RADIONUCLIDE TRANSPLANT RENAL SCAN

DATE: 10/4/2005

PROCEDURE:  Following IV injection of radiopharmaceutical, dynamic images of the transplant kidney were acquired for 29 minutes 40 seconds in the anterior projection (3 sec/frame x 20 frames; 5 sec/frame x 20 frames; 90 sec/frame x 18 frames).  Regional analysis was performed on the renal parenchyma, background and bladder activity.

RADIOPHARMACEUTICAL:  Tc 99m MAG-3 Tc99m DTPA Tc99m Glucoheptonate Tc99m DMSA

DOSE: [...] mCi

LASIX DOSE: [...] mg IV 

COMPARISON: None

CLINICAL HISTORY: The patient is a [...]-year-old [fe]male with a history of [...], status post renal transplant in [...] now with elevated creatinine and a renal ultrasound showing mild to moderate hydronephrosis in his transplant kidney. The patient is referred for further evaluation of renal function.

FINDINGS: 

The blood-flow phase images show prompt tracer in both renal fossae, consistent with normal renal perfusion. The extraction phase images demonstrate normal renal uptake function of both kidneys.  The delayed images show normal tracer excretion and clearance from both kidneys.

There is normal and prompt perfusion of the transplanted kidney visualized in the right iliac fossa. Extraction and excretion are mildly to moderately decreased with persistent tracer activity in the renal cortex. With Lasix administration, tracer is observed promptly in the renal pelvis in the early images demonstrating no obstruction, however there is significant tracer retention in the cortex consistent with an intraparenchymal process. There is minimal tracer activity in the bladder and the draining Foley catheter.

The blood-flow phase images show prompt visualization of the transplanted kidney, consistent with normal renal perfusion. The blood-pool phase images demonstrate normal renal uptake function of the kidney.  Excretion is mildly to moderately decreased with persistent tracer activity in the renal cortex.

IMPRESSIONS:

1. Normal perfusion with mildly to moderately compromised function consistent with a renal intraparenchymal process. 

2. No evidence of obstruction or of urinary leak.

Thank you for referring this patient to the UCLA Nuclear Medicine Clinic.

I, [...], M.D., Ph.D., have reviewed this Nuclear Medicine study personally, and am in full agreement with the findings of the report presented here.