대한핵의학회지 (1967년~2009년)
대한핵의학회지 1999;33(1)57~8
소아의 상부 요관확장증에서 폐쇄 유무 감별에 있어 Tc-99m DTPA 이뇨 신장 신티그램의 유용성 ( The Value of Tc-99m DTPA Diuretic Renography for Assessment of Dilated Upper Urinary Tract in Children )
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Author 양기라(Ki Ra Yang),임계연(Gye Yeon Lim),손형선(Hyung Sun Sohn),한성태(Seong Tae Hahn),이재문(Jae Mun Lee),
Affiliation
Abstract

Purpose: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children upper urinary tract. Materials and Methods: We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. Results: Six patients required pyeloplasty and eight were managed conservatively. All 6 patients requiring pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans at 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonobstructive patterns in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth., nonobstructive patterns of initial scan were coverted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. Conclusion: Tc-99m DTPA diuretic renal scan with standarized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan results in the neonatal period requires follow-up scan to monitor development of the obstructive pattern.

Keyword Tc-99rn DTPA, Diuretic renal scan, Kidney pelvis, Hydronephrosis, Child
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