How good is technetium-99m mercaptoacetyltriglycine indirect cystography?
The aim of the present study was to estimate the sensitivity of indirect radionuclide cystography (IRC) performed with technetium-99m mercaptoacetyl-triglycine (MAG3), in comparison with the micturition cystourethrography (MCUG) and direct radionuclide cystography (DRC), for the diagnosis of vesicoureteric reflux. Two groups of patients were selected: group I comprised 40 children who underwent IRC during the acute phase of urinary tract infection and an MCUG 6 weeks later; group II comprised 42 (other) children with known reflux, who underwent IRC and DRC during follow-up. Taking as the reference the total number of refluxing kidneys detected by means of any cystographic technique, 99mTc-MAG3 ICR missed two-thirds of the refluxing kidneys. Most of the small refluxes were missed, but so too were 50% of the major refluxes. Taking as the reference 99mTc dimercaptosuccinic acid (DMSA) scintigraphy, MCUG detected 91% of the patients with DMSA abnormalities on at least one kidney, DRC detected 95%, and IRC detected 46% and 43% respectively, in groups I and II. The use of 99mTc-MAG3 IRC as the sole technique for the detection of vesicoureteric reflux gives rise to an unacceptable number of false-negative results.
De Sadeleer
C
C
Department of Nuclear Medicine, Academic Hospital, Vrije Universiteit Brussel, Belgium.
De Boe
V
V
Keuppens
F
F
Desprechins
B
B
Verboven
M
M
Piepsz
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D017263:Technetium Tc 99m Mertiatide; D014521:Urethra / Q000000981:diagnostic imaging / Q000502:physiology; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000502:physiology; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging*
D017263:Technetium Tc 99m Mertiatide