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Can Technetium-99m-Mercaptoacetyltriglycine Replace Technetium-99m-Dimercaptosuccinic Acid in the Exclusion of a Focal Renal Defect?

Department of Radiology, Hospital for Sick Children and The Institute of Child Health, London England

Correspondence: For reprints contact: Isky Gordon, Department of Radiology, Hospital for Sick Children, Great Ormond St., London, England WC1N 3JH.

ABSTRACT

The presence of focal renal damage dictates different management of a child with urinary tract infection (UTI) compared with children who have normal kidneys. Technetium-99m dimercaptosuccanic (DMSA) has a high sensitivity in the detection of a focal defect, and allows estimation of differential function. The introduction of ^99mTc-MAG3 with high renal extraction suggests that this maybe useful in children with UTI but its role remains speculative. Fifty-nine children with previous UTI underwent both ^99mTc-DMSA and MAG3 within 4 wk of each other. Differential function and assessment of the images were undertaken. There is close correlation (R²=0.97) between the differential function. Analysis of the ^99mTc-DMSA and functional MAG3 images showed that the functional image had a specificity of 88% and a sensitivity of 88% in the detection of a focal parenchymal defect. Technetium-99m-MAG3 in the clinical setting of a child with UTI allows accurate assessment of differential function and a high probability of detecting a focal renal abnormality.

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