Monitoring of renal function using 99mTc-DMSA and 99mTc-DTPA scintigraphy in patients with spinal cord injury.
OBJECTIVE
The aim of this study was to assess the degree of alterations of renal function by using 99m-technetium dimercaptosuccinic acid ((99m)Tc-DMSA) and 99m-technetium diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) scintigraphy in spinal cord injury (SCI) patients.


METHODS
Twenty-two consecutive SCI (15 paraplegic and 7 tetraplegic) patients (mean age: 49.1±13.4 years) who had no urinary symptoms participated in this prospective study. The mean duration of injury was 45.6±48.8 months before. Sixteen patients had at least one urinary tract infection history. Renal cortical scintigraphy with (99m)Tc-DMSA, radionuclide renography with (99m)Tc-DTPA and renal ultrasound were performed within 2-week period.


RESULTS
Four (18%) patients had serious pathology on their kidneys such as unilateral or bilateral parenchymal scarring and increased background uptake in their renal cortical scintigraphy with (99m)Tc-DMSA. Two of them had grade 3-4 pelvicaliceal ectasia on ultrasound. Additionally, 2 of 18 remaining patients had grade 2 pelvicaliceal ectasia on ultrasound. Sixteen (73%) patients had markedly delayed or delayed and decreased functions of one or both of kidneys on radionuclide renography. However, only four patients had grade 2-4 pelvicaliceal ectasia and none of them had a finding of loosening of renal parenchyma.


CONCLUSIONS
Combined use of renal cortical scintigraphy and radionuclide renography appears to be contributive to renal ultrasound in the long-term follow-up of patients with SCI. Patients with abnormal findings should be closely followed, and early therapeutic interventions may enable lower morbidity and mortality rates in these patients.
Department of Physician Medicine and Rehabilitation, Hospital of the University of Trakya, Edirne, Turkey.
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D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000503:physiopathology; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D007677:Kidney Function Tests / Q000379:methods*; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000503:physiopathology; D007684:Kidney Tubules / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D019783:Technetium Tc 99m Dimercaptosuccinic Acid / Q000493:pharmacokinetics; D016284:Technetium Tc 99m Pentetate / Q000493:pharmacokinetics; D014463:Ultrasonography; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology; D014552:Urinary Tract Infections / Q000150:complications; D055815:Young Adult
D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D016284:Technetium Tc 99m Pentetate