Renal scintigraphy

Renal scintigraphy, alo called nuclear renal scan, refers to using nuclear imaging to image the kidney and its function.

Static renal scintigraphy

Static renal scintigraphy is used to accurately visualise the renal morphology and to measure loss of renal cortex. One can measure relative ratio of renal function between the two kidneys. The radiopharmaceutical 99mTc-DMSA is used, which accumulates in the renal parenchyme but is not excreted. Imaging is performed 3 hours after injection

Indications:

• Pyelonephritis
• Renal infarction
• Acute renal failure
• Hydronephrosis

Dynamic renal scintigraphy

Dynamic renal scintigraphy, also called camera renography, is used to accurately measure the kidney function. The radiopharmaceutical 99mTc-DTPA is used to measure glomerular function while 99mTc-MAG3 is used for for tubular secretion.

Indications:

• Obstructive renal disease
• Hypertension
• Measuring GFR

If one is uncertain whether urinary output is decreased due to functional problems with the kidney or anatomical obstruction, one can obtain images before and after administration of a loop diuretic like furosemide. If furosemide improves excretion the obstruction is anatomical, if it doesn’t then it’s a functional problem of the kidney.

Dynamic renal scintigraphy gives a time-activity curve, a renogram with 3 phases:

• Phase I – perfusion
• Phase II – filtration or secretion function
• Phase III – excretion function