Purpose: The aim of this study is to investigate possible reasons of ureter visualization on Tc-99m DMSA scintigraphy. Methods:The planar static renal scintigraphies of pediatric patients (n=2290) who attended for any reason between January 2009 and May 2015 were analyzed retrospectively by the same nuclear medicine physician. In our analysis 15 patients (12 Male (M), 3 Female (F); 0-12, mean: 4 ± 3, 8 years old) were included in the study due to bilateral or unilateral ureter visualization on Tc-99m DMSA scintigraphy. Results:In the visual assessment of scintigraphies, there were 7 patients with bilateral visualization and 8 patients (right in 4 patients, left in 4 patients) with unilateral. Additionally increased background activity was observed in two patients. Cortical defects and/or atrophy of kidneys were observed in 10 (66%) of the patients. The background pathology in these patients were posterior urethral valve (n=3), neurogenic bladder due to meningomyelocele (n=4), vesicoureteral reflux (n=3), urethral atresia (n=2), ureterovesical obstruction (n=1) and unknown (n=2). Conclusion:Ureter visualization on Tc-99m DMSA imaging usually accompanies severe kidney damage and ureteral or bladder pathology. Additionally this finding may point out the patients who could not be corrected completely by the surgical way but this issue has to be evaluated by future studies.
Purpose: We aimed to retrospectively compare the surgical and nonsurgical follow-up results of ureteropelvic junction obstruction without diuretic response. Methods:Twenty nine pediatric patients (10 Female (F), 19 Male (M); mean: 4.4 ± 3.96 years old, range: 0-15) without diuretic response were subject of this study. The diuretic renography, intravenous pyelography, voiding and ultrasonography were performed within one month and were compared with control ultrasonography and/or diuretic renography results in 7.4 ± 6.7 month follow-up.Results: Among patients with surgical follow-up 11 (100%) had recovery. In the follow-up group which consist of 18 patients 7 patients (39%) had recovery, 5 had stable disease and 6 had additional pathologies (one ureter dilatation, infection in three, one worsening of diuretic response, one volume loss). Conclusion:In patients without diuretic response in scintigraphy even without conclusive morphological results, surgery is more appropriate approach.
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