Albatros Fighters in action by John F. Connors

By John F. Connors


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Villani et al. The following technetium-99m-labeled mercaptoacetyltriglycine (MAG-3) renography revealed a poor right split renal function and right kidney hypoplasia with evidence at the right side of megaureter and slow urinary drainage but absence of obstructive urinary pattern (no diuretic injection was necessary). At the last clinical follow-up, the patient remained asymptomatic. The management of the patient is actually based on clinical and ultrasonographic evaluations (Fig. 3). b c d Fig.

The girl remained asymptomatic. Split renal function was stable (Fig. 13). b c a e f d Fig. 13 MAG3 dynamic renal scan: dynamic images (a) show good and homogeneous radiotracer uptake and normal drainage in left kidney; right kidney is larger than the other one, with good radiotracer uptake and nonhomogeneous intraparenchymal distribution; a large area devoid of tracer corresponding to very dilated renal pelvis and collecting system is evident, and drainage is poor; renograms (b) confirm normal function and drainage of left kidney and normal function but poor drainage (“plateau pattern”) of right kidney (left DRF: 48 %; right DRF: 52 %).

DMSA scan defines very well the presence of renal scarring, providing essential information for the clinical management of vesicoureteral reflux [15]. Nuclear medicine also has a role in the diagnosis of vesicoureteral reflux, traditionally entrusted to voiding cystourethrography. Both methods of radionuclide cystography, direct and indirect, can be used. The advantage of radionuclide cystography is the lower radiation dose compared to VCUG. The indirect cystography also has the advantage of not requiring catheterization of the bladder, although it requires the active cooperation of the patient, who has to be toilet-trained; this technique is therefore reserved for children over the age of 2–3 years.

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