Comparison of Three Different Diuretic Renal Scintigraphy Protocols in Patients With Dilated Upper Urinary Tracts

PURPOSE:To compare 3 different diuretic renal scintigraphy protocols in patients with dilated upper urinary tract. MATERIALS AND METHODS:Three diuresis renography protocols were performed in 22 adult patients (28 kidneys) with upper urinary tract dilatation. The diuretic was given 20 minutes after (...

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Bibliographic Details
Published in:Clinical nuclear medicine 2004-03, Vol.29 (3), p.154-160
Main Authors: Türkölmez, Şeyda, Atasever, Tamer, Türkölmez, Kadir, Gögüs, Orhan
Format: Article
Language:English
Subjects:
Adolescent
Adult
Dilatation, Pathologic - classification
Dilatation, Pathologic - diagnosis
Dilatation, Pathologic - diagnostic imaging
Diuresis - drug effects
Diuretics - administration & dosage
Dose-Response Relationship, Drug
Furosemide - administration & dosage
Humans
Image Enhancement - methods
Radioisotope Renography - methods
Radiopharmaceuticals
Reproducibility of Results
Sensitivity and Specificity
Technetium Tc 99m Mertiatide
Urologic Diseases - classification
Urologic Diseases - diagnosis
Urologic Diseases - diagnostic imaging
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Summary:PURPOSE:To compare 3 different diuretic renal scintigraphy protocols in patients with dilated upper urinary tract. MATERIALS AND METHODS:Three diuresis renography protocols were performed in 22 adult patients (28 kidneys) with upper urinary tract dilatation. The diuretic was given 20 minutes after (F+20), at the same time as (F+0), and 15 minutes before (F−15) radionuclide administration. The mean age was 29.8 years (range, 18–43 years). The 3 protocols were identical, except for the time of injection of furosemide. The F+0 protocol could not be performed in 1 and F−15 in 2 of the patients. Each of the 3 protocols was performed for the rest of the patients. The results were classified as nonobstructive, equivocal, and obstructive according to the renogram images and curves. RESULTS:None of the patients showed equivocal results in both F+0 and F−15 protocols. In the F+20 studies, 7 of the 28 kidneys were evaluated as equivocal. Of these, 5 kidneys showed nonobstructive and 2 kidneys revealed obstructive renogram patterns with the other 2 protocols (F+0 and F−15). Moreover, one kidney, which was evaluated as nonobstructive in the F+20 protocol, showed an obstructive pattern in both F+0 and F−15 protocols. All of the kidneys showing obstructive patterns in the F+20 study also revealed obstruction in the F+0 and F−15 investigations. We could not find any difference between the renogram patterns of F+0 and F-15 investigations. CONCLUSIONS:F+0 and F−15 protocols allow clarification in cases of equivocal F+20 studies. Because the F+0 study is more practical and shorter, we suggest the F+0 method when equivocal results are obtained by an F+20 study or as a single test when there is only one opportunity to confirm or exclude the presence of obstruction.
ISSN:0363-9762
1536-0229
DOI:10.1097/01.rlu.0000113852.57445.23