No abstract

In this study, 53 children suffering from recurrent urinary tract infections were investigated both by ultrasound and direct radionuclide voiding cystography (RNVC). The findings were: Most high-grade vesicopelvic refluxes were detected by both methods consistently. Discrepant results of high-grade vesicopelvic refluxes were seen in 6 kidneys from 4 children. Main advantages of RNVC are the quick results and the ease of interpretation of these results. In RNVC the whole urinary tract can be observed during the filling phase as well as during the voiding and postvoiding phase. In sonography, the different parts of the urinary tract must be explored one after another during the filling, voiding, and postvoiding phase. The investigation by sonography is time consuming and a strongly investigator-dependent procedure.

In 153 children suffering from various renal or urological disease a total of 179 individual and regional renal clearance studies were performed using 123-I-hippuran and a scintillation camera. The clinical diagnoses and questions before and the therapeutic consequences after clearance determinations are analyzed. The dynamic information fo sequential scintigraphy combined with renal clearance determination allow a quantitative estimation of the individual and regional kidney function. The method is considerably helpful in cases of unilateral small kidneys, obstructive uropathies, duplication of the urinary tract, and segmental renal disease.

The differential and ipsilateral clearance of Hippuran allows for a quantitative assessment of the function of both kidneys, a single kidney and a part of one kidney. We have performed this investigation 179 times in 156 children in relation to dysplastic kidneys, obstructive lesions in the upper urinary tract, duplex kidneys and in follow-up situations. In many of these patients this investigation produced an indication for an organ-preserving operative procedure. The radiological findings are compared with the clinical picture.