Diuretic Renal Imaging

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URINARY SYSTEM

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Theory and Criticism

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Diuretic Renal Imaging

ABNORMAL RESULTS

HETEROGENEOUS UPTAKE

ONE OR NO KIDNEY VISUAL

CLEARANCE HALF TIME OF <8 MIN OR >12 MIN

NORMAL RESULTS

BOTH KIDNEYS VISUAL

HOMOGENEOUS UPTAKE

CLEARANCE HALF TIME OF 8-12 MIN THUS SHOWING NORMAL RENOGRAM

IMAGING

IMAGE FOR AN ADDITIONAL 20 MIN AFTER FUROSEMIDE INJ.

POSTERIOR

STARTS IMMEDIATELY, 2 MIN FLOW FOLLOWED BY 18 MIN OF DYNAMICS (USUALLY)

FUROSEMIDE (LASIX)

USUALLY ADMINISTERED 15-20 MIN AFTER RPH INJECTION OR WHEN PELVIS IS DIALTED

1 mg/kg FOR CHILDREN

40 mg FOR ADULTS

INTERPRETATION

RENOGRAM

SHOWS TIME ACTIVITY CURVE

FINAL IMAGES

VISUAL UPTAKE

RADIOPHARMACEUTICALS

TC99m-DTPA (10-20 mCi)

TC99m-MAG3 (10-20 mCi)

INDICATIONS

EVALUTION OF RENAL FUNCTION AND URODYNAMICS

DISTINGUISH BETWEEN OBSTRUCTIVE HYDRONEPHROSIS AND NON-OBSTUCTIVE COLLECTING SYSTEM DIALATION

CONTRAINDICATIONS

MEDICATIONS THAT BLOCK TUBULAR SECRETION

RENAL ARTERIOGRAM USING IV IODINATED CONTRAST

PATIENT PREP

OFF ANY DIURETICS

WELL HYDRATED

OFF ACE INHIBITORS FOR 1 WEEK