Sensitivity of¹³¹I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction

Abstract

Diuresis renography and pressure flow studies were performed in 14 patients with unilateral hydronephrosis. Based upon the results of intravenous pyelography, typical symptomatology, and the outcome of surgical treatment, all patients were found to have upper urinary tract obstruction. It was therefore possible to calculate the sensitivity of the two tests. Obstruction was found at the pressure flow studies in 7 of 14 patients (50%), while an obstructive pattern was found at diuresis renography in 12 of 13 patients (92%). Due to a very low glomerular filtration rate, diuresis renography was equivocal in 1 case. Based upon these results, diuresis renography seems to be superior to pressure flow studies in cases with upper urinary tract obstruction.

Magnetic Resonance Urography in Pediatric Urology

“…Obstruction was more often shown by means of diuretic renal scans than pressure perfusion studies. However, Jakobsen et al (12) found an obstructive pattern at diuresis renography in 12/13 patients (92% sensitivity). Anton-Pacheco Sanchez et al (13), in their series of diagnosing obstructive and non-obstructive megaureters, concluded that primary megaureters are best assessed and followed up by means of diuresis renography.…”

Suspected Pyelo-Ureteral Junction Obstruction in the Fetus: When to Do What? I. A Clinical Update

“…These circum stances have led to an intense effort to find measures for sorting out the nonobstructed cases, including pressure/ flow measurements, diuretic urography, diuretic USG, and different diuretic-renogram parameters [47,48], The accuracy of renography [49][50][51] and pressure/flow measurements [51] has been excellent, as related to find ings at operation or the outcome of nonoperative follow up. The match between the different methods of investi gation [52] has varied considerably -from around 60-85% [51,[53][54][55] to around 30% [56,57], Unfortunately, a poor match seems to occur more often in obstructed and equivocal cases than in nonobstructed ones. How ever, since there is no 'golden standard', these investiga tions should be interpreted cautiously and should not be a substitute for old-fashioned, sound clinical judgement (pain, urinary tract infection, palpable mass, and oth ers)!…”

A novel quantitative method for measuring obstruction in the upper urinary tract: The ‘obstruction coefficient’

“…In addition, an isotope examination of the kidneys, that is, dynamic renography, was complemented by diuretic charge. The method of diuresis renography enabled us to determine obstruction semiquantitatively 4–7 . A resistive index helps conclude the rate of obstruction in a non‐invasive way either determined by duplex Doppler sonography, 8–10 computerized tomography, 11 or by magnetic resonance imaging 12 .…”

“…The method of diuresis renography enabled us to determine obstruction semiquantitatively. [4][5][6][7] A resistive index helps conclude the rate of obstruction in a non-invasive way either determined by duplex Doppler sonography, [8][9][10] computerized tomography, 11 or by magnetic resonance imaging. 12 This method could not spread widely, however, due to the sophisticated equipment needed , the great interpersonal differences between examiners, and because the results do not always correlate with clinical figures.…”