Figure - PMC

Skip to main content

View full-text article in PMC

. Author manuscript; available in PMC: 2013 Jun 20.

Published in final edited form as: Semin Nucl Med. 2008 Jan;38(1):67–81. doi: 10.1053/j.semnuclmed.2007.09.006

(A) The standard display shows demographic data, the dose injected, dose counted on the camera, percent dose infiltrated, the MAG3 clearance and the expected MAG3 clearance followed by the percent uptake, T_max, T_1/2, and 20-minute/max ratios for the whole kidney ROI. The voided volume, postvoid residual and urine flow rate were not measured. The upper central panel shows 2-second images at the beginning of the acquisition. The upper right panel shows the injection site; just beneath is a frame for viewing a dynamic cine, and pre and postvoid bladder images. The central panel shows twelve 2-minute images followed by a postvoid image of the kidneys with the patient lying on the camera in the same position as the initial images. The lower left panel shows the whole kidney ROIs and the whole kidney renogram curves; the lower right panel shows the cortical ROIs and the cortical renogram curves. The MAG3 clearance was reduced (94 mL/min/1.73 m² compared with a normal range of 226–439 mL/min/1.73 m²). The relative uptake of the left kidney was 26%. The T_1/2 of the left kidney was greater than 50 minutes and the T_1/2 of the right kidney was 19 minutes. The 20-minute/max ratio was bilaterally abnormal; consequently, the patient received furosemide followed by a second acquisition (Fig. 1C). (B) An expanded review is available to the reviewers. This display shows the patient values and normal ranges for the MAG3 clearance, residual urine volume, percent relative uptake and the T_max, 20-minute/max, T_1/2, and postvoid/max ratio for whole kidney and cortical ROIs. The expanded review page also shows an enlarged parenchymal image obtained at 2 to 3 minutes, an enlarged display of the 19- to 20-minute image, and quality control images showing the before and after injection syringe counts and time of the bolus arrival in the kidneys. (Color version of figure is available online.) (C) This panel shows displays the 2-minute sequential images after the administration of 43 mg of furosemide. The curves were generated from whole kidney and renal pelvic regions of interest. The T_1/2 of the left renal pelvis was 19 minutes and 46 minutes for the right renal pelvis. (D) This panel displays the baseline and furosemide acquisition on the same scale. The time activity curve generated by the pelvic region of interest is also displayed on an expanded scale. Even though the right kidney is abnormal, tracer washed out of the renal pelvis and the ratio of kidney counts in the prevoid furosemide acquisition to the maximum counts was only 0.23. On a 5-point scale, obstructed, probably obstructed, equivocal, probably nonobstructed and nonobstructed, the experts interpreted the right kidney as probably nonobstructed. Activity washed out of the pelvis and the ratio of prevoid furosemide counts to the maximal counts on the baseline study was only 0.23. RENEX interpreted the right kidney as not obstructed (certainty factor of −0.42). Relative and absolute function of the left kidney were reduced, there was prominent pelvic retention, washout was prolonged with a pelvic T_1/2 of 19 minutes and the ratio of prevoid furosemide counts to the maximal counts on the baseline study was abnormal at 0.59. The consensus interpretation of the experts was probably obstructed; RENEX also interpreted the left kidney as obstructed (certainty factor of 0.34). (Color version of figure is available online.) interpretation of diuretic renal scans but also as an educational tool for students and trainees.

(A) The standard display shows demographic data, the dose injected, dose counted on the camera, percent dose infiltrated, the MAG3 clearance and the expected MAG3 clearance followed by the percent uptake, T_max, T_1/2, and 20-minute/max ratios for the whole kidney ROI. The voided volume, postvoid residual and urine flow rate were not measured. The upper central panel shows 2-second images at the beginning of the acquisition. The upper right panel shows the injection site; just beneath is a frame for viewing a dynamic cine, and pre and postvoid bladder images. The central panel shows twelve 2-minute images followed by a postvoid image of the kidneys with the patient lying on the camera in the same position as the initial images. The lower left panel shows the whole kidney ROIs and the whole kidney renogram curves; the lower right panel shows the cortical ROIs and the cortical renogram curves. The MAG3 clearance was reduced (94 mL/min/1.73 m² compared with a normal range of 226–439 mL/min/1.73 m²). The relative uptake of the left kidney was 26%. The T_1/2 of the left kidney was greater than 50 minutes and the T_1/2 of the right kidney was 19 minutes. The 20-minute/max ratio was bilaterally abnormal; consequently, the patient received furosemide followed by a second acquisition (Fig. 1C). (B) An expanded review is available to the reviewers. This display shows the patient values and normal ranges for the MAG3 clearance, residual urine volume, percent relative uptake and the T_max, 20-minute/max, T_1/2, and postvoid/max ratio for whole kidney and cortical ROIs. The expanded review page also shows an enlarged parenchymal image obtained at 2 to 3 minutes, an enlarged display of the 19- to 20-minute image, and quality control images showing the before and after injection syringe counts and time of the bolus arrival in the kidneys. (Color version of figure is available online.) (C) This panel shows displays the 2-minute sequential images after the administration of 43 mg of furosemide. The curves were generated from whole kidney and renal pelvic regions of interest. The T_1/2 of the left renal pelvis was 19 minutes and 46 minutes for the right renal pelvis. (D) This panel displays the baseline and furosemide acquisition on the same scale. The time activity curve generated by the pelvic region of interest is also displayed on an expanded scale. Even though the right kidney is abnormal, tracer washed out of the renal pelvis and the ratio of kidney counts in the prevoid furosemide acquisition to the maximum counts was only 0.23. On a 5-point scale, obstructed, probably obstructed, equivocal, probably nonobstructed and nonobstructed, the experts interpreted the right kidney as probably nonobstructed. Activity washed out of the pelvis and the ratio of prevoid furosemide counts to the maximal counts on the baseline study was only 0.23. RENEX interpreted the right kidney as not obstructed (certainty factor of −0.42). Relative and absolute function of the left kidney were reduced, there was prominent pelvic retention, washout was prolonged with a pelvic T_1/2 of 19 minutes and the ratio of prevoid furosemide counts to the maximal counts on the baseline study was abnormal at 0.59. The consensus interpretation of the experts was probably obstructed; RENEX also interpreted the left kidney as obstructed (certainty factor of 0.34). (Color version of figure is available online.) interpretation of diuretic renal scans but also as an educational tool for students and trainees.