F – 15 or F + 20 diuretic renography protecol in patients with dilated upper urinary

مجله پزشكي هسته اي ايران

دوره 18 - شماره Supplement.1

Article Type: Original Article
Abstract: Introduction: Diuretic renal scan is preferred noninvasive investigation in evaluating upper urinary tract function and assessing upper tract dilatation or obstruction. Timing of diuretic administration is not universally standardized in renography. In the present study we compared F-15, F+20 diuretic renography protocols in patient with upper urinary tract dilatation. 
Methods: From Feb 2004 to Aug 2009, 48 patient were referred with flank pain and pyelocalyceal system dilatation without ureteral dilatation in ultrasonography IVP or retrograde pyelogram, F-15 and F+20 diuretic renal scans with TC-EC(Ethyiene dicysteine) were performed. Renal function data renograms were recorded and patients were undergone conservative or surgical therapy and followed up with physical exams and IVP or diuretic renal scan after 6 months and then we compared the results with two diuretic renal scan protocols. We used marginal homogeneity test to compare renograms and paired t-student test to compare renal function in two protocols. 
Results: Among 48 cases, 32 were male and 16 were female. Mean age were 17.8 ± 23 years. Ultrasound showed pyelocalyceal dilatation without ureteral dilatation, delayed pyelogram. The results were equivocal in 11 cases (22.91%) of F+20 scans whereas they had complete obstructive pattern in F-15 scans. 6 cases (12.58%) had nonobstructive pattern in F+20 but equivocal or obstructive pattern in F-15 scans. Obstructions were diagnosed in 31 cases (64.56%) of patient by F+20 scan and in 43 cases (91.44%) by F-15 scan. Renal split function didn’t change in both F-15 and F+20 protocols. 
Conclusion: According to equivocal results of F+20 diuretic renal scans, F-15 can reduce equivocal results of F+20 diuretic renal scans. Of course we recommend future investigations to approve or disapprove this hypothesis.