title: Comparison of renal transplant scintigraphy with renal resistance index for prediction of early graft dysfunction and evaluation of acute tubular necrosis and acute rejection.
abstract: OBJECTIVE
  We discuss whether resistance index (RI) and renal scintigraphy obtained within 48 hours after operation could predict the early graft dysfunction. We also aimed to assess the uses of scintigraphy and RI in diagnosis of acute rejection (AR) and acute tubular necrosis (ATN).
  
  
  METHODS
  A total of 153 studies were performed in 109 patients. T½ of perfusion peak, perfusion curve grades, and accumulation index (R20/3) were used as scintigraphic parameters. Baseline studies obtained within 48 hours after transplantation were evaluated for prediction of early graft dysfunction. All data were then assessed for specific diagnosis.
  
  
  RESULTS
  Scintigraphic parameters were significantly higher in patients with delayed graft function (DGF) and slow graft function (SGF) than in patients with immediate graft function. These parameters in DGF were also considerably different from those in SGF. The mean RI was significantly high in DGF, but there was no difference between SGF and immediate graft function. In diagnostic groups, the mean values of all tests were significantly different between normal functioning grafts and pathological grafts (ATN + AR). There was no significant difference between AR and ATN. However, renal scintigraphy has higher sensitivity and specificity for AR as compared with RI of Doppler ultrasonography (US).
  
  
  CONCLUSIONS
  In predicting graft dysfunction and separating normal functioning graft from pathological graft (ATN + AR), renal scintigraphy provides more accurate information than Doppler US. Even though it is superior to Doppler US, renal scintigraphy also cannot reliably separate ATN from AR. The major advantage of renal scintigraphy is the early detection of reduced renal function.
authors.affiliation: From the *Department of Nuclear Medicine, Mugla University Hospital; †Department of Pathology, Mugla University Hospital, Merkez, Mugla; and Departments of ‡Nuclear Medicine and §Nephrology, Ege University Medical Faculty, Bornova, Izmir, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Yazici
authors.forename: Ayse
authors.initials: A
authors.lastname: Yazici
authors.forename: Aylin
authors.initials: A
authors.lastname: Oral
authors.forename: Aysegül
authors.initials: A
authors.lastname: Akgün
authors.forename: Huseyin
authors.initials: H
authors.lastname: Toz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D007684:Kidney Tubules / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011877:Radionuclide Imaging; D055815:Young Adult