There are a lot of diagnostic procedures that are highly informative and do not cause pain during the research, for example, ultrasound, magnetic resonance or computer diagnostics, etc. But sometimes the data obtained with these studies is not enough. In this case, scintigraphic diagnostics is more informative. Scintigraphy is a diagnostic imaging procedure performed by administering to the patient radioactive isotopes and further determining their radiation.
Renal scintigraphy( nephroscintigraphy) is a radiotherapy technique used to evaluate the functionality of renal structures. The basis of the technique is the use of a radiopreparation, without which it is impossible to diagnose. There is absolutely wrong opinion about the dangers of such drugs, which is often associated with the banal illiteracy of the inhabitants. Most often the procedure uses the radio drug Hippuran. Scintigraphic diagnosis of the kidneys is a highly informative and effective therapeutic and diagnostic method, through which it is possible to detect pathology one year earlier than in other studies. But, unfortunately, because of the high cost of equipment and the lack of radiopharmaceuticals, this procedure is not available to everyone.
Neither can be carried out in two ways: dynamic or static. Static diagnostics is an additional method after radiography, which determines the general parameters of the kidneys, their location and shape, size, etc. Static diagnostics can not determine the presence of functional disorders in the urinary system, so it does not show a complete picture of the existing pathology.
Dynamic nephroscintigraphy is performed after the administration of a radio medication. At various intervals, the drug is delivered to the kidney structures, ureters, and urinary tissues. Photographs obtained due to dynamic nephroscintigraphy display stepwise the processes of urination and urination, which allows to study in detail the functionality of each kidney separately or both together.
Because static and dynamic nephroscintigraphy differ in diagnostic capabilities, the indications for these procedures differ slightly.
Static renal scintigraphy is shown:
- With pyelonephritis and other nephrotic pathologies;
- In the presence of malformations in the urinary system;
- If the kidneys are not positioned correctly from the anatomical and topographic point of view.
In the dynamic nephroscintigraphy the spectrum of indications is more extensive:
- With abnormal development and structure of renal structures;
- In case of a disorder of renal activity or organ dysfunction;
- Before nephrectomy( kidney removal) to determine the functionality of the second kidney and to exclude its deficiency;
- Suspected metastasis in the urinary tract;
- Hydronephrosis, manifested by the expansion of the kidney pelvis due to urinary retention;
- In the presence of tumors or cystic neoplasms to determine their nature and degree of malignancy;
- If an organ-saving operation is planned on a single kidney to assess its functionality.
Study Nephroscintigraphy usually does not require any specific preparation. The patient is recommended to undergo diagnostics on an empty stomach. In addition, you need to remove all metal objects from the body.
Method of conducting
Nephroscintigraphy is carried out on an outpatient basis on a special apparatus. In a dynamic study, the patient is administered intravenously a radiopharmaceutical, after which the patient is placed on a special table and begins the scanning procedure. During the diagnosis it is forbidden to move and speak, otherwise the quality of the received pictures will be low.
If necessary, the doctor will ask you to change your posture. If the patient is not feeling well, the change of position is the most appropriate time to inform the specialist about the worsening of the condition and discomfort like dizziness, trouble breathing, if any. Sometimes the patient is additionally injected with medications, for example, in determining obstructions in the ureteral lumen, diuretics are used, and in the diagnosis of hypertensive patients, hypotensive drugs are used. The duration of the dynamic study takes about 45 minutes to 1.5 hours, and for static nephroscintigraphy it takes half an hour.
On the video about the method of scintigraphy:
Renal scintigraphy, despite the high information content, is not allowed to all patients.
This diagnostic technique is contraindicated:
- Severe - it is quite difficult for such patients to remain stationary for a long time, and scintigraphy has a duration of at least 45 minutes;
- Pregnant patients - the introduction of a radiopharmaceutical increases the risk of exposure to the fetus. In such patients, nephroscintigraphy is performed in extremely special cases and in early periods;
- Patients who recently received radiation or chemotherapy;
- Breastfeeding women, but if there is an urgent need, then radionuclide diagnostics are still carried out, only in the next 24 hours the mother should give up GV until the radioactive drug completely disappears from the body;
- Postoperative patients, since the procedure can lead to swelling of the operated organs or tissues;
- Persons with intolerance of a radioactive preparation provoking an allergic reaction;
- People who have metal implants;
- Not drunk patients and persons who underwent radionuclide diagnostics less than a month ago.
Decoding of the results
Usually the decoding of the received data is carried out in several consecutive stages:
- First we estimate the size and shape, the topographic parameters of the kidneys, the degree of their capacity is assumed, the intensity of the blood circulation in the kidneys, the structure of the parenchyma;
- Renascintigraphy is then evaluated for pathological zones. The specialist analyzes the activity of each kidney on the concentration level of the radio preparation in the perineal structures. The analysis of these data allows to reliably determine the functionality of each kidney and their actual ratio;
- Then, to determine the excretory and secretory activity, two examination zones are analyzed. Such an assessment is necessary to determine the degree of development and level of the pathological process;
- At the last stage, the specialists are studying each segment of the kidney that has a modified tissue. This is necessary to assess their actual functionality
scintigraphy method This is an optional algorithm for processing the results of dynamic or static kidney scintigraphy. It is used, for example, before surgery, urolithiasis or focal lesions of kidney tissues. And for diffuse disorders against a background of chronic nephritis, only the initial visualization of the first stage is sufficient.
But nefrosintcinigrafiya differs inaccessibility, because it requires expensive equipment and radioactive preparations. Yes, and the study itself is not cheap.