Evaluation of obstructive uropathy in children: radionuclide renography vs. the Whitaker test.
Differentiation of obstructed from dilated, nonobstructed urinary systems in the postoperative child is a difficult diagnostic problem. A comparison study was performed in 21 children with hydroureteronephrosis using the Whitaker test in combination with conventional radionuclide renography and/or diuretic (furosemide)-augmented radionuclide renography. The results of each method were correlated with the clinical assessment and surgical findings. Conventional renography was found to be an unreliable study, with a clinical correctness of only 57%. Results were more favorable for both the Whitaker test and diuretic-augmented radionuclide renography, with clinical correctness in 86% and 85%, respectively. Furthermore, when both tests agreed, no false negatives or false positives were obtained. Due to the noninvasive nature of the study, diuretic-augmented renography should be the initial procedure once hydroureteronephrosis is established. A recommended algorithm of the child with postoperative hydroureteronephrosis is suggested.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005665:Furosemide; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007223:Infant; D011866:Radioisotope Renography / Q000379:methods; D014517:Ureteral Obstruction / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014567:Urography / Q000379:methods
D005665:Furosemide