Diuresis Renogram And Ace Inhibitor Renogram

Front 1

What are the indications for a diuresis renogram?

Back 1

To assess renal function and urodynamics, to determine what percent of total renal function is contributed to the kidneys.

Front 2

What is the patient preparation for a diuresis renogram?

Back 2

Patient must be well hydrated, give 5-10 ml/kg of water 30-60 minutes prior to the injection of the radiopharmaceutical. Patient should also void before imaging begins and frequently after imaging is done.

Front 3

What are the contraindications for a diuresis renogram?

Back 3

No iodine contrast studies within 24 hours of exam, dehydration, pregnancy, breastfeeding, no diuretics prior, and patient movement.

Front 4

What camera is used for a diuresis renogram? What kind of collimator is used?

Back 4

Gamma Camera, Large field of view.
LEHR, parallel hole

Front 5

What kind of images should be obtained during this study?

Back 5

Dynamic and Static images

Front 6

At what time should imaging begin after injection of the radiopharmaceutical?

Back 6

Immediately. Some wait 10 to 15 minutes after injection for patients with known obstruction.

Front 7

What is the total imaging time for a diuresis renogram?

Back 7

30 minutes to 1 hour

Front 8

What is the primary radiopharmaceutical that is used for a diuresis renogram? What is the dosage? What other radiopharmaceutical can be used?

Back 8

Tc-99m - MAG3
5 - 10 mCi
Tc-99m - DTPA (5-15 mCi)

Front 9

What is the mode of localization for MAG3?

Back 9

Glomerular Filtration

Front 10

At what position do we situate the patient before imaging?

Back 10

Supine

Front 11

What views of the patient's body are taken?

Back 11

Posterior

Front 12

What are considered normal results of a diuresis renogram?

Back 12

Homogenous distribution of the Rph in both kidneys, normal results with furosemide T 1/2 washout time from injection is typically at <15 minutes, 15-20 minutes is indeterminate. Curves are declining and continue to do so after administration of diuretic.

Front 13

What are considered abnormal results of a diuresis renogram?

Back 13

False-positive results and equivocal interpretation may arise when a diseased kidney is not responsive to furosemide injection (such as w/ immature renal function in neonates, severe dehydration, and poor baseline renal function) and the collecting system is dilated, and VUR or fully distended bladder is present.

Front 14

What is the name of the inner zone of the kidney?

Back 14

Medulla

Front 15

What is the name of the outer zone of the kidney?

Back 15

Cortex

Front 16

What is the basic functional unit of the kidney called?

Back 16

Nephron

Front 17

What are the indications for an ACE Inhibitor renogram?

Back 17

To diagnose or exclude urinary tract obstruction, to assess renal function and urodynamics, to determine what percent of total renal function is contributed to each kidney, renal perfusion, and trauma.

Front 18

What is the patient preparation for an ACE Inhibitor renogram?

Back 18

The patient must be well hydrated, and should void before injection and after procedure.

Front 19

What are the contraindications for an ACE Inhibitor renogram?

Back 19

No iodine contrast studies within 24 hours of exam, dehydration, pregnancy, breastfeeding, and patient movement.

Front 20

What kind of camera is used for an ACE Inhibitor renogram? What kind of collimator is used?

Back 20

Gamma, Large field of view
LEHR, Parallel Hole

Front 21

What kind of images are obtained during an ACE Inhibitor Renogram?

Back 21

Dynamic and Static Images

Front 22

How long after injection of the radiopharmaceutical should imaging begin?

Back 22

Immediate statics @ 1, 3, 5, 10, 15, 20, 25, and 30 minutes up to one hour.

Front 23

What is the total imaging time this procedure?

Back 23

Approximately 1 hour

Front 24

If a flow study is required, what is the timing per image? Dynamics? Statics?

Back 24

2 sec/frame for 1 minute
30-60 sec/frame for 20 to 30 minutes.
About 500 kcts for statics

Front 25

Number of images in a data set for either a diuresis renogram or ACE Inhibitor renogram?

Back 25

30 images for flow, 45-60 images for dynamics and statics

Front 26

What is the ancillary equipment for an ACE Inhibitor renogram?

Back 26

Blood pressure cuff

Front 27

What is the name of the pharmaceutical given during an ACE Inhibitor renogram? How much is given?

Back 27

Captopril

50 mg, PO

Front 28

What radiopharmaceutical is used for an ACE Inhibitor study? What is the dosage? What can also be used?

Back 28

Tc-99m - DTPA, 5-15 mCi
or
Tc-99m - MAG3, 5-10 mCi

Front 29

What is the mode of localization of the radiopharmaceutical?

Back 29

Glomerular Filtration

Front 30

What is the patient position?

Back 30

Supine?

Front 31

What views of the patient's body are taken during an ACE Inhibitor renogram?

Back 31

Posterior

Front 32

What are considered normal results for an ACE Inhibitor renogram?

Back 32

Normal blood pressure range (baseline), homogenous distribution in both kidneys, static images should be symmetrical, time-to-peak concentration is 3-5 minutes, and clearance of Rph (T1/2) within 8-12 minutes.

Front 33

What are considered abnormal results for an ACE Inhibitor renogram?

Back 33

Non-visualization of one or both kidneys, decreased activity, pyelonephritis, enlarged kidneys, RAS, hydroureteronephrosis, elevated blood pressure.