Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

Vojnosanit Pregl. 2008 Apr;65(4):299-302. doi: 10.2298/vsp0804299a.

Abstract

Background/aim: Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis.

Methods: Twenty-four infants (19 boys and five girls) presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy.

Results: Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU) less than 40% was found in three, and poor kidney function (RKU less than 10%) in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes) with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case.

Conclusion: A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

MeSH terms

  • Dilatation, Pathologic
  • Diuretics
  • Female
  • Humans
  • Hydronephrosis / congenital*
  • Hydronephrosis / diagnostic imaging*
  • Hydronephrosis / etiology
  • Infant
  • Kidney / diagnostic imaging*
  • Kidney Pelvis / diagnostic imaging
  • Kidney Pelvis / pathology
  • Male
  • Radioisotope Renography*
  • Radiopharmaceuticals
  • Technetium Tc 99m Dimercaptosuccinic Acid
  • Technetium Tc 99m Pentetate
  • Vesico-Ureteral Reflux / diagnostic imaging*

Substances

  • Diuretics
  • Radiopharmaceuticals
  • Technetium Tc 99m Dimercaptosuccinic Acid
  • Technetium Tc 99m Pentetate