Diagnostic difficulty in interpretation of Tc-99m MAG3 dynamic renal scan: intrarenal reflux or delayed concentration function?

Vesicoureteral Reflux in Nonfunctioning Renal Allograft Incidentally Detected in a Posttransplant 99mTc-DTPA Scan: Significance of Postvoid Imaging

ABSTRACT

In the present note, a case with rising serum creatinine shortly posttransplantation was referred for 99mTc-DTPA scan. The previous nonfunctioning renal allograft in the left hemipelvis showed no finding during dynamic phase of scan and filling phase of bladder but revealed a high-grade vesicoureteral reflux (VUR) in postvoid image, which can be responsible, partly, for the patient's present and prior symptoms.

Unexpected Vesicoureteral Reflux Into a Nonfunctioning Transplant Kidney on Renal Scintigraphy

Vesicoureteral reflux after renal transplantation is associated with increase risk of urinary tract infections, renal scarring, and graft failure. We describe a case of a 46-year-old woman with 2 transplant kidneys, one functioning and another nonfunctioning, presenting with pelvic pain after a bilateral periureteral bulking procedure. Diuretic renography was performed to exclude iatrogenic ureteral obstruction. This showed a normally functioning transplant kidney without obstruction and subsequent vesicoureteral reflux into the collecting system of the nonfunctioning transplant kidney. This inadvertent indirect nuclear cystogram illustrates an unusual imaging presentation of a common disease process requiring further treatment.

Urinary reflux from ileal neobladder into a non-functioning kidney: detection during diuretic renography

The importance of monitoring renal function in patients undergoing cystectomy and urinary diversion is well established. Dynamic renography using Tc-99m MAG3 in combination with furosemide challenge has been widely used to determine the differential function of the kidneys, occurrence of reflux as well as the patency of the outflow tract in this context. The authors have described here a patient in whom significant urinary reflux from the neo-bladder into the nonfunctioning kidney was demonstrated during MAG3 diuretic renography.