Chronic urinary schistosomiasis: patterns of abnormalities in radionuclide Tc-99 m DTPA diuretic renogram

The aim of this study was to describe the abnormal morphological and functional patterns observed in radionuclide diuretic renograms (RDR) in patients with chronic urinary schistosomiasis. A retrospective analysis of RDR for 92 patients was made. It revealed the following abnormalities: A) Morphological changes observed in the images: Pelvicalyceal retention of tracer (and dilatation) was seen in 68% of kidneys. Calyceal retention alone was seen in 5% and pelvic retention alone in 9%. An atrophic kidney was noted in 5%, nephropathic pattern in 3% and normal kidneys in 10%. Ureteric retention of tracer was seen in 64% of ureters. This was frequently associated with pelvicalyceal retention (61%) and this abnormality was bilateral in 44% of the urinary systems. B) Functional changes observed in the time activity curves: Non-obstructive delayed excretion was noted in 71% of kidneys. An obstructed kidney pattern nonresponsive to lasix was seen in 12%, plateau curve due to nephropathic kidney in 3% and atrophic kidney pattern in 4% of kidneys.