Positive VUR on Direct Cystography 99mTc DTPA

 

Posterior

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This is a 5 year old girl, with history of urinary tract infections and recently acute pyelonephritis in the right kidney. Ultrasound was normal. Underwent direct cystography with 99mTc-DTPA. In the first procedure,  bladder filling and emptying was complete. Small residual volume at the end. No activity was detected in excretory system.  This was explained by not emptying fully the bladder before  filling the bladder and administering the tracer . The second bladder filling presented above was positive. See the bladder shape, this time with intense homogeneous tracer distribution. Marked VUR in the right side, severe (GIV).

References:

Orellana P et al. Reflujo Vesicoureteral, p: 419-424 in: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.

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