Radionuclide angiography in unilateral nonfocal renal disease

A total of 90 patients with unilateral nonfocal renal disease (58 patients with obstructive uropathy, 13 patients with renal artery stenosis, 13 patients with chronic pyelonephritis, 3 patients with renal tuberculosis and 3 patients with a- or hypogenesis) were examined with the method of serial dynamic imaging of Tc-99m DTPA including radionuclide angiography. And the diagnostic significance of renal perfusion abnormality on radionuclide angiogram was qualitatively evaluated compared to that of renoparenchymal uptake abnormality on the image from one min. to four min. after intravenous administration of Tc-99m DTPA. In fifty-nine out of 90 patients (65%) with unilateral nonfocal renal disease, both perfusion and parenchymal uptake abnormalities were found at the involved side. In two of 13 patients with renal artery stenosis, however, the unilateral hypoperfusion was only found as the evidence of unilateral disease on radionuclide angiogram although these did not show any parenchymal uptake abnormality. Moreover, four out of 58 patients with obstructive uropathy, did show the slight difference of renal perfusion between the involved and the univolved sides. and did not show any difference of parenchymal uptake between both sides. In the present study, the incidence of perfusion abnormality on radionuclide angiogram was slightly higher than that of parenchymal uptake abnormality on the image from one min. to four min. in unilateral renal disease. Therefore, it is suggested that the radionuclide angiography may be accepted as one of the routine nuclear medicine imagings for the evaluation of functional abnormalities in nonfocal renal disease. (author)