Iranian Journal of Nuclear Medicine

Iranian Journal of Nuclear Medicine

Dynamic renal scintigraphy in pediatric upper urinary tract malformations in Ouagadougou (Burkina Faso): A cross-sectional study of 51 cases

Document Type : Original Article

Authors
Thierry Romuald Ki 1
Salif Djigo 2
Boubacar Drame 1
Mamounata Zoungrana 1
Stéphane Hien 1
Guy Ouedraogo 1
Kokou Adambounou 3
1 Nuclear Medicine Department, Tengandogo University Hospital, Ouagadougou, Burkina Faso
2 Nuclear Medicine Department, Idrissa Pouye Hospital, Cheikh Anta Diop University of Dakar, Senegal
3 Faculty of Health Sciences, University of Lomé, Togo
10.22034/irjnm.2026.130505.1757
Abstract
Introduction: Malformative uropathies are particularly common in children.  They primarily concern the excretory tract and are readily obstructive. Imaging plays a vital role in their characterization and management. This study aimed to evaluate the contribution of renal scintigraphy (SR) in the management of malformative uropathies of upper excretory tract.
Methods: This is a retrospective study that included renal scintigraphy examination records carried out from January 31, 2020 to January 31, 2023 in children aged 0 to 15 years in the nuclear medicine department of the Yalgado Ouedraogo University Hospital in Ouagadougou.
Results: The average age of children was 4.7 years with extremes of 5 days and 14 years. The M/F sex ratio was 3.63. Pyeloureteral junction syndrome represented 78.43% of cases (n=40). The malformations investigated were mainly bilateral (n=25). Morphological analysis of RS revealed hypotrophy-type abnormalities (n right = 5; n left =3), right hypertrophy (n = 4), pelvic kidney (n right = 1; n left =2), megaureter (n right = 2; n left =1), absence of the left kidney (n= 2). Renal units (51 x 2) were classified into 4 groups according to the values of Relative Renal Function (RRF). Group 1 with RFR 10% had a number of 21 renal units (n right = 11; n left = 10). Group 2 was characterized by 10 ≤ RRF < 43%: its number was 24 renal units (n = 12 on each side). Group 3 was characterized by 43 ≤ RRF < 57%: it totaled 14 renal units n right = 8 ; n left = 6. Group 4 was characterized by an RRF > 57%: it totaled 43 renal units (20 on the right and 23 on the left). 58 renal units (30 on the right and 28 on the left) had delayed uptake. Drainage was mainly impaired (67.85%) with 3 left non-funtioning kidneys and 2 right non-funtioning kidneys. The hyperdiuresis test carried out according to the F+20 protocol revealed 30 mechanical obstuctions (14 on the right and 16 on the left), 39 functional obstacles (18 on the right and 21 on the left) and 7 equivocal obstacles (5 on the right and 2 on left).
Conclusion: Renal scintigraphy with induced hyperdiuresis test is a sensitive examination in the characterization of the malformative pathology of upper excretory tract. It makes it possible to establish the etiological diagnosis, essential information for the therapeutic decision.
Keywords
Renal scintigraphy
Kidney
Pyeloureteral junction syndrome
DTPA
Malformative uropathies
Subjects
  1. Bouah-Kamon E, Sophie Ehile-Kacou AM, Diarrassouba G, François Eboua TK, Lasme-Guillao E. Uropathies malformatives de l’enfant : profil épidémio-clinique, thérapeutique et évolutif en milieu hospitalier ivoirien [Malformative uropathies in children: epidemiological, clinical, therapeutic and evolutive aspects in an ivoirian hospital setting]. Nephrol Ther. 2024 Aug 1;20(4):260-268.
  2. Seddouki A, Chkikar S, Ismaili Alaoui N. L’apport de la scintigraphie rénale dynamique dans le syndrome de jonction pyélo-urétrale. Méd Nucl. 2023;47(2):86.
  3. Ballouhey Q, Lopez P, Belgacem A, Verbeke S. Explorations rénales en médecine nucléaire chez l’enfant en 2024. Méd Nucl. 2024;48(2):129-133.
  4. Fremond B. Uropathies malformatives. J Radiol 2001;82:781-800.
  5. Boucenna H, Bouferoua F, Bouskia Y, Bouterfas N, Khiari M, Benhalla N, Belhadj A, Djeraba S, Raaf N, Allal K. Les uropathies malformatives. Bilan d’activité d’un service de pédiatrie sur une durée de 15 ans. Nephrol Ther. 2020;16(5):298.
  6. Sagbo G, Alao M, Lalya H, Gbénou A, Fiogbé M. Malformations des voies urinaires révélées par une infection urinaire chez l’enfant à Cotonou. Clin Mother Child Health. 2013;10:1-5.
  7. Zehnati T. Intérêt de la scintigraphie rénale dynamique au 99mtc–DTPA dans la prise en charge thérapeutique de la maladie de la jonction pyélo-urétérale chez les nourrissons. Rev Méd. 2024 Mar 15;4(1):45-52.
  8. Boughattas S, Hassine H, Chatti K, Jomaa R, Essabbah H. Place des explorations scintigraphiques dans les dilatations de la voie excrétrice supérieure chez l'enfant [Role of scintigraphic tests in upper urinary tract dilatation in children]. Ann Urol (Paris). 2002 Jan;36(1):8-21.
  9. Shipp TD, Nguyen HT, Bromley B, Lyons JG, Benacerraf BR. Importance of renal abnormalities first identified in the third trimester after normal findings on a detailed second-trimester structural fetal survey. J Ultrasound Med. 2011 Nov;30(11):1567-72.
  10. Hall M, Piepsz A, Alexander M, Schulman C, Avni FE. Insights into the pathogenesis and natural history of fetuses with renal pelvis dilatation. Eur urol. 2005 Aug 1;48(2):207-14.
  11. Ismaili K, Avni F, Hall M. Results of systematic voiding cystourethrography in infants with antenatally diagnosed renal pelvis dilation. J Pediat.2002;141:21-4.
  12. Khaoula AM : Les uropathies malformatives chez l’enfant. Thèse de médecine. Faculté de médecine; Université Abou Bekr Belkaid de Tilemcen, Algérie, 2014.
  13. Coulibaly T: Place de l’imagerie dans le diagnostic des malformations congénitales de l’appareil urinaire chez l’enfant. Thèse de médecine. Faculté de médecine de Bamako, Mali, 2020.
  14. Veyrac C. Anomalies congénitales du rein et de la voie excrétrice supérieure chez l'enfant. EMC Radiol. 2004 Oct 1;1(5):491-541.
  15. Kokou A, Djigo S, KI T, Mbodj M, Ndoye O, Seck-Gassama S. Contribution of the scintigraphy imaging in the exploration of the nephro-uropathies of the child in Dakar. J Afr Imag Méd. 2017;9(4):169-174.
  16. Olivier P, Archambaud F, Bonnin F, Guillet J, Le Cloarec J, Ramackers J. Guide pour la rédaction de protocoles pour la scintigraphie rénale dynamique chez l’enfant. Société française de biophysique et de médecine nucléaire (SFBMN); Version:1.0, 20 October 2005. Available at https://www.cnp-mn.fr/wp-content/uploads/2022/09/Rein-dynamique-V1.0.pdf
  17. Smith T, Veall N, Altman DG. Dosimetry of renal radiopharmaceuticals: the importance of bladder radioactivity and a simple aid for its estimation. Br J Radiol. 1981 Nov;54(647):961-5.
  18. Conway JJ. "Well-tempered" diuresis renography: its historical development, physiological and technical pitfalls, and standardized technique protocol. Semin Nucl Med. 1992 Apr;22(2):74-84.
  19. Ghfir I, Raïs NB. Ectopie rénale iliaque explorée par scintigraphie au 99mTc-DTPA et au 99mTc-DMSA. À propos d’un cas. Méd Nucl. 2008 Nov 1;32(11):559-63.