Comparison of three different diuretic renal scintigraphy protocols in patients with dilated upper urinary tracts

Clin Nucl Med. 2004 Mar;29(3):154-60. doi: 10.1097/01.rlu.0000113852.57445.23.


Purpose: To compare 3 different diuretic renal scintigraphy protocols in patients with dilated upper urinary tract.

Materials and methods: Three diuresis renography protocols were performed in 22 adult patients (28 kidneys) with upper urinary tract dilatation. The diuretic was given 20 minutes after (F+20), at the same time as (F+0), and 15 minutes before (F-15) radionuclide administration. The mean age was 29.8 years (range, 18-43 years). The 3 protocols were identical, except for the time of injection of furosemide. The F+0 protocol could not be performed in 1 and F-15 in 2 of the patients. Each of the 3 protocols was performed for the rest of the patients. The results were classified as nonobstructive, equivocal, and obstructive according to the renogram images and curves.

Results: None of the patients showed equivocal results in both F+0 and F-15 protocols. In the F+20 studies, 7 of the 28 kidneys were evaluated as equivocal. Of these, 5 kidneys showed nonobstructive and 2 kidneys revealed obstructive renogram patterns with the other 2 protocols (F+0 and F-15). Moreover, one kidney, which was evaluated as nonobstructive in the F+20 protocol, showed an obstructive pattern in both F+0 and F-15 protocols. All of the kidneys showing obstructive patterns in the F+20 study also revealed obstruction in the F+0 and F-15 investigations. We could not find any difference between the renogram patterns of F+0 and F-15 investigations.

Conclusions: F+0 and F-15 protocols allow clarification in cases of equivocal F+20 studies. Because the F+0 study is more practical and shorter, we suggest the F+0 method when equivocal results are obtained by an F+20 study or as a single test when there is only one opportunity to confirm or exclude the presence of obstruction.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Dilatation, Pathologic / classification
  • Dilatation, Pathologic / diagnosis
  • Dilatation, Pathologic / diagnostic imaging*
  • Diuresis / drug effects*
  • Diuretics / administration & dosage
  • Dose-Response Relationship, Drug
  • Furosemide / administration & dosage*
  • Humans
  • Image Enhancement / methods*
  • Radioisotope Renography / methods*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Technetium Tc 99m Mertiatide*
  • Urologic Diseases / classification
  • Urologic Diseases / diagnosis
  • Urologic Diseases / diagnostic imaging*


  • Diuretics
  • Radiopharmaceuticals
  • Technetium Tc 99m Mertiatide
  • Furosemide