Monitoring of renal function using 99mTc-DMSA and 99mTc-DTPA scintigraphy in patients with spinal cord injury

Abstract

AimThe aim of this study was to assess the degree of alterations of renal function by using 99m-technetium dimercaptosuccinic acid (99mTc-DMSA) and 99m-technetium diethylenetriaminepentaacetic acid (99mTc-DTPA) scintigraphy in spinal cord injury (SCI) patients. Material and methodsTwenty-two consecutive SCI (15 paraplegic and 7 tetraplegic) patients (mean age: 49.1±13.4 years) who had no urinary symptoms participated in this prospective study. The mean duration of injury was 45.6±48.8 months before. Sixteen patients had at least one urinary tract infection history. Renal cortical scintigraphy with 99mTc-DMSA, radionuclide renography with 99mTc-DTPA and renal ultrasound were performed within 2-week period. ResultsFour (18%) patients had serious pathology on their kidneys such as unilateral or bilateral parenchymal scarring and increased background uptake in their renal cortical scintigraphy with 99mTc-DMSA. Two of them had grade 3–4 pelvicaliceal ectasia on ultrasound. Additionally, 2 of 18 remaining patients had grade 2 pelvicaliceal ectasia on ultrasound. Sixteen (73%) patients had markedly delayed or delayed and decreased functions of one or both of kidneys on radionuclide renography. However, only four patients had grade 2–4 pelvicaliceal ectasia and none of them had a finding of loosening of renal parenchyma. ConclusionCombined use of renal cortical scintigraphy and radionuclide renography appears to be contributive to renal ultrasound in the long-term follow-up of patients with SCI. Patients with abnormal findings should be closely followed, and early therapeutic interventions may enable lower morbidity and mortality rates in these patients.