DOI: https://doi.org/10.22141/2307-1257.7.2.2018.127396

Diagnostic role of radionuclide renography in patients with renovascular hypertension

P.O. Korol

Abstract


Background. Arterial hypertension due to the pathology of the renal artery, according to recent years, is observed in 10–15 % of patients with hypertensive disease; in 30 % of patients, it has a nephrogenic origin. The purpose was to investigate the role of radionuclide renography in patients with renovascular hypertension based on a retrospective analysis of the renograms. Materials and methods. 677 patients with renovascular hypertension (395 women and 282 men) aged 16 to 75 years were examined using renography method. The latter is based on the intravenous administration of 131I-hippuran at a rate of 2.5 kBq/kg and continuous recording for 20 minutes of radioactivity level above the kidneys with the help of UR 1-1 renograph sensors. Results. Based on the results of the analysis of the obtained data, the main types of renograms in patients with different forms of renovascular hypertension were identified. The first type is characterized by unchanged indicators of the renogram of a healthy kidney and a significant decrease in the amplitude of the curve reflecting the function of the stenotic kidney. The second type is characterized by unmodified renographic curve from the healthy kidney and complete non-function of the affected kidney. The third type was observed with bilateral lesions of the kidneys or of the perineal arteries with predominance of unilateral functional disorders. Conclusions. In order to optimize the examination of patients with renovascular hypertension, radionuclide renography is advisable to use after visualizing stenosis of the renal artery on the angiogram. This approach significantly increases the diagnostic value of renography, transforming it from the screening method into a technique for the functional evaluation of pathological changes in both the renal artery and the kidney itself.


Keywords


radionuclide renography; arterial hypertension; renal artery

References


Vishek V. Izotopnaia renografiia v klinicheskoi praktike: monografiia [Isotope renography in clinical practice: monograph]. Prague: Avicenum;1971. 216 p. (in Russian).

Korol' PO, Kashhenko OV, Shynkarenko NV. Diagnostic significance of dynamic kidney scan in patients who are administered immunodepressive therapy after liver transplantation, which is assigned immunodepressive therapy. Ukrainian Journal of Radiology. 2010;18(3):301-303. (in Ukrainian).

Lishmanov IuB, Chernov VI, Vesnina ZhV, et al, authors; Lishmanov IuB, Chernov VI, editors. Radionuklidnaia diagnostika dlia prakticheskikh vrachei [Radionuclide diagnostics for practical doctors]. Tomsk: STT; 2004. 394 p. (in Russian).

Samoilenko LE, Sergienko VB. The role of radionuclide methods of research in arterial hypertension. Sistemnye gipertenzii. 2007;(2):47-53. (in Russian).

Tarchenko IP, Bodarets'ka OI, Zozulya OO. Methods of instrumental and laboratory diagnostics of urinary tract pathology. In: Sakharchuk II, editor. Osnovy funktsional'noi' diagnostyky vnutrishnikh khvorob [Fundamentals of functional diagnostics of internal diseases]. Kyiv: Zdorov’ja; 2000. 221-244 pp. (in Ukrainian).

American College of Radiology. ACR-SPR technical standard for diagnostic procedure using radiopharmaceuticals Resolution 29 - 2016. Available from: https://www.acr.org/-/media/ACR/Files/Technical-Standards/Radiopharmaceuticals.pdf?la=en.

American College of Radiology. ACR-SPR practice parameter for the performance of renal scintigraphy Res 29 - 2017. Available from: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/RenalScint.pdf.

Prigent A, Cosgriff P, Gates GF, et al. Consensus report on quality control of quantitative measurements of renal function obtained from the renogram: International Consensus Committee from the Scientific Committee of Radionuclides in Nephrourology. Semin Nucl Med. 1999 Apr;29(2):146-59. PMID: 10321826.

Sfakianakis GN, Cavagnaro F, Zilleruelo G, et al. Diuretic MAG3 scintigraphy (F0) in acute pyelonephritis: regional parenchymal dysfunction and comparison with DMSA. J Nucl Med. 2000 Dec;41(12):1955-63. PMID: 11138678.

Boubaker A, Prior J, Antonescu C, Meyrat B, Frey P, Delaloye AB. F+0 renography in neonates and infants younger than 6 months: an accurate method to diagnose severe obstructive uropathy. J Nucl Med. 2001 Dec;42(12):1780-8. PMID: 11752073.

Sfakianakis GN, Cohen DJ., Braunstein RH, et al. MAG3-F0 scintigraphy in decision making for emergency intervention in renal colic after helical ct positive for a urolith. J Nucl Med. 2000 Nov;41(11):1813-22. PMID: 11079488.

Esteves EP, Taylor A, Manatunga A, Folks RD, Krishnan M, Garcia EV. 99mTc-MAG3 renography: normal values for MAG3 clearance and curve parameters, excretory parameters, and residual urine volume. AJR Am J Roentgenol. 2006 Dec;187(6):W610-7. doi: 10.2214/AJR.05.1550.

Hogg RJ, Furth S, Lemley KV, et al. National Kidney Foundation's Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents : evaluation, classification and stratification. Pediatrics. 2003 Jun;111(6 Pt 1):1416-21. PMID: 12777562.

Piepsz A. Radionuclide studies in paediatric nephro-urology. Eur J Radiol. 2002 Aug;43(2):146-53. doi: 10.1016/S0720-048X(02)00111-0.

Mandell GA, Cooper JA, Leonard JC, et al. Procedure guideline for diuretic renography in children. Society of Nuclear Medicine. J Nucl Med. 1997 Oct;38(10):1647-50. PMID: 9379208.

Veitch TA. Pediatric nuclear medicine. Part I: Developmental cues. J Nucl Med Technol. 2000 Mar;28(1):3-7; quiz 19. PMID: 10763774.

Veitch TA. Pediatric nuclear medicine. Part II: Common procedures and considerations. J Nucl Med Technol. 2000 Jun;28(2):69-75; quiz 82. PMID: 10824616.




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