Nuclear Medicine Companion by Abdelhamid H. Elgazzar & Ismet Sarikaya

Author:Abdelhamid H. Elgazzar & Ismet Sarikaya
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

5.2.6 Congenital Renal Abnormalities

Case 5.14 Horseshoe Kidney

Clinical History Three-and-a-half-month-old baby boy with history of UTI 2 weeks earlier. US was negative (Fig. 5.14).

Fig. 5.14Tc-99m DMSA images in anterior, RPO and LPO projections

Findings There is apparent activity connecting the lower poles of both kidneys indicating horseshoe kidney. There is uniform uptake in the kidneys with no scars.

Companion Points The kidney is the most common site of congenital abnormalities which include agenesis (unilateral or bilateral), hypoplasia, dysplasia and multicystic kidney, polycystic kidney, simple solitary renal cyst, supernumerary kidneys, renal fusion (most common in horseshoe shape), and ectopic kidney (most common in the pelvis). Ultrasound is often used for initial evaluation. DMSA scan is also useful for the detection of renal abnormalities. SPECT, particularly SPECT/CT imaging, better defines the shape of the kidney and can also detect and localize small ectopic/hypoplastic kidney [55–57]. Dynamic renal scintigraphy helps to evaluate the functional status of these kidneys. In cases with known renal abnormalities, dynamic images should be obtained in both anterior and posterior projections and imaging field of view should include whole abdominal and pelvic region. This is because ectopic kidneys are usually located more anteriorly and inferiorly than normal kidneys. Taking images on both anterior and posterior projection provides more accurate split renal function [58].

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