engleski

Tc-99m DTPA renal scyntigraphy using deconvolution analysis with six function images of the mean time to evaluate acute pyelonephritis

In 38 children with proven P-fimbriated E.coli acute pyelonephritis, Tc-99m DTPA dynamic renal scintigraphy in zoom mode using deconvolution analysis was performed and compared with Tc-99m DMSA scans. From dynamic study 6 functional images of the mean time were generated. Each functional image was separately analysed searching for focal areas of increased mean time inside the kidney contour, especially over kidney parenchyma. Time-activity curves from these areas were generated and analysed. Tc-99m DMSA scintigraphy showed generalized or focal decreased uptake in 32 (41.8%) kidneys, while deconvolution analysis of Tc-99m DTPA scintigraphy revealed pathological renographic curves in 58 (77.6%) kidneys. Prolonged whole kidney and normal renal parenchymal transit times (dilatation without obstruction) were found in 38 (50.0%) kidneys, while prolonged whole kidney and renal parenchymal transit times (dilatation with obstruction) were observed in 20 (27.6%) kidneys. Separate analysis of each of 6 functional images of the mean time showed focal areas of increased mean time in kidney parenchyma of 11 kidneys. Time activity curves from these areas showed in 5 cases sharp increase of activity on the descending part of the curve, which in our opinion might reflect the return of urine from collecting system into kidney cortex, i.e. intrarenal reflux. The results showed that in urinary tract with acute pyelonephritis urodynamic changes exist which may lead to an obstructive nephropathy and intrarenal reflux. Tc-99m DTPA renal scintigraphy in zoom mode using deconvolution analysis with the 6 functional images of the mean time has proved to be a valuable method in the evaluation of acute pyelonephritis, allowing dynamic and morphologic analysis of the urinary tract at the same time.

scintigraphy; pyelonephritis; DTPA; deconvolution

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