Evaluation of neonatal hydronephrosis with diuretic renography
نویسندگان
چکیده مقاله:
The common use of maternal ultrasonography has increased the apparent incidence of neonatal hydronephrosis. Many of these cases are found to have partial obstruction at the ureteropelvic junction (UPJ). These patients are safely managed in our institution with careful observation and only occasionally require surgical intervention. The authors present two contrasting cases of suspected UPJ obstruction in the neonatal period. The diagnostic evaluation and management in these two patients with similar presentation and markedly different outcome are discussed. The role of various imaging modalities including voiding cystourethrography (VCUG), intravenous pyelography (rVP), ultrasonography (US) and diuretic radionuclide renography was discussed. The relationship of normalized renal uptake and diuretic clearance half-time (Tl/2) with outcome was examined in 50 patients with prenatally diagnosed hydronephrosis. The normalized uptake value is the fraction of the total Tc99m DTPA extracted by each kidney between 60 and 120 seconds following the injection of the patient There was a statistically significant difference in the renal uptake and Tl/2 in those kidneys that subsequently required surgery compared to those wtich were managed conservatively. The predictive value of renal uptake and Tl/2 in identifying those patients who require surgical correction is not yet fully defined.
منابع مشابه
evaluation of neonatal hydronephrosis with diuretic renography
the common use of maternal ultrasonography has increased the apparent incidence of neonatal hydronephrosis. many of these cases are found to have partial obstruction at the ureteropelvic junction (upj). these patients are safely managed in our institution with careful observation and only occasionally require surgical intervention. the authors present two contrasting cases of suspected upj obst...
متن کاملThe role of diuretic renography in the evaluation of obstructed hydronephrosis after pediatric pyeloplasty.
BACKGROUND The purpose of this study was to clarify the value of renal drainage half-time in the evaluation of pediatric hydronephrosis after dismembered pyeloplasty. METHODS We reviewed the records of 30 children who underwent dismembered pyeloplasty for unilateral ureteropelvic junction obstruction with no other associated urological abnormality. The follow-up duration was more than 5 years...
متن کاملCan renal doppler sonography replace diuretic radionuclide renography in infants with hydronephrosis?
Reliable differentiation between obstructive and non-obstructive hydronephrosis is decisive for the further therapeutic management in infants. The results of renal Doppler sonography were compared with diuretic radionuclide renography and with the follow-up results in 33 patients (range: 21 to 98 days). In Doppler sonography, a resistive index (RI) of > 0.9 was considered to be abnormal in the ...
متن کامل99mTc-DTPA Diuretic Renography with 3 hours late output fraction in the evaluation of hydronephrosis in children.
OBJECTIVE Dynamic renal scintigraphy complemented by late gravity assisted postvoid images to 60 minutes is a frequently used diagnostic test in the evaluation of hydrone¬phrosis. The objective of this study is to evaluate the effectiveness in acquiring images at 180 minutes to calculate the late output fraction (LOF) of 99mTc-DTPA in the diagnosis of ureteropelvic junction obstruction (UPJO). ...
متن کاملEvaluation of ureteropelvic junction obstruction (UPJO) by diuretic renography.
Of 52 cases with 56 affected renal units having symptoms and signs suggestive of Ureteropelvic Junction Obstruction (UPJO) evaluated by conventional (F + 15) diuretic renography where frusemide is given 15 minutes post-injection of radiopharmaceutical m99TC.DTPA.F + 15, twelve (21%) showed a good clearance (group A), 16 (28%) showed partial (group B) and 28 (50%) a poor clearance pattern (group...
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عنوان ژورنال
دوره 6 شماره 1
صفحات 6- 21
تاریخ انتشار 1998-12-01
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