ETDEWEB)

Dissing, Thomas H.; Mikkelsen, Mette Marie; Pedersen, Michael; Froekiaer, Joergen; Djurhuus, Jens Christian [University of Aarhus, Institute of Clinical Medicine, Aarhus (Denmark); Eskild-Jensen, Anni [Aarhus University Hospital, Department of Nuclear Medicine, Aarhus Sygehus, Aarhus (Denmark); Gordon, Isky [University College London, Institute of Child Health, London (United Kingdom); University College London, Radiology and Physics Unit, Institute of Child Health, London (United Kingdom)

2008-09-15

We investigated the functional consequences of relieving ureteric obstruction in young pigs with experimental hydronephrosis (HN) induced by partial unilateral ureteropelvic obstruction. Three groups of animals were followed from the age of 2 weeks to the age of 14 weeks: Eight animals had severe or grades 3-4 HN throughout the study. Six animals had relief of the obstruction after 4 weeks. Six animals received sham operations at both ages. Morphological and functional examinations were performed at age 6 weeks and again at age 14 weeks and consisted of magnetic resonance imaging (MRI), technetium-diethylenetriaminepentaaceticacid ({sup 99m}Tc-DTPA) renography, renal technetium-dimercaptosuccinicacid ({sup 99m}Tc-DMSA) scintigraphy, and glomerular filtration rate (GFR) measurement. After relief of the partial obstruction, there was reduction of the pelvic diameter and improvement of urinary drainage. Global and relative kidney function was not significantly affected by either obstruction or its relief. Renal {sup 99m}Tc-DMSA scintigraphy showed a change in both the appearance of the kidney and a change in the distribution within kidneys even after relief of obstruction. This study shows that partial ureteric obstruction in young pigs may be associated with little effect on global and differential kidney function. However, even after relief of HN, the distribution of {sup 99m}Tc-DMSA in the kidney remains abnormal suggesting that a normal differential renal function may not represent a normal kidney. (orig.)

Inter-observer reproducibility in reporting on renal drainage in children with hydronephrosis: a large collaborative study

Energy Technology Data Exchange (ETDEWEB)

Tondeur, Marianne; Piepsz, Amy [CHU Saint-Pierre, Departement des Radio-Isotopes, Brussels (Belgium); De Palma, Diego [Ospedale di Circolo, Nuclear Medicine, Varese (Italy); Roca, Isabel [Vall d' Hebron Hospital, Nuclear Medicine, Barcelona (Spain); Ham, Hamphrey [University Hospital, Department Nuclear Medicine, Ghent (Belgium)

2008-03-15

The goal of this study was to evaluate the inter-observer reproducibility in reporting on renal drainage obtained during {sup 99m}Tc MAG3 renography in children, when already processed data are offered to the observers. Because web site facilities were used for communication, 57 observers from five continents participated in the study. Twenty-three renograms, including furosemide stimulation and posterect postmicturition views, covering various patterns of drainage, were submitted to the observers. Images, curves and quantitative parameters were provided. Good or almost good drainage, partial drainage and poor or no drainage were the three possible responses for each kidney. An important bias was observed among the observers, some of them more systematically reporting the drainage as being good, while others had a general tendency to consider the drainage as poor. This resulted in rather poor inter-observer reproducibility, as for more than half of the kidneys, less than 80% of the observers agreed on one of the three responses. Analysis of the individual cases identified some obvious causes of discrepancy: the absence of a clear limit between partial and good or almost good drainage, the fact of including or neglecting the effect of micturition and change of patient's position, the underestimation of drainage in the case of a flat renographic curve, and the difficulties of interpretation in the case of a small, not well functioning kidney. There is an urgent need for better standardisation in estimating the quality of drainage. (orig.)

Renal imaging in paediatrics

International Nuclear Information System (INIS)

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

2003-01-01

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

Diagnostic interventions in nuclear medicine

International Nuclear Information System (INIS)

Thrall, J.H.; Swanson, D.P.

1989-01-01

Diagnostic interventions in nuclear medicine may be defined as the coadministration of a nonradioactive drug or application of a physical stimulus or physiologic maneuver to enhance the diagnostic utility of a nuclear medicine test. The rationale for each interventional maneuver follows from the physiology or metabolism of the particular organ or organ system under evaluation. Diagnostic inference is drawn from the pattern of change in the biodistribution of the tracer in response to the intervention-induced change in metabolism or function. In current practice, the most commonly performed interventional maneuvers are aimed at studies of the heart, genitourinary system, hepatobiliary system, and gastrointestinal tract. The single most commonly performed interventional study in the United States is the stress Thallium-201 myocardial perfusion scan aimed at the diagnosis of coronary artery disease. The stress portion of the study is accomplished with dynamic leg exercise on a treadmill and is aimed at increasing myocardial oxygen demands. Areas of myocardium distal to hemodynamically significant lesions in the coronary arteries become ischemic at peak stress due to the inability of the stenotic vessel to respond to the oxygen demand/blood flow needs of the myocardium. Ischemic areas are readily recognized as photopenic defects on scans obtained immediately after exercise, with normalization upon delayed imaging. Diuresis renography is aimed at the differential diagnosis of hydroureteronephrosis. By challenging the urinary tract collecting structures with an augmented urine flow, dilated, unobstructed systems can be differentiated from systems with significant mechanical obstruction. 137 references

Nuclear nephro-urology in the paediatric patient

International Nuclear Information System (INIS)

Gordon, I.

2004-01-01

Full text: Static renal scan using Tc 99m DMSA, is indicated either to detect a focal parenchymal defect or to hunt for the missing kidney. The commonest specific indication includes the squeal of a urinary tract infection (UTI) either in the acute phase or in the late phase to detect a renal scar. Renal defects in the acute phase are not scars since the defect may regress spontaneously. Animal experiments have shown a very high sensitivity of DMSA in the detection of renal defects. When hunting for the missing kidney, anterior views including the pelvis are essential. Processing of the data must include viewing the images with a low window. High quality images are essential and these can only be obtained by ensuring minimal movement of the child, a high resolution collimator and the chid lying as close as possible to the camera if not on top of the collimator. (See guidelines on DMSA at www.eanm.org). Dynamic renography using either Tc 99m MAG3 or DTPA is Indicated in the presence of dilatation of the collecting systems, to establish differential renal function (DRF), following renal transplantation and in the follow-up of older children with vesico-ureteric reflux (VUR) or bladder dysfunction. In the presence of hydronephrosis data acquisition should include the use of a diuretic as well as acquiring dynamic images following a change in posture and micturition. Processing of the renogram should include estimation of DRF during the period 50 - 130 seconds from background subtracted renal curves. The response to the diuretic challenge must take into account the function of the kidney as well as the effect of the change in posture and micturition. Interpretation of impaired drainage in prenatally diagnosed unilateral renal pelvic dilatation must be interpreted with caution as poor drainage does not imply obstruction in this group of young children. (See guidelines for diuretic renography in children on www.eanm.org). In children with bladder dysfunction, recurrent

International urinary tract imaging basic spinal cord injury data set.

Science.gov (United States)

Biering-Sørensen, F; Craggs, M; Kennelly, M; Schick, E; Wyndaele, J-J

2009-05-01

To create an International Urinary Tract Imaging Basic Spinal Cord Injury (SCI) Data Set within the framework of the International SCI Data Sets. An international working group. The draft of the Data Set was developed by a working group comprising members appointed by the Neurourology Committee of the International Continence Society, the European Association of Urology, the American Spinal Injury Association (ASIA), the International Spinal Cord Society (ISCoS) and a representative of the Executive Committee of the International SCI Standards and Data Sets. The final version of the Data Set was developed after review and comments by members of the Executive Committee of the International SCI Standards and Data Sets, the ISCoS Scientific Committee, ASIA Board, relevant and interested international organizations and societies (around 40), individual persons with specific expertise and the ISCoS Council. Endorsement of the Data Sets by relevant organizations and societies will be obtained. To make the Data Set uniform, each variable and each response category within each variable have been specifically defined in a way that is designed to promote the collection and reporting of comparable minimal data. The variables included in the International Urinary Tract Imaging Basic SCI Data Set are the results obtained using the following investigations: intravenous pyelography or computer tomography urogram or ultrasound, X-ray, renography, clearance, cystogram, voiding cystogram or micturition cystourogram or videourodynamics. The complete instructions for data collection and the data sheet itself are freely available on the websites of both ISCoS (http://www.iscos.org.uk) and ASIA (http://www.asia-spinalinjury.org).

Estimation of technetium 99m mercaptoacetyltriglycine plasma clearance by use of one single plasma sample

International Nuclear Information System (INIS)

Mueller-Suur, R.; Magnusson, G.; Karolinska Inst., Stockholm; Bois-Svensson, I.; Jansson, B.

1991-01-01

Recent studies have shown that technetium 99m mercaptoacetyltriglycine (MAG-3) is a suitable replacement for iodine 131 or 123 hippurate in gamma-camera renography. Also, the determination of its clearance is of value, since it correlates well with that of hippurate and thus may be an indirect measure of renal plasma flow. In order to simplify the clearance method we developed formulas for the estimation of plasma clearance of MAG-3 based on a single plasma sample and compared them with the multiple sample method based on 7 plasma samples. The correlation to effective renal plasma flow (ERPF) (according to Tauxe's method, using iodine 123 hippurate), which ranged from 75 to 654 ml/min per 1.73 m 2 , was determined in these patients. Using the developed regression equations the error of estimate for the simplified clearance method was acceptably low (18-14 ml/min), when the single plasma sample was taken 44-64 min post-injection. Formulas for different sampling times at 44, 48, 52, 56, 60 and 64 min are given, and we recommend 60 min as optimal, with an error of estimate of 15.5 ml/min. The correlation between the MAG-3 clearances and ERPF was high (r=0.90). Since normal values for MAG-3 clearance are not yet available, transformation to estimated ERPF values by the regression equation (ERPF=1.86xC MAG-3 +4.6) could be of clinical value in order to compare it with the normal values for ERPF given in the literature. (orig.)

Dynamic study of ammonia metabolism after rectal administration of /sup 13/N-ammonia

Energy Technology Data Exchange (ETDEWEB)

Koen, H; Arimizu, N; Musha, H; Okuda, K; Tateno, Y [Chiba Univ. (Japan). School of Medicine

1980-01-01

/sup 13/N-ammonia produced by cyclotron, short lived positron emitter (Tl/2 10 min) was instilled intrarectally in a dose of 15 - 30 mCi with liver disease, in order to study the dynamic metabolism of rectally absorbed /sup 13/N-ammonia. A NIRS positron camera connected with an on-line computer system was used for imaging of the liver and heart. /sup 13/N-activity over the head was recorded by detectors used in renography. Sequential changes of /sup 13/N-activity in blood was measured, and chromatographic analysis of /sup 13/N-labeled substances in blood was performed using Dowex 50 W x 8. In the control, /sup 13/N-ammonia was absorbed quickly into blood visualizing the liver shortly after administration, and hepatic uptake of /sup 13/N-ammonia reached a plateau in 10 - 15 min, whereas in patients with cirrhosis, the lung and heart were visualized in 5 min when the liver image was still faint. /sup 13/N-activity over the head was apparently higher in the cirrhotic group compared with the control. It was suggested that a large proportion of injected /sup 13/N-ammonia bypassed liver cells and reached peripheral tissues. We determined the heart/liver activity ratio and this ratio at 15 min was found to be closely correlated with various indices of portal hypertension. The percentages of /sup 13/N-metabolite in blood at 5 min and 15 min were lower in the cirrhotic, suggesting reduced capacity of the liver to remove /sup 13/N-ammonia in cirrhosis.

Renal Artery Embolization - A First Line Treatment Option For End-Stage Hydronephrosis

International Nuclear Information System (INIS)

Mitra, Kakali; Prabhudesai, Vikramaditya; James, R. Lester; Jones, Robert W. A.; French, Michael E.; Cowling, Mark; West, David J.

2004-01-01

Conventionally poorly functioning hydronephrotic kidneys have been removed if they are symptomatic. In our unit, patients are offered renal artery embolization as an alternative treatment option. Patients and Methods: Fifteen patients (11 male, 4 female) with a mean age of 32.9 yr (20-51 yrs) have undergone renal artery embolization for symptomatic hydronephrosis with poor function. Mean follow-up was 64.13 weeks (range 14-200). All patients had loin pain and hydronephrosis. Twelve patients had primary pelvi-ureteric junction obstruction (PUJO). Two patients had poorly functioning hydronephrotic kidneys secondary to chronic calculous obstruction. One patient had chronic pain in an obstructed but reasonably functioning kidney following a previous pyeloplasty for PUJO which demanded intervention. Mean split function on renography was 11% (range 0-46%). Selective renal artery embolization was carried out under antibiotic cover using a 7 Fr balloon occlusion catheter and absolute alcohol, steel coils, and polyvinyl alcohol particles.Results: Nine patients developed post-embolization syndrome of self-limiting pain and pyrexia with no evidence of sepsis. One patient required readmission with this condition. One patient developed a hematoma at the puncture site. Mean hospital stay was 2.3 days. Fourteen patients are happy with the result and are completely pain free. One patient has minor discomfort but is delighted with the result. Nine patients have had follow-up ultrasound confirming resolution of the hydronephrosis. Conclusion: Renal artery embolization is an effective, safe, well-tolerated minimally invasive treatment option in end-stage hydronephrosis and we routinely offer it as an alternative to nephrectomy

Diagnostic accuracy of neonatal kidney ultrasound in children having antenatal hydronephrosis without ureter and bladder abnormalities.

Science.gov (United States)

Rianthavorn, Pornpimol; Limwattana, Sorawan

2015-10-01

To determine the diagnostic accuracy of anteroposterior renal pelvic diameter (APD) measurement and the society for fetal urology (SFU) grading in neonatal ultrasonography (USG) for detecting uropathy in newborns having antenatal isolated hydronephrosis (IH), characterized by hydronephrosis without ureter and bladder abnormalities, and to study time to resolution and factors predicting resolution of insignificant hydronephrosis. Ninety-six healthy newborns (129 kidneys) with IH, who underwent USG at age 7-30 days and voiding cystourethrography (VCUG) in conjunction with diuretic renography (DR) if APD > 10 mm or SFU grade 3-4 in neonatal USG, and at least a 12-month follow-up were divided into significant and insignificant hydronephrosis using the combined data of sequential USG, VCUG, and DR as the reference standard. Areas under the receiver operating characteristic plots (95 % CI) were 0.86 (0.79-0.94) versus 0.81 (0.73-0.89); p = 0.08, and 87.6 versus 79.8 % of cases were correctly classified, for APD ≥ 16 mm versus SFU grade 4, respectively. Ureteropelvic junction obstruction (UPJO) was the most common uropathy diagnosed. Of 85 kidneys with insignificant hydronephrosis, 57 underwent spontaneous resolution. The resolution rates were 24, 40, and 68 % at age 6, 12, and 24 months, respectively. APD was the only independent factor predicting resolution with the hazard ratio of 0.83 (95 % CI 0.74-0.92; p = 0.001). In IH, neonatal USG was a useful diagnostic tool to detect uropathy, mainly UPJO. Further investigation should be recommended when APD ≥ 16 mm or SFU grade 4.

Congenital anomalies of the urinary tract.

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Pohl, Hans G; Belman, A Barry

2014-01-01

The upper urinary tract forms as a consequence of the reciprocal inductive signals between the metanephric mesenchyme and ureteric bud. A clue to the timing of events leading to an abnormality of the upper urinary tract can be the presence also of associated anomalies of internal genitalia since separation of these systems occurs at about the 10th week of gestation. Prenatal sonography has facilitated the detection of urological abnormalities presenting with hydronephrosis. Hydronephrosis suggests obstruction, but by itself cannot be equated with it. Instead, further radiographic imaging is required to delineate anatomy and function. Now, moreover, non-surgical management of CAKUT should be considered whenever possible. Despite the widespread use of prenatal screening sonography that usually identifies the majority of congenital anomalies of the urinary tract, many children still present with febrile urinary tract infection (UTI). Regardless of the etiology for the presentation, the goal of management is preservation of renal function through mitigation of the risk for recurrent UTI and/or obstruction. In the past many children underwent surgical repair aimed at normalization of the appearance of the urinary tract. Today, management has evolved such that in most cases surgical reconstruction is performed only after a period of observation - with or without urinary prophylaxis. The opinions presented in this section are not espoused by all pediatric urologists but represent instead the practice that has evolved at Children's National Medical Center (Washington DC) based significantly on information obtained by nuclear renography, in addition to sonography and contrast cystography.

Clinical Application of Renograph IR-03 for the Hospital

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R. Isaris

2012-08-01

Full Text Available The renography using renograph is one of clinical modality to investigate the renal function among other such as laboratory medical check up and X-rays. The prototype of renograph IR-03 designed by BATAN has been constructed and the laboratory tests as well as clinical tests have been carried out at PRPN-BATAN Serpong and General Hospital Dr. Sardjito Jogyakarta, respectively. Cost associated with the clinical use of renograph at the hospital are analyzed according to the two major components: radiopharmaceutical cost and the use of equipment. Annual cost of operational of renograph by estimate number of patient is about 2,000 is IDR. 30.0 millions for radiopharmaceutical 131Iodine. Total Direct Cost is about IDR. 212.5 millions and the Capital Cost for one unit renograph is IDR. 250 millions. The Break Event Point of invest one unit renograph is 1194 procedures (0.597%, or about IDR. 209,475 millions, which the cost for each procedure is IDR. 85,000.-. This value is depending on several variables, especially number of procedure can be reached. The cash flow analyses by Rate of Return (ROR showed that the value of i* is 22.6% is much greater than the value of MARR or saving rate of interest in the Bank now is about < 10%. The Payback Period calculation to see on how interesting the investment of renograph and its prospect for application in the hospitals showed about 1.818 years, that is good prospect economically

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

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Ritchie, Gillian; Wilkinson, Alistair G. [Royal Hospital for Sick Children, Edinburgh (United Kingdom); Prescott, Robin J. [University of Edinburgh Medical School, Medical Statistics Unit, Public Health Sciences, Edinburgh (United Kingdom)

2008-08-15

In children who have undergone both {sup 99m}Tc-DMSA and {sup 99m}Tc-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 {sup 99m}Tc-DMSA and those calculated using {sup 99m}Tc-MAG3. We retrospectively identified children imaged with {sup 99m}Tc-DMSA and {sup 99m}Tc-MAG3. We recorded DRF values, age, indication, and renal pelvis diameter. For the {sup 99m}Tc-DMSA studies we recorded the imaging time after injection. For the {sup 99m}Tc-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 {sup 99m}Tc-DMSA and {sup 99m}Tc-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 {sup 99m}Tc-MAG3 imaging. If a {sup 99m}Tc-MAG3 study has been performed then a {sup 99m}Tc-DMSA study is unnecessary provided DRF is normal on the {sup 99m}Tc-MAG3 study and there is no scarring. A change in practice would lead to considerable savings in time, cost and radiation burden. (orig.)

Prospective study on late renal toxicity following postoperative chemoradiotherapy in gastric cancer

International Nuclear Information System (INIS)

Jansen, Edwin; Saunders, Mark P.; Boot, Henk; Oppedijk, Vera; Dubbelman, Ria; Porritt, Bridget; Cats, Annemieke; Stroom, Joep; Valdes Olmos, Renato; Bartelink, Harry; Verheij, Marcel

2007-01-01

Purpose: Postoperative chemoradiotherapy in gastric cancer improves locoregional control and survival. Reports on late toxicity, however, have been scarce thus far. Because renal toxicity is one of the most serious late complications in upper abdominal radiotherapy, we prospectively analyzed kidney function in patients who underwent postoperative chemoradiotherapy for gastric cancer. Patients and Methods: In 44 patients, Tc 99m -thiatide renography was performed before and at regular intervals after postoperative chemoradiotherapy. The left-to-right (L/R) ratio was used as an index of the relative kidney function. Mean L/R values were calculated for four follow-up time intervals. For all patients, kidney V 20 (percentage of the volume of the kidney that received more than 20 Gy) and mean dose of both kidneys were retrieved from the three-dimensional dose-volume histograms. Results: We observed a progressive decrease in left renal function of 11% (p = 0.012) after 6 months, up to 52% (p 18 months. The V 20 (left kidney) and mean left kidney dose were identified as parameters associated with decreased kidney function. Mean serum creatinine was increased from 74.6 μmol/L before treatment to 86.1 μmol/L at 1 year after chemoradiotherapy (p < 0.001). In patients with a follow-up of 18-28 months, one case of severe renovascular hypertension was observed. Conclusion: A progressive relative functional impairment of the left kidney in patients after postoperative chemoradiotherapy for gastric cancer is demonstrated. To optimize the survival benefit that can be established with adjuvant regimens, strategies to minimize the dose to the kidneys and other critical organs should be explored

Renovascular hypertension: ten years' experience in a regional centre.

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Sellars, L; Siamopoulos, K; Hacking, P M; Proud, G; Taylor, R M; Essenhigh, D M; Wilkinson, R

1985-07-01

In a unit serving a population of three million, 60 hypertensive patients with renovascular disease were identified over a 10-year period. The presence of renovascular disease was usually suggested by intravenous urography (IVU), although this was falsely negative in 21 per cent of cases; isotope renography (IR) was normal in a similar proportion of patients (25 per cent). Eight patients were treated medically and 52 underwent surgical procedures; nephrectomy in 32, autotransplantation in 10, by pass graft in six and percutaneous transluminal angioplasty in four. Twenty-three per cent of patients were cured, 37 per cent improved and 40 per cent unchanged one year after surgery, but the response could not be accurately predicted. Clinical features were of some value in that those patients most likely to benefit from surgery were younger, had less severe hypertension of shorter duration, smoked less, had less severe retinopathy and less cardiomegaly. There was also a trend for those with better renal function and less electrocardiographic evidence of left ventricular hypertrophy to benefit from surgery. The IVU and IR did not predict response to surgery but arteriographic appearances of fibromuscular dysplasia indicated there should be a favourable response. The renal vein renin ratio, basal or stimulated, was of no prognostic value since approximately two-thirds of patients with ratios above or below the threshold value had some benefit from surgery. We conclude that the surgical treatment of renovascular hypertension is worthwhile but the number of patients suitable for surgery is small. Clinical features and the results of simple investigations provided the best guide to surgical outcome in our patients.

Causes and outcome of prenatally diagnosed hydronephrosis

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Ahmadzadeh Ali

2009-01-01

Full Text Available Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with ultrasonography (U/S. Hydronephrosis may be obstructive or non-obstructive; obstructive lesions are more harmful to the developing kidneys. The aim of the study was to evaluate the causes of renal pelvic dilatation and the outcome of postnatal treatment in infants with hydronephrosis diagnosed prenatally with U/S. We prospectively studied 67 (60 males newborns with hydronephrosis diagnosed prenatally and confirmed postnatally with U/S from Sept. 2005 to Oct. 2007. The patients were allocated to three groups based on the mea-surement of the anteroposterior renal pelvic diameter (APRPD in transverse plane: mild (6-9.9 mm, moderate (10-14.9 mm and severe (> 15 mm hydronephrosis. Voiding cystourethrography (VCUG was obtained in all of the patients to rule out vesicoureteral reflux (VUR. In cases with negative VUR, Diethylenetriamine-pentaacetic acid (DTPA scan with diuretic renography was performed to detect ureteropelvic joint obstruction (UPJO. Twenty two cases (32.8% had mild, 20 (29.9% had moderate, and 25 (37.3% had severe hydronephrosis. The causes of hydroneph-rosis were VUR (40.2%, UPJO (32.8%, posterior urethral valves (PUVs (13.4 %, and transient hydronephrosis (13.4 %. The lesion was obstructive in 37 (55.2% infants. Totally, 33 (49.2% patients with hydronephrosis (9 mild, 9 moderate, and 15 severe subsequently developed com-plications such as UTI and renal insufficiency, or required surgery. Associated abnormalities were observed in 15 (22.4% patients. We conclude that every newborn with any degree of hydro-nephrosis should be assessed postnatally for specific diagnosis and treatment.

Causes and outcome of prenatally diagnosed hydronephrosis

International Nuclear Information System (INIS)

Ahmadzadeh, Ali; Tahmasebi, Morteza; Gharibvand, Mohammad Momen

2009-01-01

Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with ultrasonography (U/S). Hydronephrosis may be obstructive or nonobstructive; obstructive lesions are more harmful to the developing kidneys. The aim of the study was to evaluate the causes of renal pelvic dilatation and the outcome of postnatal treatment in infants with hydronephrosis diagnosed prenatally with U/S. We prospectively studied 67 (60 males) newborns with hydronephrosis diagnosed prenatally and confirmed postnatally with U/S from Sept. 2005 to Oct. 2007. The patients were allocated to three groups based on the mea-surement of the anteroposterior renal pelvic diameter (APRPD) in transverse plane: mild (6-9.9 mm), moderate (10-14.9 mm) and severe (> 15 mm) hydronephrosis. Voiding cystourethrography (VCUG) was obtained in all of the patients to rule out vesicoureteral reflux (VUR). In cases with negative VUR, Diethylenetriamine-pentaacetic acid (DTPA) scan with diuretic renography was performed to detect ureteropelvic joint obstruction (UPJO). Twenty two cases (32.8%) had mild, 20 (29.9%) had moderate, and 25 (37.3%) had severe hydronephrosis. The causes of hydronephrosis were VUR (40.2%), UPJO (32.8%), posterior urethral valves (PUVs) (13.4 %), and transient hydronephrosis (13.4 %). The lesion was obstructive in 37 (55.2%) infants. Totally, 33 (49.2%) patients with hydronephrosis (9 mild, 9 moderate, and 15 severe) subsequently developed complications such as UTI and renal insufficiency, or required surgery. Associated abnormalities were observed in 15 (22.4%) patients. We conclude that every newborn with any degree of hydronephrosis should be assessed postnatally for specific diagnosis and treatment. (author)

Nuclear Medicine Engineering

International Nuclear Information System (INIS)

Mateescu, Gheorghe; Craciunescu, Teddy

2000-01-01

'An image is more valuable than a thousand words' - this is the thought that underlies the authors' vision about the field of nuclear medicine. The monograph starts with a review of some theoretical and engineering notions that grounds the field of nuclear medicine: nuclear radiation, interaction of radiation with matter, radiation detection and measurement, numerical analysis. Products and methods needed for the implementation of diagnostic and research procedures in nuclear medicine are presented: radioisotopes and radiopharmaceuticals, equipment for in-vitro (radioimmunoassay, liquid scintillation counting) and in-vivo investigations (thyroid uptake, renography, dynamic studies, imaging). A special attention is focused on medical imaging theory and practice as a source of clinical information (morphological and functional). The large variety of parameters, components, biological structures and specific properties of live matter determines the practical use of three-dimensional tomographic techniques based on diverse physical principles: single-photon emission, positron emission, X-rays transmission, nuclear magnetic resonance, ultrasounds transmission and reflection, electrical impedance measurement. The fundamental reconstruction algorithms i.e., algorithms based on the projection theorem and Fourier filtering, algebraic reconstruction techniques and the algorithms based on statistical principles: maximum entropy, maximum likelihood, Monte Carlo algorithms, are depicted in details. A method based on the use of the measured point spread function is suggested. Some classical but often used techniques like linear scintigraphy and Anger gamma camera imaging are also presented together with some image enhancement techniques like Wiener filtering and blind deconvolution. The topic of the book is illustrated with some clinical samples obtained with nuclear medicine devices developed in the Nuclear Medicine Laboratory of the National Institute of Nuclear Physics and

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

International Nuclear Information System (INIS)

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

1990-01-01

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

A comparison of deconvolution and the Rutland-Patlak plot in parenchymal renal uptake rate.

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Al-Shakhrah, Issa A

2012-07-01

Deconvolution and the Rutland-Patlak (R-P) plot are two of the most commonly used methods for analyzing dynamic radionuclide renography. Both methods allow estimation of absolute and relative renal uptake of radiopharmaceutical and of its rate of transit through the kidney. Seventeen patients (32 kidneys) were referred for further evaluation by renal scanning. All patients were positioned supine with their backs to the scintillation gamma camera, so that the kidneys and the heart are both in the field of view. Approximately 5-7 mCi of (99m)Tc-DTPA (diethylinetriamine penta-acetic acid) in about 0.5 ml of saline is injected intravenously and sequential 20 s frames were acquired, the study on each patient lasts for approximately 20 min. The time-activity curves of the parenchymal region of interest of each kidney, as well as the heart were obtained for analysis. The data were then analyzed with deconvolution and the R-P plot. A strong positive association (n = 32; r = 0.83; R (2) = 0.68) was found between the values that obtained by applying the two methods. Bland-Altman statistical analysis demonstrated that ninety seven percent of the values in the study (31 cases from 32 cases, 97% of the cases) were within limits of agreement (mean ± 1.96 standard deviation). We believe that R-P analysis method is expected to be more reproducible than iterative deconvolution method, because the deconvolution technique (the iterative method) relies heavily on the accuracy of the first point analyzed, as any errors are carried forward into the calculations of all the subsequent points, whereas R-P technique is based on an initial analysis of the data by means of the R-P plot, and it can be considered as an alternative technique to find and calculate the renal uptake rate.

Estimation of kidney depth effective renal plasmatic flux and absorbed dose, from a radio isotopic renogram

International Nuclear Information System (INIS)

Carvalho Pinto Ribela, M.T. de.

1979-01-01

A technique for the estimation of kidney depth is described. It is based on a comparison between the measurements obtained in a radioisotopic renogram carried out for two specific energies and the same measurements made with a phanto-kidney at different depths. Experiments performed with kidney and abdomen phantoms provide calibration curves which are obtained by plotting the photopeak to scatter ratio for 131 I pulse height spectrum against depth. Through this technique it is possible to obtain the Hippuran- 131 I kidney uptake with external measurements only. In fact it introduces a correction in the measurements for the depth itself and for the attenuation and scattering effects due to the tissues interposed between the kidney and the detector. When the two kidneys are not equidistant from the detector, their respective renograms are different and it is therefore very important to introduce a correction to the measurements according to the organ depth in order to obtain the exact information on Hippuran partition between the kidneys. The significative influence of the extrarenal activity is analyzed in the renogram by monitoring the praecordial region after 131 I-human serum albumin injection and establishing a calibration factor relating the radioactivity level of this area to that present in each kidney area. It is shown that it is possible to obtain the values for the clearance of each kidney from the renogram once the alteration in efficiency due to the organ depth and to non-renal tissue interference in the renal area is considered. This way, values for the effective renal plasma flow were obtained, which are comparable to those obtained with other techniques, estimating the total flow of the kidneys. Finally the mean absorbed dose of the kidneys in a renography is also estimated. (Author) [pt

Development and prospective evaluation of an automated software system for quality control of quantitative 99mTc-MAG3 renal studies.

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Folks, Russell D; Garcia, Ernest V; Taylor, Andrew T

2007-03-01

Quantitative nuclear renography has numerous potential sources of error. We previously reported the initial development of a computer software module for comprehensively addressing the issue of quality control (QC) in the analysis of radionuclide renal images. The objective of this study was to prospectively test the QC software. The QC software works in conjunction with standard quantitative renal image analysis using a renal quantification program. The software saves a text file that summarizes QC findings as possible errors in user-entered values, calculated values that may be unreliable because of the patient's clinical condition, and problems relating to acquisition or processing. To test the QC software, a technologist not involved in software development processed 83 consecutive nontransplant clinical studies. The QC findings of the software were then tabulated. QC events were defined as technical (study descriptors that were out of range or were entered and then changed, unusually sized or positioned regions of interest, or missing frames in the dynamic image set) or clinical (calculated functional values judged to be erroneous or unreliable). Technical QC events were identified in 36 (43%) of 83 studies. Clinical QC events were identified in 37 (45%) of 83 studies. Specific QC events included starting the camera after the bolus had reached the kidney, dose infiltration, oversubtraction of background activity, and missing frames in the dynamic image set. QC software has been developed to automatically verify user input, monitor calculation of renal functional parameters, summarize QC findings, and flag potentially unreliable values for the nuclear medicine physician. Incorporation of automated QC features into commercial or local renal software can reduce errors and improve technologist performance and should improve the efficiency and accuracy of image interpretation.

Role of technetium 99-m DTPA scintigraphy in evaluation of patients undergoing extracorporeal shock wave lithotripsy

International Nuclear Information System (INIS)

Rasheed, A.

1993-01-01

Pre and post-treatment renography with Tc-99m DTPA was done in 33 patients undergoing Extracorporeal Shock Wave Lithotripsy (ESWL). The parameters studied included time to maximum, GFR and relative function of the treated kidney. Quantitative analysis revealed that in patients who developed obstructive uropathy after ESWL, time to maximum increased significantly in 26% patients at 24 hours, in 31% patients at 1 week and in 26% patients at 3 weeks, while GFR decreased by more 8% in 18% patients at 24 hours, in 35% patients at 1 week and in 47% patients at 3 weeks post ESWL. Patients having outflow obstruct at 24 hours and 1 week after ESWL had significantly decreased GFR at 24 hours when compared with patients who did not have outflow obstruction at these times. In patients who are obstructed before ESWL, time to maximum decreased significantly on the treated side after ESWL indicating immediate functional benefit. No significant change in relative renal function was noticed after ESWL 45% patients developed obstructive uropathy after ESWL, out of which 24% had total and rest had partial obstruction. 6% patients needed percutaneous nephrostomy to relieve obstruction while in the rest of 18% patients obstruction got relieved spontaneously. The incidence of developing outflow obstruction was seen to be directly proportional to the size of calculus. This study indicates that obstructive uropathy after ESWL can be conveniently detected and followed by sequential renal radionuclide studies. Furthermore, time to maximum was found to be a sensitive parameter for early detection of renal outflow obstruction that may occur after ESWL treatment. This study also underscores that obstructive uropathy and shock waves may have a composite effect on renal function after ESWL. (author)

Evaluation of renal function using 99mTc-MAG3

International Nuclear Information System (INIS)

Takayama, Teruhiko; Aburano, Tamio; Shuke, Noriyuki

1993-01-01

The utility of 99m Tc-mercaptoacetyltriglycine (MAG3) was studied clinically. In the renography obtained with 99m Tc-MAG3, the abdominal aorta and the common iliac arteries were clearly visualized in the vascular phase. Due to less background activity and high target to background ratio, the quality of 99m Tc-MAG3 image was superior to that of 123 I-OIH or 99m Tc-DTPA image. The parameters on the renogram including T max , T 2/3 , and T 1/2 were compared. The correlation of T max and T 2/3 or T 1/2 were not significant between 99m Tc-MAG3 and 123 I-OIH. Another parameter of C 20 /C max , where C 20 and C max are renal activities at 20 min after injection and at T max respectively, showed an excellent correlation between 99m Tc-MAG3 and 123 I-OIH. Using C 20 /C max , pattern of renogram can be characterized numerically. Concerning the relation between C 20 /C max and renogram pattern, standard renogram pattern showed the C 20 /C max value of less than 0.4, while hypofunctioning pattern showed more than 0.5. The correlation coefficient between the renal uptake of 99m Tc-MAG3 and 123 I-OIH was 0.880 with a correlation plot: 'Y=1.16X-0.043', where X and Y represent renal uptake of 99m Tc-MAG3 and 123 I-OIH, respectively. It can be concluded that 99m Tc-MAG3 is a useful renal imaging agent as an alternative to 123 I-OIH, in order to evaluate the proximal tubular function and calculate ERPF. (author)

Evaluation of obstructive uropathy by deconvolution analysis of {sup 99m}Tc-mercaptoacetyltriglycine ({sup 99m}Tc-MAG3) renal scintigraphic data. A comparison with diuresis renography

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Hada, Yoshiyuki [Mie Univ., Tsu (Japan). School of Medicine

1997-06-01

Clinical significance of ERPF (effective renal plasma flow) and MTT (mean transit time) calculated by deconvolution analysis was studied in patients with obstructive uropathy. Subjects were 84 kidneys of 38 patients and 4 people without renal abnormality (22 males and 20 females) whose age was 53.8 y in a mean. Scintigraphy was done with a Toshiba {gamma}-camera GCA-7200A equipped with a low energy-high resolution collimator with the energy width of 149 keV{+-}20% at 20 min after loading of 500 ml of water and rapidly after intravenous administration of {sup 99m}Tc-MAG3 (200 MBq). At 5 min later, blood was collected and at 10 min, furosemide was intravenously given. Plasma radioactivity was measured in a well-type scintillation counter and was used for correction of blood concentration-time curve obtained from heart area data. Split MTT, regional MTT and ERPF were calculated by deconvolution analysis. Impaired transit was judged from renogram after furosemide loading and was classified into 6 types. ERPF was found lowered in cases of obstruction and in low renal function. Regional MTT was prolonged only in the former cases. The examination with the deconvolution analysis was concluded to be widely used since it gave useful information for the treatment. (K.H.)

Ectopic ureterocele and ectopic ureter in pediatric patients

International Nuclear Information System (INIS)

Lloret, M. T.; Ricart, V.; Muro, M. D.; Perez, D.; Martinez, I.; Brugger, S.; Romero, M. J.; Cortina, H.

2000-01-01

To describe the radiological findings associated with ectopic ureterocele and ectopic ureter in pediatric patients. To assess the role of ultrasound (US), serial micturating cystourethrography (SM-CU) and intravenous urography (IVU) in the diagnosis of these two entities. The authors performed a retrospective study of 132 patients, 73 with ectopic ureterocele and 59 with ectopic ureter. The imaging studies used were US, SMCU, IVU and methods to determine renal function (diuretic renography and renal scintigraphy). The findings were confirmed during surgery in every case. The most common radiological findings in ectopic ureterocele were renal duplication (86,3%). vesicoureteral reflux (VUR) to the lower half of the kidney (46.6%), dilatation of the lower pole of the kidney (38.4%) and contralateral duplication (30.1%). In boys, the ectopic ureter entered via bladder neck and posterior urethra (73.7%) or into seminal vesicles (15.8%); in girls, it went to vagina (32.5%), bladder neck (30%) or urethra (22.5%). Renal duplication was associated in 64.4%, with VUR to the ectopic ureter in 21% while there was a single renal system in 35.6%, with VUR to the ectopic ureter in 57.1% and contralateral renal agenesis in 19%. Eighteen patients (13.6%) presented a single, dy plastic, nonfunctioning renal system (6 cases of ureterocele and 12 of ectopic ureter). Knowledge of the embryological development of ureteral duplication is essential for the understanding of these two entities and helps to differentiate between them, thus facilitating a sometimes complicated diagnosis. Ectopic ureters and ureteroceles accompanied by a single, dysplastic renal system are associated with a greater incidence of congenital anomalies and a higher rate of complications than the duplicate systems. A prenatal US examination enables early diagnosis. The anatomical information provided by US is, on occasion, more valuable than that resulting from IVU or SMCU, However, IVU is indispensable in girls

How to measure renal artery stenosis - a retrospective comparison of morphological measurement approaches in relation to hemodynamic significance

International Nuclear Information System (INIS)

Andersson, Malin; Jägervall, Karl; Eriksson, Per; Persson, Anders; Granerus, Göran; Wang, Chunliang; Smedby, Örjan

2015-01-01

Although it is well known that renal artery stenosis may cause renovascular hypertension, it is unclear how the degree of stenosis should best be measured in morphological images. The aim of this study was to determine which morphological measures from Computed Tomography Angiography (CTA) and Magnetic Resonance Angiography (MRA) are best in predicting whether a renal artery stenosis is hemodynamically significant or not. Forty-seven patients with hypertension and a clinical suspicion of renovascular hypertension were examined with CTA, MRA, captopril-enhanced renography (CER) and captopril test (Ctest). CTA and MRA images of the renal arteries were analyzed by two readers using interactive vessel segmentation software. The measures included minimum diameter, minimum area, diameter reduction and area reduction. In addition, two radiologists visually judged the diameter reduction without automated segmentation. The results were then compared using limits of agreement and intra-class correlation, and correlated with the results from CER combined with Ctest (which were used as standard of reference) using receiver operating characteristics (ROC) analysis. A total of 68 kidneys had all three investigations (CTA, MRA and CER + Ctest), where 11 kidneys (16.2 %) got a positive result on the CER + Ctest. The greatest area under ROC curve (AUROC) was found for the area reduction on MRA, with a value of 0.91 (95 % confidence interval 0.82–0.99), excluding accessory renal arteries. As comparison, the AUROC for the radiologists’ visual assessments on CTA and MRA were 0.90 (0.82–0.98) and 0.91 (0.83–0.99) respectively. None of the differences were statistically significant. No significant differences were found between the morphological measures in their ability to predict hemodynamically significant stenosis, but a tendency of MRA having higher AUROC than CTA. There was no significant difference between measurements made by the radiologists and measurements made with

LAPAROSCOPIC PLASTIC WITH PRIMARY STRICTURES OF THE URETEROPELVIC SEGMENT

Directory of Open Access Journals (Sweden)

N. V. Polyakov

2017-01-01

Full Text Available Determination of indications for performing reconstructive and plastic surgical interventions in stricture of UPS is a difficult task. When making an incorrect decision, the treatment can be ineffective. Functional and anatomical preservation of the kidney can significantly affect the outcome of the operation.Purpose. Evaluation of the effectiveness of laparoscopic plastic surgery of stricture of UPS, depending on the anatomical and functional state of the ipsilateral kidney.Material and method. The results of treatment of 134 patients, who underwent for the period from 2012 to 2015 the different types of reconstructive surgical interventions for stricture of the pelvic-ureteral segment (Calp de Virde scrappy plastic surgery, Andersen-Heinz ureteropyelanastomosis, and antineoplastic ureteropyeloanastomosis, were analyzed. To analyze the effectiveness of the treatment, in the preand postoperative period, the following parameters were evaluated: the presence of pain syndrome, the presence of pyeloectasia, the functional state of the renal parenchyma (according to radioisotope renography, and the absence of recurrence of the UPS stricture.Result. The overall efficacy of laparoscopic UPS reconstruction was 94.7%. The results of treatment did not depend on the chosen technique of operative intervention. In this case, the effectiveness of the treatment was dependent on the initial deficiency of kidney function: the best results were seen in patients with kidney function deficiency of less than 25%, and the proportion of ineffective interventions was highest among patients with a deficit of more than 75%. The degree of dilatation of the pelvis in the postoperative period was also associated with preoperative indicators of kidney function deficiency, this may be due to the presence of cup-pelvis-plating system atony.Conclusion. Thus, the results of our work demonstrated the high efficiency of laparoscopic plastics of UPS. The effective- ness of

Recommendations on procedures for renal function imaging; Anleitung zur Durchfuehrung der Nierenfunktionsszintigraphie

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Klaeser, B.; Eberl, A.; Bubeck, B. [Klinik fuer Nuklearmedizin, Kantonsspital St. Gallen (Switzerland)

2003-09-01

Renal function diagnostics in nuclear medicine is nowadays performed primarily as scintigraphic study using {sup 99m}Tc-MAG3, in many cases accompanied by quantitative clearance measurement. The present recommendations are based on the technical protocols of the Clinic of Nuclear Medicine at the Kantonsspital St. Gallen and do not claim to be complete or the Gold Standard. The procedures described are not subject to discussion, but the authors attempt to give practical guidelines as orientation for users in their daily routine. Focal points are preparation and performance of the diuretic renography with furosemide to evaluate urinary outflow obstructions and scintigraphic studies under captopril for detection of renovascular hypertension. Further subjects are the quantitative clearance measurement according to the single-sample method and, of course, the calculation of the split clearance. All of these subjects are described mainly under practical aspects, looking in particular at frequent pitfalls or wrong interpretations, but also taking into account quality assurance and data analysis. Selected cases are presented to document the importance of renal function imaging in practice. (orig.) [German] Die nuklearmedizinische Nierenfunktionsdiagnostik wird heute vorrangig als Szintigraphie mit {sup 99m}Tc-MAG3 betrieben, haeufig mit begleitender quantitativer Clearancemessung. Die vorliegende Anleitung basiert auf den Untersuchungsprotokollen der Klinik fuer Nuklearmedizin des Kantonsspitals St. Gallen und erhebt weder Anspruch auf Vollstaendigkeit noch darauf, als Goldstandard zu gelten. Die beschriebenen Vorgehensweisen werden nicht diskutiert, sondern die Autoren versuchen, pragmatische Leitlinien zu vermitteln, an denen sich der Anwender in der taeglichen Routine orientieren kann. Schwerpunkte bilden die Vorbereitung und Durchfuehrung der so genannten Lasix-Szintigraphie zur Beurteilung der renalen Abflussverhaeltnisse und die Captopril-Szintigraphie bei der Frage

Ectopic ureterocele and ectopic ureter in pediatric patients; Ureterocele ectopico y ectopia ureteral en pacientes pediatricos

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Lloret, M. T.; Ricart, V.; Muro, M. D.; Perez, D.; Martinez, I.; Brugger, S.; Romero, M. J.; Cortina, H. [hospital General Universitario La Fe. Valencia (Spain)

2000-07-01

To describe the radiological findings associated with ectopic ureterocele and ectopic ureter in pediatric patients. To assess the role of ultrasound (US), serial micturating cystourethrography (SM-CU) and intravenous urography (IVU) in the diagnosis of these two entities. The authors performed a retrospective study of 132 patients, 73 with ectopic ureterocele and 59 with ectopic ureter. The imaging studies used were US, SMCU, IVU and methods to determine renal function (diuretic renography and renal scintigraphy). The findings were confirmed during surgery in every case. The most common radiological findings in ectopic ureterocele were renal duplication (86,3%). vesicoureteral reflux (VUR) to the lower half of the kidney (46.6%), dilatation of the lower pole of the kidney (38.4%) and contralateral duplication (30.1%). In boys, the ectopic ureter entered via bladder neck and posterior urethra (73.7%) or into seminal vesicles (15.8%); in girls, it went to vagina (32.5%), bladder neck (30%) or urethra (22.5%). Renal duplication was associated in 64.4%, with VUR to the ectopic ureter in 21% while there was a single renal system in 35.6%, with VUR to the ectopic ureter in 57.1% and contralateral renal agenesis in 19%. Eighteen patients (13.6%) presented a single, dy plastic, nonfunctioning renal system (6 cases of ureterocele and 12 of ectopic ureter). Knowledge of the embryological development of ureteral duplication is essential for the understanding of these two entities and helps to differentiate between them, thus facilitating a sometimes complicated diagnosis. Ectopic ureters and ureteroceles accompanied by a single, dysplastic renal system are associated with a greater incidence of congenital anomalies and a higher rate of complications than the duplicate systems. A prenatal US examination enables early diagnosis. The anatomical information provided by US is, on occasion, more valuable than that resulting from IVU or SMCU, However, IVU is indispensable in girls

Evaluation of renal function using [sup 99m]Tc-MAG3; Comparison with [sup 123]I-OIH and [sup 99m]Tc-DTPA

Energy Technology Data Exchange (ETDEWEB)

Takayama, Teruhiko; Aburano, Tamio; Shuke, Noriyuki (Kanazawa Univ. (Japan). School of Medicine) (and others)

1993-07-01

The utility of [sup 99m]Tc-mercaptoacetyltriglycine (MAG3) was studied clinically. In the renography obtained with [sup 99m]Tc-MAG3, the abdominal aorta and the common iliac arteries were clearly visualized in the vascular phase. Due to less background activity and high target to background ratio, the quality of [sup 99m]Tc-MAG3 image was superior to that of [sup 123]I-OIH or [sup 99m]Tc-DTPA image. The parameters on the renogram including T[sub max], T[sub 2/3], and T[sub 1/2] were compared. The correlation of T[sub max] and T[sub 2/3] or T[sub 1/2] were not significant between [sup 99m]Tc-MAG3 and [sup 123]I-OIH. Another parameter of C[sub 20]/C[sub max], where C[sub 20] and C[sub max] are renal activities at 20 min after injection and at T[sub max] respectively, showed an excellent correlation between [sup 99m]Tc-MAG3 and [sup 123]I-OIH. Using C[sub 20]/C[sub max], pattern of renogram can be characterized numerically. Concerning the relation between C[sub 20]/C[sub max] and renogram pattern, standard renogram pattern showed the C[sub 20]/C[sub max] value of less than 0.4, while hypofunctioning pattern showed more than 0.5. The correlation coefficient between the renal uptake of [sup 99m]Tc-MAG3 and [sup 123]I-OIH was 0.880 with a correlation plot: 'Y=1.16X-0.043', where X and Y represent renal uptake of [sup 99m]Tc-MAG3 and [sup 123]I-OIH, respectively. It can be concluded that [sup 99m]Tc-MAG3 is a useful renal imaging agent as an alternative to [sup 123]I-OIH, in order to evaluate the proximal tubular function and calculate ERPF. (author).

Quantitative Analysis of Renogram

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Choi, Keun Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1969-03-15

Radioisotope renography was carried out in 564 cases consisting of 150 normal controls, 140 hypertensive, 102 hypertensive nephropathys, 62 chronic renal diseases, 53 unilateral, and 57 bilateral non-functioning kidneys. It was aimed to study which parameter of the renogram is most applicable to any definite disease of the kidney. The analytical methods adopted were; Tobe, Spencer, Krueger, Matchida and Takeuchi. In the non-functioning kidney groups, the hemograms and serum nitrogen series were also studied to evaluate the relationships between the renograms and renal anemia. The parameters were; time of maximum amplitude (Tmax), half-time of maximum amplitude (T-1/2), Kac value calculated from these two parameters in Tobe's method, slopes of B and C phase, B/A and B/C values in Spencer's method, total concentration (T.C.), minute concentration (M.C.) and minute excretion (M.E.) in Krueger's method, Matchida's K value and Takeuchi's renal function Index (R.F.I.). Following were the results: 1) In general, marked differences in the patterns of the renogram were observed between the normal controls and nephropathys. In Tobe's method, each parameter showed statistically significant delay or decrease in patients with hypertensive nephropathys and chronic renal diseases. In Spencer's method, slopes of B and C phase and B/C, also showed the statistically significant decrease in patients with hypertension, hypertensive nephropathys and chronic renal diseases. In Krueger's method, M.C. and ME showed the statistically significant differences between the control and patients with hypertension, hypertensive nephropathys and chronic renal diseases, In Matchida's method, K value showed the statistically significant differences between the control and patients with hypertensive nephropathys and chronic renal diseases. 2) It appeared, therefore, that Tobe's T{sub 1}/2, Kac, Spencer's slopes of B and C phase, B/A, B/C values, Krueger's T.C., M.C., and M.E. values, matchida's K

Is furosemide administration effective in improving the accuracy of determination of differential renal function by means of technetium-99m DMSA in patients with hydronephrosis

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Kabasakal, Levent; Turkmen, Cuneyt; Ozmen, Ozlem; Alan, Nalan; Onsel, Cetin; Uslu, Ilhami [Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Aksaray Istanbul, 34303 (Turkey)

2002-11-01

It has been suggested that determination of differential renal function (DRF)using technetium-99m dimercaptosuccinic acid (DMSA) may lead to overestimation of the function of an obstructed kidney in patients with excretion abnormalities owing to pelvic retention of DMSA. Recently published guidelines have recommended use of furosemide injection when calculating DRF in these particular patients. The aim of this study was to evaluate the effect of diuretic administration on the determination of DRF using DMSA scintigraphy. For this purpose, 19 patients, aged from 1 month to 69 years (19.4{+-}24.8 years, 15 males, 4 females), in whom pelvic retention had been documented by diuresis scintigraphy were included in the study. DMSA scintigraphy was performed in all patients 2-4 h after injection and six planar images were obtained. Immediately after the standard study, furosemide was injected in all patients, and 30 min later the same number of images was obtained. DRF was calculated for each patient and from each DMSA study by using the arithmetic mean method. The difference between two studies (DMSA scintigraphy with or without furosemide administration and diuresis scintigraphy) was expressed as a percentage of the mean value of the two studies (the DRF value of the affected kidney was thus taken into account). The mean of the differences represented the systemic bias and the SD of the mean of the differences represented the precision of the technique. In seven patients, diuresis renography revealed an obstructive curve pattern. We did not observe any significant difference between the DRF values obtained before and after diuretic administration (P>0.5). When we compared DRF values obtained from standard and from diuretic DMSA studies, the mean of the differences was only 0.3% and the SD was only 1.2%. There was also no significant difference in DRF between patients with the obstructive curve pattern and those with a dilated renogram curve pattern (with washout of

Is furosemide administration effective in improving the accuracy of determination of differential renal function by means of technetium-99m DMSA in patients with hydronephrosis

International Nuclear Information System (INIS)

Kabasakal, Levent; Turkmen, Cuneyt; Ozmen, Ozlem; Alan, Nalan; Onsel, Cetin; Uslu, Ilhami

2002-01-01

It has been suggested that determination of differential renal function (DRF)using technetium-99m dimercaptosuccinic acid (DMSA) may lead to overestimation of the function of an obstructed kidney in patients with excretion abnormalities owing to pelvic retention of DMSA. Recently published guidelines have recommended use of furosemide injection when calculating DRF in these particular patients. The aim of this study was to evaluate the effect of diuretic administration on the determination of DRF using DMSA scintigraphy. For this purpose, 19 patients, aged from 1 month to 69 years (19.4±24.8 years, 15 males, 4 females), in whom pelvic retention had been documented by diuresis scintigraphy were included in the study. DMSA scintigraphy was performed in all patients 2-4 h after injection and six planar images were obtained. Immediately after the standard study, furosemide was injected in all patients, and 30 min later the same number of images was obtained. DRF was calculated for each patient and from each DMSA study by using the arithmetic mean method. The difference between two studies (DMSA scintigraphy with or without furosemide administration and diuresis scintigraphy) was expressed as a percentage of the mean value of the two studies (the DRF value of the affected kidney was thus taken into account). The mean of the differences represented the systemic bias and the SD of the mean of the differences represented the precision of the technique. In seven patients, diuresis renography revealed an obstructive curve pattern. We did not observe any significant difference between the DRF values obtained before and after diuretic administration (P>0.5). When we compared DRF values obtained from standard and from diuretic DMSA studies, the mean of the differences was only 0.3% and the SD was only 1.2%. There was also no significant difference in DRF between patients with the obstructive curve pattern and those with a dilated renogram curve pattern (with washout of

Quantitative Analysis of Renogram

International Nuclear Information System (INIS)

Choi, Keun Chul

1969-01-01

Radioisotope renography was carried out in 564 cases consisting of 150 normal controls, 140 hypertensive, 102 hypertensive nephropathys, 62 chronic renal diseases, 53 unilateral, and 57 bilateral non-functioning kidneys. It was aimed to study which parameter of the renogram is most applicable to any definite disease of the kidney. The analytical methods adopted were; Tobe, Spencer, Krueger, Matchida and Takeuchi. In the non-functioning kidney groups, the hemograms and serum nitrogen series were also studied to evaluate the relationships between the renograms and renal anemia. The parameters were; time of maximum amplitude (Tmax), half-time of maximum amplitude (T-1/2), Kac value calculated from these two parameters in Tobe's method, slopes of B and C phase, B/A and B/C values in Spencer's method, total concentration (T.C.), minute concentration (M.C.) and minute excretion (M.E.) in Krueger's method, Matchida's K value and Takeuchi's renal function Index (R.F.I.). Following were the results: 1) In general, marked differences in the patterns of the renogram were observed between the normal controls and nephropathys. In Tobe's method, each parameter showed statistically significant delay or decrease in patients with hypertensive nephropathys and chronic renal diseases. In Spencer's method, slopes of B and C phase and B/C, also showed the statistically significant decrease in patients with hypertension, hypertensive nephropathys and chronic renal diseases. In Krueger's method, M.C. and ME showed the statistically significant differences between the control and patients with hypertension, hypertensive nephropathys and chronic renal diseases, In Matchida's method, K value showed the statistically significant differences between the control and patients with hypertensive nephropathys and chronic renal diseases. 2) It appeared, therefore, that Tobe's T 1 /2, Kac, Spencer's slopes of B and C phase, B/A, B/C values, Krueger's T.C., M.C., and M.E. values, matchida's K value

Correlation and clinical significance between glomerular filtration rate and age in living-related kidney donors

International Nuclear Information System (INIS)

Zhao Xiuyi; Shao Yahui; Wang Yanming; Zhang Aimin; Hao Junwen; Tian Jun; Sun Ben; Han Jiankui

2010-01-01

Objective: To quantitatively investigate the effect of age on the glomerular filtration rate (GFR) in living-related kidney donors. to analyze the clinical value and the dependence of GFR on age and to provide an objective basis for the selection of the living kidney donor. Methods: One hundred and sixty-one living-related kidney donors were divided into four age groups, namely 20-29 years (n=52), 30-39 years (n=44), 40-49 years (n=38) and ≥50 years (n=27). On the other hand, the total donors were divided into the groups older than 55 years (n=24) and younger than 55 years (n=137). To quantify GFR in all the subjects using the 99 Tc m -diethylenetriamine pentaacetic acid ( 99 Tc m -DTPA) renography according to standard procedure and to evaluate the effects of age on renal function. Results: The total GFR in living-related kidney donors was calculated as (89.55±12.87) ml·min -1 ·(1.73 m 2 ) -1 . The GFR in the first to the four age groups were (88.27±12.29) ml·min -1 ·(1.73 m 2 ) -1 , (91.85±14.51) ml·min -1 ·(1.73 m 2 ) -1 , (98.25±11.26) ml·min -1 ·(1.73 m 2 ) -1 and (88.24±13.20) ml·min -1 ·(1.73 m 2 ) -1 . The difference of GFR were not significant between the four age groups (F=2.09, P=0.10). The GFR in the donors older than 55 years and younger than 55 years were (88.57±13.14) ml·min -1 ·(1.73 m 2 ) -1 and (89.44±10.34) ml·min -1 ·(1.73 m 2 ) -1 , there no significant difference in GFR between the two groups (F=1.31, P=0.25). When relating GFR to age in all the living-related kidney donors, there was no significant correlation (r=-0.033, P=0.69). No serious complications occurred after living kidney transplantation, serum creatinine values and blood urea nitrogen recovered to the normal levels in a short period, hepatic and renal functions were normal. Conclusion: This study indicated that the GFR values were not correlated with the change of age in living-related kidney donors, and the results were helpful for the selection of living

Diagnosis of nutcracker syndrome of the left renal vein. Value of the corticomedullary phase of helical CT

International Nuclear Information System (INIS)

Igari, Hidenori

2001-01-01

The clinical significance of the corticomedullary phase of helical CT in the diagnosis of nutcracker syndrome of the left renal vein (LRV) was evaluated. A total of 38 patients with hematuria of unknown origin (12 men and 26 women, mean age 24 years [range: 18-32 years]) were examined by helical CT of the kidneys, retrograde left renal venography, and measurement of renocaval pressure gradients. The sensitivity and specificity of the corticomedullary and nephrographic phases of helical CT for detecting the nutcracker syndrome were determined. The nutcracker syndrome was diagnosed on the basis of the renography findings combined with pressure measurements in 19 patients: 12 with LRV hypertension and collateral veins, 1 with hypertension and no collateral veins, and 6 with collateral veins and normal pressure gradients or borderline hypertension. Both the corticomedullary- and nephrographic-phase images revealed distended LRVs in 26 (68%) of the 38 patients. The LRV mean attenuation values in the corticomedullary phase (164±22 Hounsfield units [H], range: 138-209 H) was significantly greater (p<0.001) than in the nephrographic phase (80±14 H, range: 62-100 H). During the corticomedullary phase, opacified blood from the renal vein was mixed with unopacified blood in the IVC. In the nephrographic phase, however, the IVC was enhanced homogeneously, but only slightly. Corticomedullary-phase imaging detected collateral veins that exhibited early enhancement, indicating retrograde flow from the LRVs in 15 out of 18 patients (83% of those with collateral veins), while the nephrographic-phase imaging revealed collateral veins in 8 patients (44% of those with collateral veins). The sensitivity and specificity of the corticomedullary-phase scan for detecting the nutcracker syndrome were 79% and 100%, respectively, as opposed to 42% and 100%, respectively, for the nephrographic phase. Retrograde flow from the LRV into the collateral veins in the corticomedullary phase is a

Fetal genitourinary anomalies. Perinatal and postnatal management with imaging techniques; Fetale Harntraktveraenderungen. Peri- und postnatales bildgebendes Management

Energy Technology Data Exchange (ETDEWEB)

Gassner, I. [Universitaetsklinik fuer Kinder- und Jugendheilkunde, Abteilung Kinderradiologie, Innsbruck (Austria)

2005-12-01

Improvements in ultrasound technology and the appropriate timing of antenatal ultrasound has led to refined prenatal diagnosis and enhanced accuracy of diagnosis of fetal renal anomalies and makes it possible to treat obstructive and/or refluxing uropathies before the onset of clinical symptoms. The third trimester renal sonography is the most important to detect hydronephrosis amenable to treatment. Classically, the prenatal diagnosis of hydronephrosis, unilateral renal agenesis, or MDKD initiates postnatal investigations, including sonography, voiding cystourethrography (VCUG), and isotopic renography. The exact degree of renal pelvic dilatation that requires full postnatal investigation is still not entirely resolved. Most authors accept the upper limit of 7 mm for the AP diameter of the renal pelvis. The US examination should be performed after the physiological dehydration period, namely 3-5 days after birth, in an urgent case on the 1st day. A meticulous ultrasound examination performed by a physician who is familiar with the renal abnormalities shows the whole extent of underlying pathology. The role of MR urography in the work-up of renal anomalies, particularly of hydronephrosis, is currently being investigated. Due to the close developmental relationship of the urinary and genital tracts, malformations frequently occur in both of these systems. Therefore in all patients, especially in girls with renal anomalies (unilateral renal agenesis, multicystic dysplastic kidney disease), the internal genitalia need to be evaluated. (orig.) [German] Die praenatale Ultraschalluntersuchung, v. a. im 3. Trimenon, erfasst viele Harntraktanomalien, die einer Behandlung zugaenglich sind, bevor sie klinisch durch eine Harnweginfektion oder Niereninsuffizienz symptomatisch werden. Sie lenkt die gezielte postnatale Bildgebung, mit der beim Neugeborenen die praenatal entdeckte Pathologie abgeklaert wird. Die Ultraschalluntersuchung durch einen mit dem Spektrum moeglicher

Overvalue relative renal function in unilateral ureteropelvic junction obstruction?

International Nuclear Information System (INIS)

Baquedano, P.; Orellana, P.; Varas, J.

2002-01-01

Introduction: Relative renal function (RRF) is used as an important parameter in the surgical decision of hydronephrosis. In addition, the presence of a supranormal RRF (RRF > 55%) in the hydronephrotic kidney had been recognized. However, this over estimation is, in our experience, not only present with a RRF over 55%. We evaluated demographic data, ultrasonographic finding, age of surgery, presentation (antenatal diagnosis vs postnatal clinical symptoms) in children with unilateral hydronephrosis and a RRF which decreased after surgery. Materials and Methods: Of a series of 66 patients with unilateral ureteropyelic junction obstruction (UPJ) obstruction consecutively operated and followed in the Pediatric Urology unit of Catholic University of Chile, we analyzed 8 cases (12%) in which the relative renal function quantified by diuretic renography with Tc99 MAG3 decreased during follow-up after surgery, over 10% of the baseline value; 6 to 12 months post pyeloplasty, 7 boys, 6 cases with UPJ obstruction of the left side. 3 cases were diagnosed by prenatal ultrasound, 1 by abdominal mass, 1 by urinary tract infection, 1 by abdominal pain and 2 by screening. The age at the time of the surgery was in 4 cases 1 month of life, in two children between 6 and 12 months of age, one boy was 2.4 year old and another one was 7.3 year old. All were considered as a severe hydronefrosis in the ultrasound and 4 cases had a severe atrophy of renal parenchyma. The initial RRF of these cases varied from 35% to 62%. In half of the cases the initial RRF was considered normal, in 2 cases was abnormal ( 55%). In all of these children the RRF decreased after surgery in an average of 35% (28%-54%) of the initial RRF, none of these patients had a normal RRF after surgery. There was no differences in clinical presentation and radiological findings among them. However, it is worth to mention that the symptomatic presentation (pain, abdominal mass) was more frequent in this group that in our

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

Paediatric nuclear medicine imaging.

Science.gov (United States)

Biassoni, Lorenzo; Easty, Marina

2017-09-01

cortical bone level, difficult to demonstrate on MRI, which can act as pain generators. Positron emission tomography (PET) is being tested in the staging, response assessment and at the end of treatment of several paediatric malignancies. PET is becoming more widely utilized in neurology in the pre-surgical assessment of some children with drug resistant epilepsy. The use of PET/MRI scanners is very attractive as it combines benefits of MR imaging with the assessment of cellular viability and metabolism with PET in one examination. This imaging technique will allow important research on tumour in-vivo metabolism (possible applications include lymphomas, neuroblastomas, malignant germ cell tumours andbrain tumours), with the aim of offering a personalized biological profile of the tumour in a particular patient. Ground-breaking research is also envisaged in neurosciences, especially in epilepsy, using PET tracers that would enable a better identification of the epileptogenic focus, and in psychiatry, with the use of radiolabeled neurotransmitters. In paediatric nephro-urology, the identification of the asymptomatic child with ante-natally diagnosed hydronephrosis at risk of losing renal parenchymal function if left untreated is another area of active research involving radionuclide renography. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com