New aspects for nuclear renal diagnosis

Non-invasive nuclear methods of examination have gained great importance in renal diagnosis because they can be carried out without discomfort to the patient. Unilateral clearance is valuable in cases of unilateral renal damage where the impaired functioning of one kidney may be mashed by the compensatory action of the other, contralateral kidney. This is offen the case with chronic pyelonephritis, ureteral stenosis, and nephrolithiasis. In ectactic renal pelves, unilateral clearance should be obligatory, as functional assessment on the basis of the excretory urogram is impossible. The pathological X-ray picture often leads to false conclusions in this type of disease. Due to the low radiation exposure involved, close-meshed control examinations are possible which indicate functional changes early enough for the necessary therapy. The emphasis in scintiscanning has shifted to dynamic investigations. The main fields of application for sequential scintiscanning are unilateral and segmental renal diseases, differential diagnosis of anuria, traumatic changes, and emergency diagnoses in infants. Suspected growing and displacing processes are only an indirect indication for scintiscanning today. (orig.)