Abstract
ObjectiveTo investigate the influence of bladder fullness on the diagnosis of urinary tract obstruction during dynamic renal scintigraphy with a diuretic stimulator.Materials and methodsWe studied 82 kidneys in 82 patients submitted to dynamic renal scintigraphy with a diuretic stimulator. We compared the proportional elimination of the radiopharmaceutical 99mTc-DTPA from the kidneys before and after bladder emptying in post-diuretic images, classifying each image as representing an obstructed, indeterminate, or unobstructed kidney.ResultsThe overall elimination of 99mTc-DTPA from the kidneys was 10.4% greater after bladder emptying than before. When the analysis was performed with a full bladder, we classified 40 kidneys as obstructed, 16 as indeterminate, and 26 as unobstructed. When the 40 kidneys classified as obstructed were analyzed after voiding, 11 were reclassified as indeterminate and 3 were reclassified as unobstructed. Of the 16 kidneys classified as indeterminate on the full-bladder images, 13 were reclassified as unobstructed after voiding.ConclusionIn dynamic renal scintigraphy with a diuretic stimulator, it is important to obtain images after voiding, in order to perform a reliable analysis of the proportional excretion of 99mTc-DTPA from the kidneys, avoiding possible false-positive results for urinary tract obstruction.
Highlights
Urinary tract obstruction (UTO) is a relatively common clinical condition in various age groups and can be defined as partial or total restriction of urinary flow that can result in kidney injury and renal failure[1]
To determine the most appropriate treatment, it is extremely important to differentiate between mechanical obstruction, as in the case of ureteropelvic junction anomalies, and non-obstructive dilatation, as occurs in non-obstructive hydronephrosis[4]
Neonatal hydronephrosis is commonly identified through imaging studies during pregnancy and can have an obstructive origin, often caused by obstruction at the ureteropelvic junction or ureterovesical junction, or a non-obstructive origin
Summary
Urinary tract obstruction (UTO) is a relatively common clinical condition in various age groups and can be defined as partial or total restriction of urinary flow that can result in kidney injury and renal failure[1]. UTO is a leading cause of renal dysfunction. To determine the most appropriate treatment, it is extremely important to differentiate between mechanical obstruction, as in the case of ureteropelvic junction anomalies, and non-obstructive dilatation, as occurs in non-obstructive hydronephrosis[4]. Non-obstructive hydronephrosis can be caused by reflux, primary megaureter, or previously resolved obstruction. Neonatal hydronephrosis is commonly identified through imaging studies during pregnancy and can have an obstructive origin, often caused by obstruction at the ureteropelvic junction or ureterovesical junction, or a non-obstructive origin. The distinction between those two origins plays an important role in the decision-making process regarding the clinical management of the condition[5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
