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Technetium-99m-dimercaptosuccinic acid renal scintigraphy and single photon emission computed tomography/computed tomography in patients with sickle cell disease

Ramos, Celso Darioa; Onusic, Daniel Massaroa; Brunetto, Sergio Querinob; Amorim, Bárbara Juareza; Souza, Thiago Ferreiraa; Saad, Sara Teresinha Olallac; Lima, Mariana da Cunha Lopesa

doi: 10.1097/MNM.0000000000001086
Original Articles
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Purpose Sickle cell disease (SCD) is a common hematologic hereditary disorder characterized by vaso-occlusive episodes affecting multiple organs, and substantially alters renal structure and function. We aimed to evaluate the utility of renal scintigraphy and single photon emission computed tomography/computed tomography (SPECT/CT) with technetium-99m-dimercaptosuccinic acid (99mTc-DMSA) in adult patients with SCD and no clinical evidence of renal insufficiency.

Materials and methods Twenty-six patients (16 female) aged 23–58 years with SCD and no clinical evidence of renal insufficiency were prospectively studied. Planar and SPECT/CT images were, respectively, obtained after 3 and 4 hours of the injection of 110–180 MBq of 99mTc-DMSA. The relative radiopharmaceutical uptake and renal length were, respectively, determined using SPECT and CT images. Planar and SPECT/CT images were visually analyzed to identify focal areas of 99mTc-DMSA reduced uptake and anatomical deformities of the kidneys.

Results Focal areas of reduced 99mTc-DMSA uptake with an image aspect of renal scars or inflammation were present in 21/26 patients (81%). In 11/21 (52%) of these patients, the cortical lesions were clearly identified only on SPECT images. Prominent renal columns were observed in 17/26 (65%) patients. The left kidney tended to be more affected than the right kidney. Most patients had enlarged kidneys.

Conclusion 99mTc-DMSA scintigraphy and SPECT/CT identify renal lesions possible related to renal infarcts or infections in most adult patients with SCD and no clinical evidence of renal insufficiency. Prominent renal columns and increased renal size tend to occur in most of these patients.

aNuclear Medicine Division, Department of Radiology

bHematology Division, Department of Internal Medicine

cCenter for Biomedical Engineering (CEB), University of Campinas, Campinas, Brazil

Received 14 May 2019 Accepted 19 July 2019

Correspondence to Celso Dario Ramos, MD, PhD, Division of Nuclear Medicine, Department of Radiology, University of Campinas, Zeferino Vaz Avenue, S/N. PO Box 6149, Campinas 13080-000, Brazil, Tel: +55 19 3521 7772; fax: +55 19 3731 4144; e-mail: cdramos@unicamp.br

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