Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function

  • Nevena Manevska Institute of Patophysiology and Nuclear Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Sinisa Stojanoski Institute of Patophysiology and Nuclear Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Venjamin Majstorov Institute of Patophysiology and Nuclear Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Daniela Pop-Gjorcheva Institute of Patophysiology and Nuclear Medicine, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Nikolina Zdraveska University Children's Hospital, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Dafina Kuzmanovska University Children's Hospital, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
Keywords: VUR, renal function, 99mTc-DTPA scintigraphy, 99mTc-DMSA scintigraphy, hydronephrosis

Abstract

BACKGROUND: Radionuclide techniques, as direct radionuclide cystography and 99mTc-DMSA scintigraphy, have been used in evaluation of vesicoureteral reflux (VUR) and reflux nephropathy (RN) in children. Dynamic 99mTc-DTPA scintigraphy is reserved for evaluation of differential renal function and obstruction in children, where hydronephrosis is detected by ultrasonography (US) pre- or postnatally.

CASE REPORT: Six year old boy was prenatally diagnosed with bilateral hydronephrosis. Postnatal, severe bilateral VUR was detected by voiding urethrocytography. US and 99mTc-DTPA scintigraphy performed in the first month of life showed small left kidney that participated with 2% in the global renal function. Bilateral cutaneous ureterostomy has been performed in order to obtain good renal drainage and promote optimal renal growth. Twelve months later, classic antireflux procedure was done. Control 99mTc-DTPA scintigraphy, 5 ys after antireflux surgery, revealed persisting radioactivity during the diuretic phase, in the left kidney that indicated antireflux procedure failure with VUR reappearance.

CONCLUSION: 99mTc-DTPA scintigraphy is the first method of choice for long-term monitoring of individual kidney function in children with VUR and other congenital urinary tract anomalies. Additionally, it can be used as indirect radionuclide cystography when rising of radioactivity in the kidney region, during the diuretic phase can indicate presence of VUR.

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Published
2015-12-31
How to Cite
1.
Manevska N, Stojanoski S, Majstorov V, Pop-Gjorcheva D, Zdraveska N, Kuzmanovska D. Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function. Open Access Maced J Med Sci [Internet]. 2015Dec.31 [cited 2020Dec.5];4(1):135-8. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2016.012
Section
C- Case Reports