Positive VUR on Indirect Cystography 99mTc DTPA

Posterior

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        This is a 15 year old male, with history of urinary tract infections and recent acute pyelonephritis in the right kidney. On the left, note activity in both kidneys. The right one is smaller, due to previous infections and scarring. The bladder is starting to fill up. On the right side, the bladder has filled up adequately.  Marked VUR in the right pelvis and ureter (arrow), severe (Grade IV-V in the International Radiological Classifiction). The disadvantage of the indirect procedure is the remaining tracer in the kidneys and excretory system which may prevent differentiation from true VUR.

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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