The accuracy of (99m)Tc-DTPA scintigraphy in the evaluation of acute renal graft complications.
OBJECTIVE
Renal scintigraphy has been used for many years in the evaluation of renal transplants and can help in the diagnosis of graft complications, leading to prompt clinical management and preventing further deterioration of renal function. The purpose of this study was to evaluate the overall accuracy of renal scintigraphy with (99m)Tc-DTPA in the diagnosis of acute renal graft complications.


METHODS
Seventy-six scintigraphic studies performed in 55 patients (ages ranging from 6 to 65 years), were reviewed. Scintigraphy results were compared to biopsies performed within 5 days of imaging. (99m)Tc-DTPA study was performed within a mean time of 19 days after kidney transplants. Dynamic images were performed in the anterior position of the abdomen and pelvis every 2 seconds for 80 seconds (flow phase) and every 15 seconds for 30 minutes (functional phase), after an intravenous injection of 370 MBq (10 mCi) of (99m)Tc-DTPA.


RESULTS
The scintigraphic results were concordant with the biopsies in 86% of the cases studied. The sensitivities of renal scintigraphy for detection of acute tubular necrosis (ATN), acute rejection (AR) and cortical necrosis (CN) were 98%, 87% and 100%, respectively. Specificities and accuracies for detection of ATN, AR and CN were 89%, 86% and 100%, and 95%, 87% and 100%, respectively.


CONCLUSIONS
Renal scintigraphy with (99m)Tc-DTPA showed a good overall accuracy in the detection of acute renal graft complications. It can be used as a reliable tool in the routine evaluation of these patients.
Sanches
Adelina
A
Division of Nuclear Medicine, Department of Radiology, Campinas State University, UNICAMP, Campinas, São Paulo, Brazil.
Etchebehere
Elba C S C
EC
Mazzali
Marilda
M
Filho
G Alves
GA
Lima
Mariana C L
MC
Santos
Allan O
AO
Ramos
Celso D
CD
Cardinalli
Izilda
I
Billis
Athanase
A
Camargo
Edwaldo E
EE