Newer Diagnostic Imaging Procedures in Neonatal Renal Disease

Abstract

At present radioisotope scintigraphy(RS) and ultrasonography(U) are the imaging modalities of choice for the investigation of the kidneys in the neonate. They are relatively(RS) or totally(U) noninvasive and they may be performed in the nursery with portable and relatively inexpensive equipment. Whereas both RS and U provide diagnostic structural information, RS gives functional information, identifies the level of obstruction and detects easily ectopic units, whereas U has a better anatomical resolution independent of function and identifies cystic structures promptly. The two modalities are complimentary, RS is easier to perform and interpret, U requires expertise and dedication, being operator dependent. Our current protocol calls for an IV injection of lmCi of Tc-99m-Glucoheptonate followed by a flow phase, sequential imaging for 20 min and delayed scintigrams 4–6 hours post injection(1). A retrospective analysis concluded in our Institution showed that RS of the kidneys in neonates agreed with the final diagnosis in 96% of the cases, U in 82% and excretory urography(IVP) in only 55% of the cases studies(2).