Renal Cortical Imaging in Children

Abstract

To determine the potentials of technitium-99m mercaptoacetyltriglycine (99mTc MAG3) to replace technitium-99m dimercaptosuccinic acid (99mTc DMSA) in assessment of renal cortex and split renal function (SRF). This a retrospective study in which we reviewed the scintigraphic results of 52 patients with age range of 7 days-10 years (mean, 5.3 years). A total of 104 studies (1 99mTc MAG3 and 1 99mTc DMSA per patient) were performed between 1 January, 2009 and 31 December, 2010 because of various renal disorders. Both studies were performed within 24 hours of each other, starting with 99mTc MAG3. Twenty patients had normal SRF, and 26 patients had abnormal SRF (6 with solitary kidney, 4 with 1 kidney SRF <10%, and 16 with 1 kidney SRF >10%). In all 46 patients, SRF assessed by 99mTc MAG3 correlated with that by 99mTc DMSA (P = 0.0001). In remaining 6 patients, the correlation was less optimal, and the diseased kidney had overestimation of SRF by 99mTc MAG3. Nonvisualized kidneys and cortical defects were observed equally on both studies. 99mTc MAG3 provides adequate images for assessment of renal cortex and accurate measurement of SRF comparable with 99mTc DMSA results. In addition, it provides important information on the urodynamics of both kidneys, avoids unnecessary radiation to the children, as well as is time saving. We consider it is time to replace the 99mTc DMSA with 99mTc MAG3 in most nephrourologic disorders in pediatric patients and to keep the former to doubtful cases obtained using the latter.