Comparison of three different diuretic renal scintigraphy protocols in patients with dilated upper urinary tracts.
OBJECTIVE
To compare 3 different diuretic renal scintigraphy protocols in patients with dilated upper urinary tract.


METHODS
Three diuresis renography protocols were performed in 22 adult patients (28 kidneys) with upper urinary tract dilatation. The diuretic was given 20 minutes after (F+20), at the same time as (F+0), and 15 minutes before (F-15) radionuclide administration. The mean age was 29.8 years (range, 18-43 years). The 3 protocols were identical, except for the time of injection of furosemide. The F+0 protocol could not be performed in 1 and F-15 in 2 of the patients. Each of the 3 protocols was performed for the rest of the patients. The results were classified as nonobstructive, equivocal, and obstructive according to the renogram images and curves.


RESULTS
None of the patients showed equivocal results in both F+0 and F-15 protocols. In the F+20 studies, 7 of the 28 kidneys were evaluated as equivocal. Of these, 5 kidneys showed nonobstructive and 2 kidneys revealed obstructive renogram patterns with the other 2 protocols (F+0 and F-15). Moreover, one kidney, which was evaluated as nonobstructive in the F+20 protocol, showed an obstructive pattern in both F+0 and F-15 protocols. All of the kidneys showing obstructive patterns in the F+20 study also revealed obstruction in the F+0 and F-15 investigations. We could not find any difference between the renogram patterns of F+0 and F-15 investigations.


CONCLUSIONS
F+0 and F-15 protocols allow clarification in cases of equivocal F+20 studies. Because the F+0 study is more practical and shorter, we suggest the F+0 method when equivocal results are obtained by an F+20 study or as a single test when there is only one opportunity to confirm or exclude the presence of obstruction.
Türkölmez
Seyda
S
Department of Nuclear Medicine, Gazi University School of Medicine, Ankara, Turkey. sturkolmez@yahoo.com
Atasever
Tamer
T
Türkölmez
Kadir
K
Gögüs
Orhan
O
D000293:Adolescent; D000328:Adult; D004108:Dilatation, Pathologic / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging*; D004231:Diuresis / Q000187:drug effects*; D004232:Diuretics / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D011866:Radioisotope Renography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017263:Technetium Tc 99m Mertiatide; D014570:Urologic Diseases / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging*
D004232:Diuretics; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; D005665:Furosemide