Utility of technetium-99m-mag3 diuretic renography in the neonatal period

Wong, Joseph C. H., Rossleigh, Monica A. and Farnsworth, Robert H. (1995) Utility of technetium-99m-mag3 diuretic renography in the neonatal period. The Journal of Nuclear Medicine, 36 12: 2214-2219.


Author Wong, Joseph C. H.
Rossleigh, Monica A.
Farnsworth, Robert H.
Title Utility of technetium-99m-mag3 diuretic renography in the neonatal period
Journal name The Journal of Nuclear Medicine
ISSN 0161-5505
0022-3123
0097-9031
Publication date 1995
Sub-type Article (original research)
Volume 36
Issue 12
Start page 2214
End page 2219
Total pages 6
Place of publication Chicago, Ill., USA
Publisher Highwire Press
Language eng
Subject 110320 Radiology and Organ Imaging
Abstract Diuretic renography performed in the neonatal period has been reported to be unreliable in diagnosing obstruction. Methods: The scans of 27 neonates (age up to 28 days; mean 17 days) with a total of 53 renal units were reviewed; a renal unit being defined as comprising a kidney and its ureter. All were referred following perinatal ultrasound diagnosis of hydronephrosis or hydroureteronephrosis. The neonates had standard diuretic renography using MAG3 with a frusemide dose of 1 mg/kg followed by another image obtained after gravity-assisted drainage. Results: There were 17 normal undilated renal units showing excellent diuretic responses with clearance half-times of 0.6–7.7 min. Eighteen renal units were diagnosed as having pelvi-ureteric junction (PUJ) obstruction, with surgical confirmation in all. Eight were diagnosed as unobstructed and of these seven were confirmed nonobstructed by serial imaging using ultrasound and MAG3, but one subsequently had pyeloplasty performed for PUJ obstruction. One unit was in determinate for PuJ obstruction but had good clearance with gravity-assisted drainage and was shown to be unobstructed on repeat studies. Of nine units diagnosed as having vesico-ureteric junction (VUJ) obstruction, eight had surgicalconfirmation and one remains of uncertain final diagnosis. Co-existing VUJ obstruction could not be diagnosed in two units with PUJ obstruction because of insufficient radiotracer drainage through the tight stenosis into the ureter. Conclusion: An adequate diuretic response is present in the neonatal period using MAG3 and this allows for reliable diagnosis of obstruction. An unobstructed or indeterminate result necessitates follow-up imaging to ensure obstruction does not develop. Co-existing VUJ obstruction may be missed in a scan showing PUJ obstruction.
Keyword technetium-99m- MAG3
neonate
pelvi-ureteric
vesisco-ureteric obstruction
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Wed, 07 Jul 2010, 14:28:54 EST by Laura McTaggart on behalf of Faculty Of Health Sciences