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• W1977763389 abstract "No AccessJournal of UrologyPediatric Urology1 May 1998A PROSPECTIVE RANDOMIZED TRIAL COMPARING 2 DIURESIS RENOGRAPHY TECHNIQUES FOR EVALUATION OF SUSPECTED UPPER URINARY TRACT OBSTRUCTION IN CHILDRENis corrected byDIURESIS RENOGRAPHY TECHNIQUES M.M.R. FODA, C.T. GATFIELD, M. MATZINGER, V. BRIGGS, G. WELLS, S. WALKER, and J.F. SCHILLINGER M.M.R. FODAM.M.R. FODA More articles by this author , C.T. GATFIELDC.T. GATFIELD More articles by this author , M. MATZINGERM. MATZINGER More articles by this author , V. BRIGGSV. BRIGGS More articles by this author , G. WELLSG. WELLS More articles by this author , S. WALKERS. WALKER More articles by this author , and J.F. SCHILLINGERJ.F. SCHILLINGER More articles by this author View All Author Informationhttps://doi.org/10.1097/00005392-199805000-00094AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compare the diagnostic impact of 2 diuresis renography techniques for evaluation of suspected upper urinary tract obstruction in children. Materials and Methods: A total of 72 children were randomly assigned to 1 of 2 standardized diuresis renography protocols. The protocols were identical, except for the time of furosemide (F) injection. In the F+20 scans furosemide was given 20 minutes after the99m technetium pentetic acid radiopharmaceutical. With the modified F-15 scans furosemide was injected 15 minutes before renography. Hydration, bladder catheterization, urine output determination, radiopharmaceutical injection and scan acquisition were identical. Renography outcomes (obstructed, nonobstructed or equivocal) were analyzed for the investigated side(s) and for the contralateral side, which was used as a control in children with suspected unilateral obstruction. Chi-square test was used to compare the percentage of obstructed and nonobstructed scans of both protocols. Fisher's exact test was used to compare the nonobstructed scans and equivocal results of both protocols. Results: Of the 96 scans performed 8 were excluded because of technical problems. The remaining scans included 44 F+20 and 44 F-15. Of the 88 scans 10 were used to evaluate possible bilateral obstruction. A total of 48 boys and 24 girls were evaluated. Because 2 children had a solitary kidney each, the total number of renal units studied for outcome was 174. The F-15 scan showed 7 times more obstruction than the F+20 scan on the investigated side, and this difference was statistically significant. No obstruction was diagnosed on the contralateral side with either technique when used to investigate cases of suspected unilateral obstruction. Conclusions: The timing of the furosemide injection (F-15 scan versus F+20) has a significant impact on the obstructive versus nonobstructive renography results when evaluating children with suspected upper urinary tract obstruction. References 1 : Urinary tract obstruction in children. J. Urol.1995; 154: 1874. Link, Google Scholar 2 : Transitional hydronephrosis of the newborn and infant. J. Urol.1990; 144: 579. Link, Google Scholar 3 : The “well tempered” diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephrosis. A report from combined meetings of The Society for Fetal Urology and members of The Pediatric Nuclear Medicine Council-The Society of Nuclear Medicine. J. Nucl. Med.1992; 33: 2047. Google Scholar 4 : “Well-tempered” diuresis renography: its historical development, physiological and technical pitfalls, and standardized protocol. Sem. Nucl. Med.1992; 22: 74. Google Scholar 5 : Problems with the interpretation of the diuretic renogram in the diagnosis of obstruction. Curr. Opin. Urol.1993; 3: 455. Google Scholar 6 : Imaging and follow up of neonatal hydronephrosis. Curr. Opin. Urol.1995; 5: 75. Google Scholar 7 : Intermittent hydronephrosis: a diagnostic challenge. J. Urol.1988; 140: 1222. Abstract, Google Scholar 8 : Diuresis renography. Recent advances and recommended protocols. Brit. J. Urol.1992; 69: 113. Google Scholar 9 : Modified method of diuresis renography for the assessment of equivocal pelviureteric junction obstruction. Brit. J. Urol.1987; 59: 10. Google Scholar 10 : The F-15 diuresis renogram in suspected obstruction of the upper urinary tract. Brit. J. Urol.1992; 69: 126. Google Scholar 11 : Diuretic-induced urinary flow rates at varying clearances and their relevance to the performance and interpretation of diuresis renography. Brit. J. Urol.1988; 61: 14. Google Scholar 12 : The importance of renal function in the interpretation of diuresis renography. Brit. J. Urol.1992; 69: 121. Google Scholar 13 : When to operate on neonatal hydronephrosis. Urology1993; 42: 617. Google Scholar 14 : Hydronephrosis: when is obstruction not obstruction?. Urol. Clin. N. Amer.1995; 22: 31. Google Scholar From the Division of Urology and Department of Radiology, Children's Hospital of Eastern Ontario, Clinical Epidemiology Unit, Loeb Research Unit and Departments of Medicine, and Community Medicine and Epidemiology, University of Ottawa, Ottawa, Ontario, Canada.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of Urology9 Nov 2018DIURESIS RENOGRAPHY TECHNIQUES Volume 159Issue 5May 1998Page: 1691-1693 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information M.M.R. FODA More articles by this author C.T. GATFIELD More articles by this author M. MATZINGER More articles by this author V. BRIGGS More articles by this author G. WELLS More articles by this author S. WALKER More articles by this author J.F. SCHILLINGER More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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