Effect of radionuclide renograms on treatment of patients with spinal cord injuries.
OBJECTIVE
Urinary tract problems stemming from neurologic dysfunction are a major cause of morbidity in patients with spinal cord injury. Radionuclide renograms have been used to monitor renal function in these patients. However, the effect of renographic results on the treatment of patients has not been studied. A retrospective study was done to determine the effect of radionuclide renography on the diagnostic evaluation and therapeutic treatment of patients with spinal cord injury.


METHODS
The records of 199 patients with spinal cord injuries were reviewed. A decline in effective renal plasma flow of 20% or more, a low effective renal plasma flow for age, and abnormal tracer time-activity curves were correlated with diagnostic procedures and therapeutic interventions. Diagnostic procedures included renal sonography, CT, excretory urography, and urodynamics. Therapeutic interventions included changes in medication, changes in bladder management, and surgery.


RESULTS
Patients with abnormal findings on renograms underwent more diagnostic procedures and therapeutic interventions. A significant correlation was found between abnormal tracer time-activity curves and use of excretory urography. A decline in effective renal plasma flow was the best predictor of therapeutic intervention.


CONCLUSIONS
Radionuclide renograms influence the diagnostic evaluation and therapeutic treatment of patients with spinal cord injury.
Phillips
J R
JR
Nuclear Medicine Service (115), Veterans Affairs Palo Alto Health Care System, CA 94304, USA.
Jadvar
H
H
Sullivan
G
G
Lin
V W
VW
Segall
G M
GM
D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011866:Radioisotope Renography; D017596:Renal Plasma Flow, Effective; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014570:Urologic Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy