Analysis of the I¹³¹ Sodium o-Iodohippurate Renogram

Abstract

our experience:) We have not been able to reliably differentiate cyst from neoplasm on the basis of the renoscan. In cases of fetal lobulation where neo¬ plasm has been suspected on the basis of pyelog¬ raphy, there has been equal Hg2"3 uptake in the lobular area, thus helping to rule out neoplasm. Through the judicious use of the renal seintiscan in conjunction with excretory urography, the need for more hazardous special studies such as retrograde pyelograms and aortograms can often be avoided.In brief, our data indicate that the renal photoscan with the aid of Hg2UJ-labelled chlormerodrin has proven of value in the diagnosis of renal vascu¬ lar disease and tumors. The technique ranks be¬ tween the urine analysis and the intravenous pyelogram in ease of performance and lack of toxicity. It does not supplant but complements other diag¬ nostic techniques. Summary and ConclusionsRenal scintiscans may be performed using I131 sodium o-iodohippurate ( Hippuran ) or Hg20:i chlor¬ merodrin (Neohydrin). The latter is superior both in ease of performance and in quality of diagnostic information obtained. In 10 cases of renal vascular disease, the Hg2'" chlormerodrin seintiscan cor¬ rectly predicted the operative findings in 80% of the cases. It gave useful information regarding the kid-ney size and the functioning state of renal tissue. In 10 cases of renal carcinoma, the Hg203 seintiscan correctly predicted the position and extent of the neoplasm in 9. It detected only those carcinomas or cysts that significantly distorted the renal paren¬ chyma. The superior delineation of renal paren¬ chyma with Hg2"3 chlormerodrin may permit the diagnosis of a tumor when pyelograms are equivo¬ cal. The Hg203 chlormerodrin renal seintiscan is a significant addition to the available diagnosis tests for renal abnormality.

Study of the Radiohippuran Renogram Vascular Phase

“…Soon thereafter the secretion process and the accumulation of radioactivity in the upper urinary tract begins to be evident. The existence of such a rapid process like "hippuran trapping" supports also Wax's (16) observation, that 15 sec after radiohippuran application to animals it is not possible to find 29°/o of the administered radioactivity in both vascular capacity and background tissue. Moreover, our theoretical study of radiohippuran kinetics in the body (8) might show at the beginning of the curve the presence of a more rapid process than that of secretion.…”

“…The initial spike of the radioactive tracer renogram represents, according to Winter (18), Zum Winkel et al (19), Meade et al (10) and Lawrence et al (9), the vascular capacity of the kidney plus that of background tissue in the kidney region. Wax et al (16) in experiments with animals demonstrated an overlapping of the phases of the radiohippuran renogram. For clinical purposes it is necessary to know, in which part each process influences the shape of the renogram, to determine better the kidney function.…”

Isotope Nephrography with 131I “Hippuran”

“…the half-life. Indeed, this has been stressed by several authors (13,17,19,21). Stewart and Haynie (1 8) have taken particular interest in this aspect.…”

“…As already mentioned, the first phase was originally thought to represent the Idood flow, while the secondary rise was believed to represent tubular function and the descending part of the curve the excretion in the pelvis and the urine flow. However, thorough investigations, chiefly by Wax and McDonald (21) showed that this division cannot be maintained. T h e first, so-called "vascular" phase, is due predominantly to the functional capacity of the kidney, in the form of glomerular filtration and tubular secretion, and only to a minor extent to its vascular capacity.…”

Tierexperimentelle Studien zur Funktionsbeurteilung von Harnstauungsnieren mit der katheterlosen seitengetrennten Bestimmung der 131J-Hippuran-Clearance

“…B. einer Harnstauung, die renale Leistung wiedergibt. Dabei wird abweichend von Literaturangaben (17,28,53,54) unterstellt, daß Hippuran vor der 120. Sek.…”