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Titolo:
The use of renal scintigraphy in assessing the potential for recovery in the obstructed renal tract in children
Autore:
Thompson, A; Gough, DCS;
Indirizzi:
Royal Manchester Childrens Hosp, Dept Pediat Urol, Manchester M27 4HA, Lancs, England Royal Manchester Childrens Hosp Manchester Lancs England M27 4HA England
Titolo Testata:
BJU INTERNATIONAL
fascicolo: 9, volume: 87, anno: 2001,
pagine: 853 - 856
SICI:
1464-4096(200106)87:9<853:TUORSI>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
HYDRONEPHROSIS; MANAGEMENT;
Keywords:
urinary tract obstruction; DMSA scintigraphy; renography; functional recovery; surgical outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Gough, DCS Royal Manchester Childrens Hosp, Dept Pediat Urol, Manchester M27 4HA, Lancs, England Royal Manchester Childrens Hosp Manchester Lancs England M27 4HA
Citazione:
A. Thompson e D.C.S. Gough, "The use of renal scintigraphy in assessing the potential for recovery in the obstructed renal tract in children", BJU INT, 87(9), 2001, pp. 853-856

Abstract

Objective To assess the value of renal scintigraphy with Tc-99m-dimercaptosuccinic acid (DMSA) in predicting functional recovery after the surgical relief of obstructed kidneys in children. Patients and methods Forty-three children underwent surgery to relieve upper urinary tract obstruction; 37 had pelvi-ureteric junction obstruction and six had vesico-ureteric junction obstruction. The indication for surgery was a combination of an obstructed renogram with symptoms of either pain orpyelonephritis. Most children (41) had < 40% function on the affected sidebefore surgery, with just two having hyperfunction (>55%). In all patientsintravenous urography before surgery showed hydronephrosis, and a micturating cystogram was used to exclude coexisting reflux in the presence of an associated megaureter. Diuretic renography (using Tc-99m-mercaptoacetyl triglycine or I-123-hippuran) and DMSA scintigraphy were both carried out before surgery and the renography repeated 6 months afterward. Results The renographic drainage curves improved from obstructed to unobstructed or 'dilated unobstructed' on all postoperative studies, Regression analysis showed that preoperative DMSA scan was an excellent predictor of outcome (P<0.001) whilst the preoperative renogram was a relatively poor predictor of the functional result. In four patients where the initial renographic function was <10%, DMSA scintigraphy predicted correctly the capacity for recovery in three and the inability to improve in the fourth. Conclusion Before surgery, DMSA scintigraphy in children with upper urinary tract obstruction is a more useful estimate of probable long-term renal function than value from diuresis renography. If there is doubt about the desirability of reconstructive surgery, a DMSA scan may eliminate the need for more invasive methods of estimating recovery, e.g. a period of nephrostomy drainage.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 01:15:44