[Dynamic urinary flow images in patients with ileal loop diversion assessed by I-123-hippuran scintigraphy. Detection of ileoureteral reflux].
To evaluate upper urinary tract and ileal loop functions, dynamic urinary flow studies using I-123 hippuran were performed in 52 kidneys of 27 patients with ileal loop urinary diversion. Analysis of regional renograms enabled easy assessment of the cortical, pelvic and loop functions. Normal pattern was found in 33 cortices (63.5%), 22 pelvis (45.8%) and 14 loops (51.9%). Most of the abnormal findings in the upper urinary tract were delayed excretion and/or retention of the pelvic and ureteral urines. Diagnosis of ileoureteral reflux under normal physiological circumstances was made to compare the pelvic and loop curves. Small peaks and/or irregular spike waves observed in the down slope of the pelvic curve concurrently with the increased activity of the loop curve indicate a production of the ileoureteral reflux associated with ileal movement. This reflux was noted in 22 of the 27 cases (81.5%). Bilateral reflux was evident in 3 cases, and unilateral reflux in 19 cases. Ileoureteral reflux was noticed in 14 of the 15 cases (90%) in which retrograde loopography was performed. Although bilateral reflux was found in 8 cases, the hippuran study revealed bilateral in only one case, unilateral in 5 and no reflux in 2. Thus, I-123 hippuran scintigraphy consisting of sequential renal images, loopograms and regional renograms enables the diagnosis of ileoureteral reflux and obstructive uropathies and is a useful tool to detect functional complications of the upper urinary tract in patients with ileal loop diversion.
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging*; D007081:Ileostomy; D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011866:Radioisotope Renography; D014515:Ureteral Diseases / Q000000981:diagnostic imaging*; D014547:Urinary Diversion
D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid