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Imaging of renal cortex in nuclear medicine

2014, Journal of Clinical Excellence

Abstract

Acute pyelonephritis (APN) is the main predisposing factor for renal cortical scar (RCS) performing. Hypertension is a complication of RCS and appears in 10-20 Percent of patient in their life. Diagnosis and treatment of APN are necessary for prevention of RCS. The aim of this review is assessment of 99mTc-DMSA (99mTc-dimercaptosuccinic acid) scan value in diagnosis of APN and RCS and comparison of its results with other diagnostic methods such as radiology and ultrasonography. Ultrasonography (US) showed almost 39% of APN that diagnosed with 99mTC-DMSA scan. Computed Tomography Scan (CT scan) is a sensitive and effective method in diagnosis of APN and its complication. Spiral CT scan and Magnetic Resonance Imaging (MRI) are sensitive and relatively reliable tools in diagnosis of APN; however they are not practicable in the first evaluation and fallow up of infant and children with acute urinary tract infection. Power Doppler Ultrasonography (PDUS) demonstrated a sensitivity of 70 percent and a specificity of 85 percent in diagnosis of APN. 99m Tc-DMSA scan is the most sensitive diagnostic tool of APN and RCS with a sensitivity and specificity of 89-91 and 100 percent, respectively. Because 99m Tc-MAG3(99mTc-mercapto-acetylglycyl-glycyl-glycine)