Renal Cortical imaging is done by –
Correct Answer: DMSA
Description: Ans. is 'b' i.e., DMSAo For imaging of renal cortex Tc-99m-DMS A is used,o Other three agents (of options) are used for dynamic renal scintigraphy.Renal scintigraphy1) Static renal scintigraphyFor static renal scintigraphy Tc - 99m - DMSA (Dimercaptosuccinic acid) is used. DMSA is cleared by renal tubules. When DMSA is labeled with Tc - 99 and injected intravenously, it can be used to create an image of the renal cortex which reflects vascular flow and tubular function. It is called static scintigraphy because radiopharmaceutical is tubularly fixed in the renal cortex.Beside Tc - 99m - DMSA, other radiopharmaceuticals used for static scintigraphy are Tc - 99m - glucoheptone, (Tc-GH)Indications for static renal scintigraphy (Tc - 99m - DMSA) >Assessment of individual functionInvestigation of UTI (particularly in children)A ssessment of reflux nephropathy (scars)Space occupying lesions (cortical mass)Investigation of horse shoe, solitary or ectopic kidney2) Dynamic renal scintigraphy (functional imaging)For dynamic renal scintigraphy Tc - 99m - DTPA (Diethylene triamine pentaacetic acid) and Tc - 99m - MAG3 (mercaptoacetyltriglycine) and I-123-OIH (O - iodohippurate) are used.Tc - 99m - DTPA is filtered completely by the glomerulus but are not reabsorbed, metabolized or secreted by renal tubules. Therefore this agent can be used to measure GFR.Tc - 99m - MAG3 and I - 123 - OIH are secreted by renal tubules. These are used to determine effective renal plasma flow.Tc - 99m - MAG3 is the best (amongst three) for dynamic renal scintigraphy, but is costly.This is called dynamic scintigraphy because tracers are readily transported either by glomerulus or renal tubules (in contrast to static scintigraphy, where tracer is tubularly fixed in the renal cortex).Indications of dynamic renal scintigraphyi) Diagnosis of obstructed vs non - obstructed dilatationiv) Demonstration of vesico-urethral refluxii) Diagnosis of renal artery stenosisv) Assessment of renal transplantationiii) Assessment of perfusion in ARFvi) Renal trauma
Category:
Radiology
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