technetium-tc-99m-gluceptate and Postoperative-Complications

This article describes the role of nuclear medicine in the evaluation of the genitourinary tract. The technical aspects of radionuclide imaging (radiopharmaceuticals, radiation dosimetry, instrumentation, and method) are briefly presented, and each of the indications for renal scintigraphy--including the evaluation of differential renal function, hypertension, obstruction, renal transplants, masses, trauma, congenital anomalies, vesicoureteral reflux, and infection--are discussed. The relative advantages and disadvantages of radionuclide imaging with respect to alternative radiographic examinations (such as intravenous urography, ultrasonography, CT, angiography, and magnetic resonance imaging) are emphasized wherever applicable.

Topics: Graft Rejection; Humans; Hypertension, Renovascular; Iodohippuric Acid; Kidney; Kidney Function Tests; Kidney Neoplasms; Kidney Transplantation; Kidney Tubular Necrosis, Acute; Male; Organotechnetium Compounds; Pentetic Acid; Postoperative Complications; Pyelonephritis; Radioisotope Renography; Spermatic Cord Torsion; Succimer; Sugar Acids; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate; Ureteral Obstruction; Urinary Tract; Vesico-Ureteral Reflux

We report a 15-year-old girl who developed a ureteral perforation soon after living-related donor renal transplantation. Her presentation was unusual in that a symptomatic pleural effusion accumulated as an extension of the perinephric urine collection. Recognition and surgical correction of the ureteral pathology led to resolution of respiratory symptomatology and full recovery of renal function.

Topics: Adolescent; Diagnosis, Differential; Female; Humans; Kidney Transplantation; Organotechnetium Compounds; Pleural Effusion; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Sugar Acids; Ureteral Diseases

Post-transplant hypertension can be a diagnostic dilemma. In a select population of pediatric patients, in whom other diagnostic methods failed to reveal an abnormality, renal cortical SPECT imaging, using either Tc-99m GH or Tc-99m DMSA, revealed information that was not apparent on conventional planar renal scintigraphy. Abnormalities detected by this methodology included unsuspected renal infarct and areas of segmental perfusion deficit. The authors conclude that this methodology is a valuable tool in the evaluation of post renal transplantation hypertension in pediatric patients.

Topics: Adolescent; Adult; Child; Female; Humans; Hypertension, Renal; Kidney Cortex; Kidney Transplantation; Male; Organotechnetium Compounds; Postoperative Complications; Succimer; Sugar Acids; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed, Single-Photon

To determine the value of scintigraphy to detect posttransplantation complications of the allografted pancreas, we retrospectively reviewed 209 scintigrams obtained with 99mTc-sulfur colloid (99mTc-SC) and 99mTc-glucoheptonate (99mTc-GH). The scintigraphic studies were performed in 37 recipients of simultaneous renal and pancreatic allografts harvested from the same donor. 99mTc-SC was used as an indicator of thrombotic vasculitis; pancreatic perfusion and blood-pool parameters were monitored with 99mTc-GH. In 11 of the 37 recipients, scintigraphic abnormalities suggested posttransplantation infarction. Recurrent episodes of acute rejection of the pancreatic allograft, which always coincided with acute rejection of the renal allograft, were monitored in 24 recipients. Rejection-induced ischemic pancreatitis was suggested in 12 of the 24 recipients and persisted in 10 recipients for several weeks after improvement of renal allograft rejection. Pancreatic atrophy was suggested scintigraphically in 16 of the 24 recipients with recurrent episodes of rejection. Spontaneous pancreatic-duct obstruction and obstructive pancreatitis were associated with a scintigraphic pattern similar to that of rejection-induced ischemic pancreatitis. We concluded that the specific radionuclides used in this series are useful for the surveillance and assessment of posttransplantation pancreatic infarction, acute rejection, pancreatitis, and atrophy.

Topics: Adult; Graft Rejection; Humans; Kidney; Kidney Transplantation; Middle Aged; Organotechnetium Compounds; Pancreas; Pancreas Transplantation; Postoperative Complications; Radionuclide Imaging; Retrospective Studies; Sugar Acids; Technetium; Technetium Tc 99m Sulfur Colloid

Thirteen consecutive patients who had undergone renal transplantation were scanned 24 hours after glucoheptonate injection to document the incidence of gastrointestinal activity mimicking urinary extravasation. In six of the 13 patients, the activity was clearly within the small bowel or the colon but, in seven patients, the activity was noted surrounding the renal allograft. Using scintigraphy alone, it could not be determined whether this appearance represented cecal activity or urinary extravasation.

Topics: Adult; Cecum; Colon; Female; Gallbladder; Humans; Intestine, Small; Kidney; Kidney Transplantation; Male; Organotechnetium Compounds; Postoperative Complications; Postoperative Period; Radionuclide Imaging; Sugar Acids; Technetium; Time Factors; Ultrasonography; Urine

Urinary leakage after kidney transplantation is a serious complication. In a retrospective study we analyzed 8 relevant cases of 14 patients with urinary leakage. In these eight patients kidney scintigraphy indicated the presence of urinary extravasation. Compared with other imaging modalities such as IV urography, cystography and ultrasound, scintigraphy seems to be an easy and safe method to detect urinary leakage. Moreover scintigraphic examination may suggest leakage, while this may not be clinically evident or suspected.

Topics: Humans; Kidney; Kidney Transplantation; Organotechnetium Compounds; Postoperative Complications; Radionuclide Imaging; Sugar Acids; Technetium; Transplantation, Homologous; Urinary Bladder; Urine; Urologic Diseases