Korean J Urol.  2006 Apr;47(4):402-406. 10.4111/kju.2006.47.4.402.

Comparison of the Effectiveness of the Renogram, the Serial Renal Scan and the Diuretic Half Time according to the Renal Function for Interpreting a Diuretic DTPA Scan following Pyeloplasty

• Nam JK
• Lee SD

• KMID: 1997151
• DOI: http://doi.org/10.4111/kju.2006.47.4.402

Abstract

PURPOSE
The diuretic renal scan has been considered to be a good tool for evaluating the postoperative renal function in the patients with ureteropelvic junction obstruction (UPJO). We evaluated the diagnostic accuracy of the renogram, the serial renal scan and the diuretic half time according to the differential renal function (DRF) on the diuretic renal scan.
MATERIALS AND METHODS
We reviewed the diuretic renal scans of 27 pediatric patients (25 males and 2 females) who underwent pyeloplasty due to unilateral UPJO. Diuretic renal scanning was done using the 99mTc- DTPA (diethylenetriaminepentaacetic acid) standardized protocol. We compared the diagnostic accuracy of the renogram, the serial renal scan and the diuretic half time according to the DRF (group I: above 40%, group II: below 40%).
RESULTS
The mean age of the patients was 48.0 59.2 months (range: 2-210 months). The diuretic half time, renogram, serial renal scan and each combination demonstrated statistical significance for the interpretation of ureteral obstruction (generalized estimation equation, p=0.003). The interpretation of the diuretic renal scan was not affected by the DRF (McNemar test, p=0.598). The false positive rate and specificity of the renogram, serial renal scan and diuretic half time were 22.2%, 29.6%, 59.3% and 77.8%, 70.4%, 40.7%, respectively. In addition, the false positive rate and specificity of a combination of the diuretic half time and renogram, the diuretic half time and serial renal scan, the renogram and serial renal scan, the diuretic half time and renogram, and serial renal scan were 22.2%, 25.9%, 14.8%, 14.8%, and 77.8%, 74.1%, 85.2%, 85.2%, respectively.
CONCLUSIONS
The diuretic half time, renogram and serial renal scan were individually correlated with the postoperative status of the UPJO. However, a combination of various factors of the renal scan should be considered for evaluating the postoperative status of UPJO.

Keyword

Radionuclide imaging; Ureteral obstruction; Follow-up studies

MeSH Terms

Follow-Up Studies
Humans
Male
Pentetic Acid*
Radionuclide Imaging
Sensitivity and Specificity
Ureteral Obstruction
Pentetic Acid

Figure

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  Fig. 1 Interpretation of the diuresis renograms according to the rate and completeness of excretion following injection of furosemide. Group 1 (pattern I)-normal, group 2 (pattern II)-obstruction, group 3a (pattern IIIa)-stasis without obstruction and 3b (pattern IIIb)-partial obstruction.

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  Fig. 2 Statistical analysis* for high specificity and the low false positive rate of interpreting the factors of the diuretic renal scan. (A) half time, (B) renogram, (C) serial renal scan. *: McNemar test.

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