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Technetium-99m-L,L-ethylenedicysteine is more effective than technetium-99m diethylenetriamine penta-acetic acid for excluding obstruction in patients with pyelocalicinal dilation.
Lima, Mariana C L; de Lima, Marcelo Lopes; Pepe, Carlos F V; Etchebehere, Elba C S C; Santos, Allan O; Amorim, Bárbara J; Camargo, Edwaldo E; Ferreira, Ubirajara; Palma, Paulo C R; Ramos, Celso D.
Afiliação
  • Lima MC; Division of Nuclear Medicine, Department of Radiology, State University of Campinas, Campinas, São Paulo, Brazil. mar.lima@terra.com.br
Urology ; 76(2): 283-8, 2010 Aug.
Article em En | MEDLINE | ID: mdl-20206974
OBJECTIVE: To evaluate the utility of diuretic dynamic renal scintigraphy (DDRS) with technetium-99m-L,L-ethylenedicysteine ((99m)Tc-EC) in patients with indeterminate or possible false-positive results for urinary obstruction by technetium-99m diethylenetriamine penta-acetic acid ((99m)Tc-DTPA) DDRS. METHODS: A total of 92 patients (63 male; mean age, 16.6 +/- 21.25 years) were studied, with a total of 103 kidneys presenting indeterminate (20/103) or possible false-positive results for obstruction attributable to reduced renal function or severe kidney dilation (83/103) by (99m)Tc-DTPA DDRS (<60% of radiopharmaceutical excreted in 20 minutes-half-time clearance [T(1/2)] >15 minutes). Patients were reimaged after intravenous injection of (99m)Tc-EC, with dynamic images before and after furosemide administration using the same acquisition parameters applied in the previous (99m)Tc-DTPA study. Time interval between (99m)Tc-DTPA and (99m)Tc-EC renograms was 2-64 days. The percentage of excreted material 20 minutes after furosemide was calculated using both radiopharmaceuticals, and were statistically compared using the paired samples t test. RESULTS: The excretion after furosemide injection was 25.3% +/- 18.2% for (99m)Tc-DTPA and 41.2% +/- 26.1% for (99m)Tc-EC, with a statistically significant difference between both radiopharmaceuticals (P <.0001). Using (99m)Tc-EC obstruction was excluded in 36 of 103 kidneys, which excreted >60%. A total of 10 of 83 kidneys (12.0%) with an obstructive pattern by (99m)Tc-DTPA study turned out to be indeterminate by (99m)Tc-EC DDRS. There was an agreement between (99m)Tc-EC and (99m)Tc-DTPA studies in 54 of 83 kidneys with obstructive (65.1%) and in 3 of 20 (15.0%) with indeterminate patterns. CONCLUSIONS: (99m)Tc-EC was more effective than (99m)Tc-DTPA for excluding obstruction, presenting less false-positive and indeterminate results. (99m)Tc-EC can substitute (99m)Tc-DTPA to evaluate patients with urinary tract dilation.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Obstrução Ureteral / Compostos de Organotecnécio / Pentetato de Tecnécio Tc 99m / Compostos Radiofarmacêuticos / Cisteína / Pelve Renal Limite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Idioma: En Revista: Urology Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Obstrução Ureteral / Compostos de Organotecnécio / Pentetato de Tecnécio Tc 99m / Compostos Radiofarmacêuticos / Cisteína / Pelve Renal Limite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Idioma: En Revista: Urology Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos