Optimal scintigraphic evaluation of a hydronephrotic horseshoe kidney.
A 25-y-old man with horseshoe kidney was referred for diuretic-augmented renal scintigraphy. Single-detector dynamic posterior imaging was performed and revealed asymmetric retention of radiotracer in the left collecting system. Renal scintigraphy was repeated with a modified protocol. Dynamic imaging was performed this time using dual-detector acquisition of both anterior and posterior data. Thereafter, pregravity and subsequently postgravity static images were obtained in both anterior and posterior projections. This second study showed near-complete emptying of the left collecting system. This case illustrates the utility of using simultaneous anterior and posterior imaging and geometric mean calculations for functional analysis and also highlights the value of physiologic maneuvers to augment the traditional diuretic challenge.
Nuclear Medicine Section, Department of Radiology, Boston University Medical Center, Boston, MA, USA.
Mark L
ML
Lessne
Nirav P
NP
Shah
James F
JF
Stinchon
Mary E
ME
Cross
M Elizabeth
ME
Oates
D000328:Adult; D002985:Clinical Protocols; D004232:Diuretics / Q000008:administration & dosage; D053159:Dysuria; D005665:Furosemide / Q000008:administration & dosage; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D011866:Radioisotope Renography / Q000187:drug effects; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D016683:Supine Position; D017263:Technetium Tc 99m Mertiatide / Q000493:pharmacokinetics; D013997:Time Factors; D014055:Tomography, Emission-Computed; D014517:Ureteral Obstruction; D016138:Walking
D004232:Diuretics; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; D005665:Furosemide