Role of dynamic renal scintigraphy with Tc99m DTPA in symptomatic patients with horseshoe kidney

Aditi K Sehgal, Ravinder S Sethi, Padma A Namgyal, Deepa Kumar

Astrocyte 2016 3(2):86-89

Objectives: The purpose of this study was to diagnose obstructive hydronephrosis in symptomatic patients of horseshoe kidney with Technetium-99m (Tc-99m) diethylenetriamine pentaacetic acid (DTPA) diuretic renal scintigraphy. Patients and Methods: We retrospectively reviewed 30 symptomatic patients with horseshoe kidney who were referred to our department for Tc99m-DTPA/Tc99m L, L EC scan to look for subrenal drainage pattern from January 2011 to May 2016. Tc99m DTPA scan was done in all 30 patients. Tc99m dimercaptosuccinic acid III (DMSA-III) scan was done in 12 of these patients. Results: 30 symptomatic patients (21 adults and 9 children) with mean age 32.47 yrs and 5.55 years respectively with a known diagnosis of horse shoe kidney on ultrasonography (USG) were analysed with respect to patient symptoms, drainage pattern and consequences of stasis due to renal anomaly. Out of 30 patients (60 renal moieties), 24 were hydronephrotic as reported on USG by a competent radiologist. Out of these 24 moieties, 10 showed obstructed clearance pattern/slow sub-renal drainage and rest were normal. Other outcomes like asymmetrical cortical function, urolithiasis, Urinary tract infection (UTI) and scarring have also been described. Conclusion: DTPA renal scintigraphy is a non-invasive and sensitive investigation for the diagnosis of obstructive hydronephrosis in horseshoe kidney. It can very well be used in very young patients for an early diagnosis and management. Long term follow up would be advisable in these patients especially to monitor development of complications. Its importance along with USG cannot be downplayed as the added advantages like functional information, drainage pattern, differential function are necessary for a justified management protocol.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2iOTj5U
via IFTTT