The absent kidney in 99Tcm-MAG3 renogram: a dramatic reversible consequence of contrast nephrotoxicity superimposed on renal obstruction.
99Tcm-mercaptoacetyltriglycine (MAG3) renogram is a robust imaging technique used to delineate upper urinary tract obstruction. The changes observed on the renogram are often reversible on relief of obstruction. We present two cases illustrating the extreme consequence of contrast nephrotoxicity on pre-existing obstructed kidneys. In one case, this led to severe impairment of perfusion and uptake observed on 99Tcm-MAG3 renogram and in the second case virtual non-visualization of the obstructed kidney. Subsequent treatment of obstruction, led to dramatic improvement in renal function. It is important for clinicians, nuclear medicine physicians and radiologists to be aware of the potential of contrast nephrotoxicity in obstructed kidneys.
Kayani
I
I
Institute of Nuclear Medicine, Middlesex Hospital, Mortimer Street, London W1T 3AA, UK.
Groves
A M
AM
Syed
R
R
Nagabushan
N
N
Pakzad
F
F
Prvulovich
E M
EM
Bomanji
J B
JB
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000000981:diagnostic imaging; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011866:Radioisotope Renography / Q000009:adverse effects*; D019275:Radiopharmaceuticals / Q000009:adverse effects*; D017263:Technetium Tc 99m Mertiatide / Q000009:adverse effects*; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000150:complications / Q000000981:diagnostic imaging*
D003287:Contrast Media; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide