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

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

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.

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References

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