Quantitative Evaluation of Renal Parenchymal Mass With sup 99m Technetium Dimercapto-Succinic Acid Scintigraphy After Nephrolithotomy (original) (raw)
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Scintigraphic evaluation of the kidney
Romanian Journal of Military Medicine, 2015
There are more than one technique used to evaluate the kidney, besides the standard ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), there is also renal scintigraphy. The renal nuclear medicine procedures are grouped as in vitro (urine counting wells, basic probe detectors for clearance studies) and in vivo procedures (static and/or dynamic examinations done with planar gamma cameras, and single-photon emission computed tomography (SPECT) to determine kidney parameters or for cortical imaging). Renal scintigraphy has been a useful tool, since the early 1950s, in the diagnosis and management of many pathological changes in the kidney, especially in measuring renal function (e.g. obstructive/nonobstructive uropathies, renal inflammatory diseases, tumours, renal hypertension, and renal transplant viability). [1]
S.T.O.N.E. Nephrolithometry: Novel Surgical Classification System for Kidney Calculi
Urology, 2013
OBJECTIVE To, first, propose a novel scoring system to standardize reporting for percutaneous nephrolithotomy because the instruments currently available to predict the percutaneous nephrolithotomy outcomes are cumbersome, not validated, and of limited clinical utility; and, second, assess and predict the stone-free rates and perioperative parameters applying S.T.O.N.E. nephrolithometry. MATERIALS AND METHODS Five reproducible variables available from preoperative noncontrast-enhanced computed tomography were measured: stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence or stone density (E). RESULTS A total of 117 patients were included. The mean score was 7.7 (range 4-11). The stone-free rate after the first procedure was 80%. There were 18 complications (21%). The most frequent complications were postoperative sepsis and bleeding. The S.T.O.N.E. score correlated with the postoperative stone-free status (P ¼ .001). The patients rendered stone free had statistically significant lower scores than the patients with residual stones (6.8 vs 9.7, P ¼ .002). Additionally, the score correlated with the estimated blood loss (P ¼ .005), operative time (P ¼ .001), and length of hospital stay (P ¼ .001). CONCLUSION The novel scoring system we have presented was found to predict treatment success and the risk of perioperative complications after percutaneous nephrolithotomy. Reproducible, standardized parameters obtained from computed tomography imaging can be used for preoperative patient counseling, surgical planning, and evaluation of surgical outcomes across institutions and within medical studies. UROLOGY 81: 1154e1160, 2013.
Journal of Experimental and Clinical Medicine, 2012
Uzun süren üreteral obstrüksiyonun böbrek fonksiyon kaybına neden olduğu iyi bilinmektedir. Üriner sistem taşına bağlı herhangi bir obstrüksiyonun kontrastsız çok kesitli bilgisayarlı tomografi (KÇKBT) ile belirlenmesi tedavi zamanlaması hakkında karar vermek açısından çok önemlidir. Çalişmamızda deneysel hidronefroz oluşturulan ratlarda renal parankim dansitesinde meydana gelen değişiklikler KÇKBT ile değerlendirildi. Bu çalışmada sol üreterlerinde total veya parsiyel obstrüksiyon oluşturulmuş Spraque-Dawley ratların böbrek parankim dansiteleri deneyin 1.,3. ve 30. günlerinde KÇKBT ile değerlendirilerek, sham ve kontrol grubu ratların böbrek parankim dansiteleri ile karşılaştırıldı. Parsiyel üreteral obstrüksiyon oluşturulmuş ratların böbrek parankim dansiteleri ile kontrol grubunun böbrek parankim dansiteleri arasında anlamlı bir fark olmadığı saptandı. Bununla birlikte total üreteral obstrüksiyon oluşturulmuş ratların böbrek parankim dansitelerinin karşı taraf böbrekleri ve kontrol grubu ile karşılaştırıldığında anlamlı olarak azaldığı saptandı. Böbrek üst, orta ve alt segmentlerinin ortalama dansite değerleri benzerdi. Elde edilen bu bulguların insanlarda üreter obstrüksiyonun sonuçlarının değerlendirilmesinde yararlı olabileceğini düşünmekteyiz. KÇKBT değerlendirilmesinde renal parankim dansitesinin azalması renal parankimal hasarın bir göstergesi olabilir.
Evaluation of Renal Function by using Renal Scintigraphy and Creatinine Clearance
2015
This study was conducted in the period from July 2015 to October 2015 at the Radiation and Isotopes Center in Khartoum at nuclear medicine department and medical laboratory, the Data was collected from 85 patients with normal renal function, and was carried out in order to evaluate renal function using renal scintigraphy and creatinine clearance. 99mTc-DTPA were administered to the patient intravenously and gamma camera" Mediso" was use to detected the count and hence GFR were calculated and collection the urine over 24 hours from patient to calculate the volume of urine and urine creatinine and taken the serum creatinine then applied an equation formulae to calculate the creatinine clearance. The results showed that the GFR was inversely associated with the age and BMI 0.01 ml\years and 0.02 ml\kg\m 2 respectively. Creatinine clearance was inversely associated with age 0.03 ml\years and directly with BMI and 0.04 ml\kg\m 2. and It also showed a direct linear correlation between the total evaluation of renal function using isotope and creatinine clearance by correlation coefficient of 0.7 and regression coefficient of 1.02 ml. 49 4:5 a scatter plot show direct linear relationship between creatinine clearance results and patients age. 49 4:6 a scatter plot show direct linear relationship between creatinine clearance results and BMI .
Annals of Nuclear Medicine, 2003
Technetium-99m dimercaptosuccinic acid (Tc-99m DMSA) as a static renal agent is currently the most frequently used agent in the detection of renal scarring, and allows accurate calculation of differential renal function (DRF). But this agent has some disadvantages such as relatively higher radiation dose and time consumption. Methods: The purpose of this study was to evaluate the potential of summed image that obtained from parenchymal phase of the dynamic technetium-99m-N,N-ethylenedicysteine (Tc-99m EC) scintigraphy in the detection of renal parenchymal defects and in the estimation of DRF, and to compare the results of this method with those of Tc-99m DMSA scintigraphy. The uptake ratios of the kidney to body background were also calculated for these two methods. Twenty-nine children with various renal disorders underwent both static Tc-99m DMSA and dynamic Tc-99m EC scintigraphy. The cortical analysis of Tc-99m EC scintigraphy was performed on the summed image obtained from dynamic images using the time interval between the first 45-120 sec. Results: There was a very close correlation between these two methods with respect to DRF (r = 0.99). In the detection of renal parenchymal lesions, scintigraphy with Tc-99m DMSA detected more lesions, and the sensitivity and specificity of the summed Tc-99m EC images were calculated as 92.6% and 100%, respectively. In addition, the ratios of mean uptake values for Tc-99m DMSA and Tc-99m EC images were 7.59 ± 2.17 and 2.95 ± 0.91, respectively. This ratio of Tc-99m EC seems to be acceptable and allows good delineation of the kidneys. But, the main disadvantages of the summed Tc-99m EC images in comparison with static Tc-99m DMSA images are the use of only posterior projection that may be an important drawback in patients with abnormal kidney positions, lower image counts and higher pixel size because of dynamic acquisition. Conclusion: These results show that summed Tc-99m EC images with an acceptable high image contrast provide an accurate DRF calculation in patients without abnormal kidney positions and allow the detection of most renal parenchymal abnormalities. However, Tc-99m DMSA scintigraphy remains the gold standard method because of its well known advantages.
Radionuclide Imaging. An Update on the Use of Dynamic Renal Scintigraphy
Medicina Moderna - Modern Medicine, 2017
Renal scintigraphy is a nuclear medicine technique that uses medical radioactive isotopes for the evaluation of the renal function. Functional data complete clinical and anatomical data obtained through other imaging techniques and can assist the clinician in the diagnostic and management of various renal disorders. Radionuclide imaging provides important functional informations which complement anatomic evaluation performed by morphologic techniques-intravenous urography, ultrasound imaging, computerized tomography (CT) or magnetic resonance imaging (MRI). It also have the advantage of evaluating the functional status of each kidney-information that cannot be obtained through biochemical assessment of serum creatinine and blood urea nytrogen (BUN). The current work will focus on the dynamic scintigraphy, protocol of examination, quantitative parameters and current indications, with emphasize on the obstructive renal disease.
Radionuclide distinction of vascular and non-vascular lesions of the kidney
Canadian Medical Association journal
THE renal scanning agents such as radiochlormerodrin, radiohippurate, technetium-99m-iron-ascorbic acid complex1 and indium-113m -diethylenetriaminepentaacetic acid (DTPA)2 depend upon the integrity of the nephron for concentration. Lesions which replace or displace the functioning parenchyma will be visualized on the scan as areas of re¬ duced or absent radioactivity. Differentiation between a vascular and non-vascular lesion, and in particular between cyst and malignant neo¬ plasm, cannot be made. However, by injecting intravenously a sufficient quantity of a shortlived radionuclide test agent, and then, with a rapid imaging device, taking serial five-second scans of the kidney from the time of administra¬ tion, the presence of radioactivity in the defect can be construed as being the result of its vascular supply. On the other hand, the absence of radioactivity in the defect may be interpreted as an absence of vascularity. Thus a distinction between a vascular and non-vascular lesion can be made with an innocuous intravenous injec¬ tion. Early experience with this technique using radiopertechnetate (99mTc04) as the test agent, and the gamma-ray scintillation cameraj as the rapid imaging device, has been reported pre¬ viously.3* 4 The present communication is an analysis of 100 consecutive cases which include cysts, malignant neoplasms, abscesses, hamartomas, arteriovenous malformations and renal pel¬ vic tumours .