Clinical History

The patient is a 78-year-old male with a previous right nephrectomy for carcinoma. The patient currently demonstrates increasing BUN/creatinine values. The examination is performed for further evaluation. No previous examinations are available for comparison.

Technique

Following the intravenous injection of 5.5 millicuries of 99m Tc MAG3, multiple dynamic, blood pool, and delayed images were performed for 40 minutes. Lasix was administered at approximately 20 minutes and a Lasix wash-out curve was obtained.

Findings

1.On the perfusion flow images, prompt radiotracer activity is noted in the abdominal aorta in both iliacs. There is delayed flow to the single left kidney indicating vascular compromise.

2.On the tubular function images, there is increased uptake and poor function in the solitary left kidney with activity seen in the urinary bladder by 15 minutes. Lasix was administered at approximately 20 minutes and there is a markedly delayed Lasix wash-out time.

Impressions

DELAYED FLOW TO THE SOLITARY LEFT KIDNEY WITH POOR FUNCTION AND MARKEDLY DELAYED LASIX WASH-OUT CONSISTENT WITH MEDICAL RENAL DISEASE.

Comments

Click here if you would like to view a cine of the Two Phase Renal Scan. This is a quicktime movie file.