Deneysel olarak vezikoüreteral reflü oluşturulan tavşanlarda renal hasarın renal kortikal sintigrafi ve fonksiyonel manyetik rezonans ile görüntülenmesi
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Abstract
SUMMARY We aimed to evaluate the renal damage by means of 99mTc- dimercapto- succinic acid renal sintigraphy ( 99mTc DMSA) and functional magnetic resonans imaging (MR) based on the histopathologic alterations. A total of 30 prepubertal 3-month - old male New Zealand rabbits were used in this study. Thirty prepubertal male rabbits were divided into three equal groups. Group 1 was vesicoureteral reflux plus infected urine group, Group 2 was vesicoureteral reflux plus steril urine group and Group 3 was control group. Urine culture, cystouretrography, 99mTc- dimercapto-succinic acid renal sintigraphy and magnetic resonans were performed before reflux procedure. To create unilateral vesicoureteral reflux, the roof of the left intravesical ureter was incised in 20 rabbits, in Group 1 and Group 2, left vesicoureteral reflux was confirmed by cystography 2 weeks after reflux procedure and 1ml of E coii suspension (105 K-12 strain of E Coli in 1ml ) was inoculated into the bladder in addition to the reflux procedure in Group 1. One week after introduction of the infection, urine cultures were perfomed for all rabbits. Urine cultures were positive only in rabbits of Group 1. 99mTc- dimercapto-succinic acid renal sintigraphy and magnetic resonans were performed at 8 weeks after reflux procedure and the animals were sacrified and examined histopatologically. Each kidney was divided into three zones (upper, middle and lower). Image findings were then compared with the pathology results for the presence or absence of renal damage in each zone. Thirty kidneys (90 zones) were imaged and examined. Histopathologic examination revealed renal damage in 38 zones in 13 kidneys. Sensitivity and specificity for detecting renal damage in the kidneys were 100% and 100% for DMSA, 100% and 94% for MR imaging. Sensitivity and specificity for detecting renal damage in the zones were 94.7% and 98% for DMSA, 94.7% and 88% for MR imaging. MRİ had a sensitivity of 90% and a specificity 85% for the renal function of the kidneys which had renal VIIdamage using DMSA as the gold standart. There were high correlation between DMSA findings and MR imaging. In this study, there is no statistically significant difference between the two techniques in the detection of pathology. MR imaging show significant coreiation with DMSA in determination of pathology. MRI may be a reliable diagnostic method, which can be used as a complementary method to DMSA in the determination of patients with renal damage Key Words: Vesicoureteral reflux, reflux nephropathy, dynamic functional magnetic resonans, 99mTc DMSA renal scintigraphy Vlll SUMMARY We aimed to evaluate the renal damage by means of 99mTc- dimercapto- succinic acid renal sintigraphy ( 99mTc DMSA) and functional magnetic resonans imaging (MR) based on the histopathologic alterations. A total of 30 prepubertal 3-month - old male New Zealand rabbits were used in this study. Thirty prepubertal male rabbits were divided into three equal groups. Group 1 was vesicoureteral reflux plus infected urine group, Group 2 was vesicoureteral reflux plus steril urine group and Group 3 was control group. Urine culture, cystouretrography, 99mTc- dimercapto-succinic acid renal sintigraphy and magnetic resonans were performed before reflux procedure. To create unilateral vesicoureteral reflux, the roof of the left intravesical ureter was incised in 20 rabbits, in Group 1 and Group 2, left vesicoureteral reflux was confirmed by cystography 2 weeks after reflux procedure and 1ml of E coii suspension (105 K-12 strain of E Coli in 1ml ) was inoculated into the bladder in addition to the reflux procedure in Group 1. One week after introduction of the infection, urine cultures were perfomed for all rabbits. Urine cultures were positive only in rabbits of Group 1. 99mTc- dimercapto-succinic acid renal sintigraphy and magnetic resonans were performed at 8 weeks after reflux procedure and the animals were sacrified and examined histopatologically. Each kidney was divided into three zones (upper, middle and lower). Image findings were then compared with the pathology results for the presence or absence of renal damage in each zone. Thirty kidneys (90 zones) were imaged and examined. Histopathologic examination revealed renal damage in 38 zones in 13 kidneys. Sensitivity and specificity for detecting renal damage in the kidneys were 100% and 100% for DMSA, 100% and 94% for MR imaging. Sensitivity and specificity for detecting renal damage in the zones were 94.7% and 98% for DMSA, 94.7% and 88% for MR imaging. MRİ had a sensitivity of 90% and a specificity 85% for the renal function of the kidneys which had renal VIIdamage using DMSA as the gold standart. There were high correlation between DMSA findings and MR imaging. In this study, there is no statistically significant difference between the two techniques in the detection of pathology. MR imaging show significant coreiation with DMSA in determination of pathology. MRI may be a reliable diagnostic method, which can be used as a complementary method to DMSA in the determination of patients with renal damage Key Words: Vesicoureteral reflux, reflux nephropathy, dynamic functional magnetic resonans, 99mTc DMSA renal scintigraphy Vlll
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