title: Use of technetium-99m-MAG3 for renal scintigraphy after angiotensin-converting enzyme inhibition.
abstract: Technetium-99m-mercaptoacetyltriglycine (99mTc-MAG3) was tested in 82 hypertensive patients submitted to renal scintigraphy 1 hr after oral premedication with 50 mg of Captopril. Baseline studies were obtained only for those patients showing abnormal findings in the provocative study. All patients underwent renal arteriography. Sensitivity and specificity for the detection of renal artery stenosis (RAS) greater than 50% were 89% and 91%, respectively. After Captopril administration, tracer parenchymal transit time increased significantly in ischemic kidneys (334 +/- 93 sec in baseline conditions versus 468 +/- 96 sec after Captopril, p less than 0.001) but not in kidneys with no RAS or RAS less than 50% (243 +/- 46 sec versus 271 +/- 95 sec, p = ns). False-positive responses were mostly bilateral and associated with a marked decrease in blood pressure. Technetium-99m-MAG3 is an effective compound for detecting RAS greater than or equal to 50% with Captopril renal scintigraphy. Performing the provocative test as a first step considerably reduced the number of scintigraphic studies required.
authors.affiliation: Department of Nuclear Medicine, S. Orsola-Malpighi Policlinic Hospital, Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Dondi
authors.forename: N
authors.initials: N
authors.lastname: Monetti
authors.forename: S
authors.initials: S
authors.lastname: Fanti
authors.forename: F
authors.initials: F
authors.lastname: Marchetta
authors.forename: C
authors.initials: C
authors.lastname: Corbelli
authors.forename: P
authors.initials: P
authors.lastname: Zagni
authors.forename: A
authors.initials: A
authors.lastname: De Fabritis
authors.forename: F
authors.initials: F
authors.lastname: Losinno
authors.forename: M
authors.initials: M
authors.lastname: Levorato
authors.forename: A
authors.initials: A
authors.lastname: Zuccalá
mesh_terms: D000284:Administration, Oral; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D002216:Captopril / Q000008:administration & dosage*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D009842:Oligopeptides; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D017263:Technetium Tc 99m Mertiatide
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D009842:Oligopeptides; D015609:Organotechnetium Compounds; D017263:Technetium Tc 99m Mertiatide; D002216:Captopril