Abstract
We present the results obtained in the follow-up of 66 children with vesico-ureteric reflux (VUR) of different grades (111 refluxing renal units, RU; the VUR being bilateral in 47 children), employing the renal cortical agent 99mTc-aprotinin (TcA). Together with the visual inspection of the scan, we adopted a quantitative approach, expressing the results as the split percent uptake of the injected dose. The detection of morphological anomalies was more frequent in the cases of more severe reflux. Scars were noted in 38 RU, with a higher prevalence in more severe grades, except for grade V where severe impairment was more frequent. With regard to the amount of functioning parenchyma, the probability of a significant loss of nephrons (expressed by a low uptake of TcA), rose with the grades, although the higher grades were not invariably associated with parenchymal failure. The abnormality detection rate is higher by about 2:1 with the TcA scan than with other diagnostic modalities such as i.v. pyelography or echography. No differences were found between RU with or without scars as regards evolution over time; only when the TcA uptake at presentation was lower than 10% was the normal development of the RU likely to be hindered. From these data it can be concluded that early diagnosis is the key factor in the management of these children with VUR; the morpho-functional assessment with TcA uptake is probably the most effective technique for the detection of parenchymal abnormalities. In addition, the test has a high prognostic value, an uptake lower than 10% indicating an unfavourable prognosis. Therefore, the test should be included in the work-up of children with urinary tract infection who are known or suspected to have VUR, and in the follow-up after medical or surgical treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 89-95 |
| Number of pages | 7 |
| Journal | Journal of nuclear biology and medicine (Turin, Italy : 1991) |
| Volume | 38 |
| Issue number | 1 |
| Publication status | Published - 1994 |
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Keywords
- Tc-aprotinin
- renal scan
- vesico-ureteric reflux
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Cortical kidney scan evaluation in the follow-up of children with vesico-ureteric reflux. / Aprile, C.; Saponaro, R.; Di Maio, D.; Beluffi, G.; Chiari, G.; Ruggiero, R.; Cannizzaro, G.; Avolio, L.
In: Journal of nuclear biology and medicine (Turin, Italy : 1991), Vol. 38, No. 1, 1994, p. 89-95.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cortical kidney scan evaluation in the follow-up of children with vesico-ureteric reflux
AU - Aprile, C.
AU - Saponaro, R.
AU - Di Maio, D.
AU - Beluffi, G.
AU - Chiari, G.
AU - Ruggiero, R.
AU - Cannizzaro, G.
AU - Avolio, L.
PY - 1994
Y1 - 1994
N2 - We present the results obtained in the follow-up of 66 children with vesico-ureteric reflux (VUR) of different grades (111 refluxing renal units, RU; the VUR being bilateral in 47 children), employing the renal cortical agent 99mTc-aprotinin (TcA). Together with the visual inspection of the scan, we adopted a quantitative approach, expressing the results as the split percent uptake of the injected dose. The detection of morphological anomalies was more frequent in the cases of more severe reflux. Scars were noted in 38 RU, with a higher prevalence in more severe grades, except for grade V where severe impairment was more frequent. With regard to the amount of functioning parenchyma, the probability of a significant loss of nephrons (expressed by a low uptake of TcA), rose with the grades, although the higher grades were not invariably associated with parenchymal failure. The abnormality detection rate is higher by about 2:1 with the TcA scan than with other diagnostic modalities such as i.v. pyelography or echography. No differences were found between RU with or without scars as regards evolution over time; only when the TcA uptake at presentation was lower than 10% was the normal development of the RU likely to be hindered. From these data it can be concluded that early diagnosis is the key factor in the management of these children with VUR; the morpho-functional assessment with TcA uptake is probably the most effective technique for the detection of parenchymal abnormalities. In addition, the test has a high prognostic value, an uptake lower than 10% indicating an unfavourable prognosis. Therefore, the test should be included in the work-up of children with urinary tract infection who are known or suspected to have VUR, and in the follow-up after medical or surgical treatment.
AB - We present the results obtained in the follow-up of 66 children with vesico-ureteric reflux (VUR) of different grades (111 refluxing renal units, RU; the VUR being bilateral in 47 children), employing the renal cortical agent 99mTc-aprotinin (TcA). Together with the visual inspection of the scan, we adopted a quantitative approach, expressing the results as the split percent uptake of the injected dose. The detection of morphological anomalies was more frequent in the cases of more severe reflux. Scars were noted in 38 RU, with a higher prevalence in more severe grades, except for grade V where severe impairment was more frequent. With regard to the amount of functioning parenchyma, the probability of a significant loss of nephrons (expressed by a low uptake of TcA), rose with the grades, although the higher grades were not invariably associated with parenchymal failure. The abnormality detection rate is higher by about 2:1 with the TcA scan than with other diagnostic modalities such as i.v. pyelography or echography. No differences were found between RU with or without scars as regards evolution over time; only when the TcA uptake at presentation was lower than 10% was the normal development of the RU likely to be hindered. From these data it can be concluded that early diagnosis is the key factor in the management of these children with VUR; the morpho-functional assessment with TcA uptake is probably the most effective technique for the detection of parenchymal abnormalities. In addition, the test has a high prognostic value, an uptake lower than 10% indicating an unfavourable prognosis. Therefore, the test should be included in the work-up of children with urinary tract infection who are known or suspected to have VUR, and in the follow-up after medical or surgical treatment.
KW - Tc-aprotinin
KW - renal scan
KW - vesico-ureteric reflux
UR - http://www.scopus.com/inward/record.url?scp=0028234831&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028234831&partnerID=8YFLogxK
M3 - Article
VL - 38
SP - 89
EP - 95
JO - Journal of nuclear biology and medicine (Turin, Italy : 1991)
JF - Journal of nuclear biology and medicine (Turin, Italy : 1991)
SN - 0368-3249
IS - 1
ER -