3,18-20] The choice of side should be determined by the findings on renography
and CT angiography.
The distinction between renal artery stenosis and renal vascular hypertension explains the different roles of angiography and captopril renography
in the management of these patients.
The differential renal function was assessed with computerized isotope renography
(DTPA renal scan) in selected patients.
The gamma camera as an absolute measurement device determination of glomerular filtration rate in 99 mTc-DTPA renography
using a dual head gamma camera.
In cases of obstruction, a study called diuretic renography
is sometimes later performed, after kidney function has matured.
which was introduced by Gates, (5) is considered to be more accurate than 24 hours creatinine clearance and is recommended for clinical use in patients with reduced renal function.
14) Thus, the clinical setting and the use of further imaging such as diuretic renography
may be necessary to determine the functional significance of the appearance of a dilated collecting system.
For specification of kidneys' damage with concrement and evaluation of kidneys' functional state, ultrasound, roentgenologic (review, excretory or infusion urography), radioisotope (radioisotope renography
, kidneys' scanning, dynamic nephrosonography) studies were used.
For further investigation of the differential diagnosis, more invasive diagnostic tests may need to be ordered such as: renal biopsy; renal ultrasound to assess renal size, echogenicity, and cortical thickness; plain abdominal film if nephrocalcinosis is suspected; intravenous urogram if obstruction/stones suspected; nuclear medicine scans such as MAG-3 renography
for differential function; and DTPA scan for evidence of scarring (Dellow et al.
in the diagnosis of renal artery stenosis and the prediction of improvement with revascularization: the Yale Vascular Center experience.
With regards to diagnostic imaging, there has been reasonable access to ultrasonography, voiding cystourethrography (with experienced pediatric nurses placing the catheters), Lasix renography
, and magnetic resonance imaging.