Normal Images Transplant
Male 40 year old, kidney in the left abdominal quadrant normal sized. Perfusion is adequate, synchronously with aortic flow (left, upper image and right, time activity curves). The uptake of 99m Tc-MAG-3 is good and background activity in soft tissues is low. Note renographic functional images at bottom, with rapid uptake and washout into the bladder.
99mTc-MAG-3 Normal Images
In a normal perfusion study activity in the kidney transplant shows maximum counts between 6 and 8 seconds after the peak in the iliac artery. Peak renal activity should be higher than in blood activity. The time activity curve obtained in the flow phase, rises rapidly, with a steep slope and reach a peak higher than the arterial curve.
The functional phase can also be evaluated visually or using activity curves (renograms). In many centers renal function is estimated by simple visual analysis of images and curves from 1-30 minutes after injection of the tracer. Reaching a peak in a normal transplant between 2-5 minutes after injection. The images in the second or third minute is 3-5 times higher than the "background". Within five minutes there is clear visualization of the pelvicalyceal system. The concentration of the tracer in the collecting system and renal parenchyma decreases progressively and at 30 minutes activity in the kidney is less than half of the activity on the second or third minute. The renogram shows the same changes, with a sharp peak in the first 5 minutes, gradually decreases the activity to less than half at 30 minutes.
References:
1 Itoh K. , et al. 99mTc-MAG3: review of pharmacokinetics, clinical application
to renal diseases and quantification of renal function. Ann Nucl Med. 2001
Jun;15(3):179-90.
2 Etchebere, Elba, Ramos Celso Dario y Camargo, Edwaldo. Trasplante Renal.p: 425-433 en: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.
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