Acquisition
- Use gammacamera with paralell high resolution collimator for imaging.
- Obtain a dynamic study for perfusion and effective plasma flow phase. If retention is present, inject furosemide 1 mg/kg (maximun = 40 mg) iv at 15 min to characterize response whether functional or obstructive. This is also valid in the captopril renogram. In the latter case, check the blood pressure at the end of the procedure before discharging the patient. Administer iv fluids if marked hypotension ensues.
- Delay images at 2 h are optional and may be useful in patients with obstructive uropathy to estimate retention severity.
- In patients with a renal transplant, functional images are non-invasive and should be used routinely to assess renal blood flow and function simultaneously. Renal transplant patients may be studied at least in the first, fourth and seventh postoperative day and the day before being discharged from the hospital.
- In renal transplant patients, delay imaging is useful to assess obstructive uropathy and radiotracer leaking into the abdominal cavity.
References:
1 Estorch M. Detección de las Cicatrices Renales y Valoracion de la Nefropatia Obstructiva, p: 411-418; Orellana P et al. Reflujo Vesicoureteral, p: 419-424 in: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.
2 Mandell G. A. et al., Procedure Guideline for Renal Cortical Scintigraphy in Children 2.0 Society Of Nuclear Medicine Procedure Guidelines Manual 2001-2002; 157-160.
3 Taylor A. et. al.. Consensus Report on ACE Inhibitor Renography Detecting Renovascular Hypertension. J Nucl Med 1996; 37:1876-1882.