Radionuclide Evaluation of the Genitourinary System

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Which property of the glomerulus allows only small molecules to pass through?

Impermeability

Selective filtration

Semipermeable membrane (correct)

Tubular secretion

What is the main purpose of using radiopharmaceuticals to evaluate renal function and anatomy?

To assess renal perfusion and collecting system

To quantify glomerular filtration rate (GFR)

To image the renal cortex in high resolution

All of the above (correct)

Which radiopharmaceutical binds to the sulfhydryl groups in the proximal renal tubules?

99mTc-DTPA

99mTc-glucoheptonate

99mTc-DMSA (correct)

None of the above

What is a disadvantage of using 99mTc-DMSA for renal imaging?

All of the above Signup and view all the answers

Which radiopharmaceutical is cleared by both glomerular filtration and renal tubular secretion?

99mTc-glucoheptonate Signup and view all the answers

What is the main advantage of using 99mTc-glucoheptonate for renal imaging?

Allows for assessment of renal perfusion and collecting system Signup and view all the answers

Which radiopharmaceutical is the only one used for the evaluation of glomerular filtration function?

99mTc-DTPA Signup and view all the answers

Which radiopharmaceutical is best suited for high-resolution imaging of the renal cortex?

99mTc-DMSA Signup and view all the answers

Which radiopharmaceutical is not effectively used for imaging the ureters or bladder?

99mTc-DMSA Signup and view all the answers

Which radiopharmaceutical is used to assess both renal perfusion and the renal collecting system?

99mTc-glucoheptonate Signup and view all the answers

Which of the following is NOT a primary mechanism of the excretory function of the kidneys?

Magnetic resonance imaging (MRI) Signup and view all the answers

What percentage of renal plasma flow is cleared by glomerular filtration?

20% Signup and view all the answers

What is the role of nuclear renal imaging, according to the passage?

All of the above Signup and view all the answers

What is the primary reason for the diminished use of nuclear techniques in the evaluation of renal anatomy?

All of the above Signup and view all the answers

Which of the following is NOT an indication for radionuclide scanning, according to the passage?

Evaluation of suspected renovascular hypertension Signup and view all the answers

What is the relationship between the two primary mechanisms of the excretory function of the kidneys, according to the passage?

They are complementary processes, with 20% of renal plasma flow cleared by glomerular filtration and 80% by tubular secretion Signup and view all the answers

What is the purpose of measuring the 20-minute maximal cortical ratio for 99mTc-MAG3?

To assess the transit time of the radiopharmaceutical in the kidney Signup and view all the answers

What is the significance of the clearance of a particular substance per minute (mL/min) as the plasma passes through the kidneys?

It defines the effective renal plasma flow (ERPF) Signup and view all the answers

What is the difference between the radionuclide methods of determining GFR and ERPF?

Plasma sample-based clearances are more tedious and require meticulous attention to detail, while camera-based clearances are more accurate Signup and view all the answers

What is the normal range for the 20-minute maximal cortical ratio for 99mTc-MAG3?

0.19 (standard deviation 0.07 and 0.04 for the right and left kidneys) Signup and view all the answers

What is the relationship between the clearance of insulin and the glomerular filtration rate (GFR)?

The clearance of insulin, which is entirely filtered, defines the GFR Signup and view all the answers

What is the relationship between the clearance of para-aminohippurate (PAH) and the effective renal plasma flow (ERPF)?

The clearance of PAH, which is both filtered and secreted by the tubules, defines the ERPF Signup and view all the answers

What is the normal glomerular filtration rate (GFR) in mL/min?

125 Signup and view all the answers

Why does DTPA tend to slightly underestimate the GFR?

It is bound to plasma proteins Signup and view all the answers

Which radiopharmaceutical is predominantly cleared by the proximal tubules with minimal filtration?

Mertiatide (MAG3) Signup and view all the answers

Why is MAG3 considered to provide more satisfactory images than 99mTc-DTPA?

Greater extraction efficiency Signup and view all the answers

Which phase of the kidney scan involves evaluation of renal blood flow and function of native kidneys from the posterior projection?

Renal perfusion phase Signup and view all the answers

In which patients is 99mTc-DTPA not considered an ideal agent for demonstrating intraparenchymal renal lesions?

Patients with renal obstruction Signup and view all the answers

What is the typical administered activity for adults for 99mTc-MAG3?

= 10 mCi (370 MBq) Signup and view all the answers

'Imaging renal perfusion is usually begun as the bolus is visualized in the proximal abdominal aorta' refers to which phase of a kidney scan?

'Renal perfusion phase' Signup and view all the answers

'The spleen overlies the left kidney, giving a false impression of asymmetrically increased left renal perfusion' indicates what type of issue in imaging?

'Biological artifact' Signup and view all the answers

Which radiopharmaceutical can be used to measure effective renal plasma flow (ERPF)?

Mertiatide (MAG3) Signup and view all the answers

What phase of the renogram curve represents the period during minutes 1 through 5 with the peak of the curve?

Cortical or tubular concentration phase Signup and view all the answers

Which phase of the renogram curve is characterized by the down slope of the curve and is produced by excretion of the radiopharmaceutical from the kidney and clearance from the collecting system?

Clearance or excretion phase Signup and view all the answers

What should be considered abnormal if the relative renal uptake ratio at 2 to 3 minutes is 40% or less in one kidney?

Half-time excretion Signup and view all the answers

Which term refers to the time for half of the peak activity to be cleared from the kidney?

Half-time excretion (T 1/2) Signup and view all the answers

What is the normal percentage expected for differential cortical retention at 15 minutes after injection in each kidney?

50% Signup and view all the answers

What should be taken into account if cortical regions of interest are used and are not of equal size when measuring relative renal function between the two kidneys?

Differential cortical retention at 15 minutes Signup and view all the answers

Which part of the renogram curve is helpful in deriving semiquantitative indices and inspecting for alterations in the normal configuration?

'Long tail' extending to the right Signup and view all the answers

What is a significant effect of dehydration on renograms?

'Delayed parenchymal clearance' Signup and view all the answers

What part of the renogram curve closely correlates with ERPF values?

Initial uptake slope Signup and view all the answers

What is indicated by an abnormal renogram curve that shows delayed peak activity, delayed parenchymal clearance, and/or an elevation of the excretion slope?

Dehydration Signup and view all the answers

What is the function of the renal perfusion phase in renal imaging studies?

Thought to contribute the least to functional assessment Signup and view all the answers

Which radiopharmaceutical is commonly used in renal parenchymal function imaging?

99mTc-DTPA Signup and view all the answers

At what time interval is the maximal parenchymal activity typically observed in imaging with 99mTc-MAG3?

3 to 5 minutes Signup and view all the answers

What is the purpose of administering furosemide (Lasix) during renal imaging studies?

To facilitate transit of activity from the renal pelvis to the bladder Signup and view all the answers

What do renograms provide a graphic representation of?

Uptake and excretion of a radiopharmaceutical by the kidneys Signup and view all the answers

When is the information displayed on a renogram curve obtained using agents like 99mTc-MAG3?

Around 20 to 30 minutes after injection Signup and view all the answers

How many phases are typically present in a normal computer-generated renogram curve using a tubular radiopharmaceutical?

Three phases Signup and view all the answers

Which region of interest might be used to assess the discreteness and adequacy of the injected bolus in a renogram?

Aortic region Signup and view all the answers

At what point in time is maximal activity usually observed in both kidneys during normal renal blood flow imaging with technetium-99m diethylenetriamine pentaacetic acid (99mTc-DTPA)?

5-6 seconds Signup and view all the answers

What is the main advantage of omitting the renal perfusion phase in renal imaging studies?

Reduction in patient radiation dose Signup and view all the answers

Radionuclide Evaluation of the Genitourinary System

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Questions and Answers

Which property of the glomerulus allows only small molecules to pass through?

What is the main purpose of using radiopharmaceuticals to evaluate renal function and anatomy?

Which radiopharmaceutical binds to the sulfhydryl groups in the proximal renal tubules?

What is a disadvantage of using 99mTc-DMSA for renal imaging?

Which radiopharmaceutical is cleared by both glomerular filtration and renal tubular secretion?

What is the main advantage of using 99mTc-glucoheptonate for renal imaging?

Which radiopharmaceutical is the only one used for the evaluation of glomerular filtration function?

Which radiopharmaceutical is best suited for high-resolution imaging of the renal cortex?

Which radiopharmaceutical is not effectively used for imaging the ureters or bladder?

Which radiopharmaceutical is used to assess both renal perfusion and the renal collecting system?

Which of the following is NOT a primary mechanism of the excretory function of the kidneys?

What percentage of renal plasma flow is cleared by glomerular filtration?

What is the role of nuclear renal imaging, according to the passage?

What is the primary reason for the diminished use of nuclear techniques in the evaluation of renal anatomy?

Which of the following is NOT an indication for radionuclide scanning, according to the passage?

What is the relationship between the two primary mechanisms of the excretory function of the kidneys, according to the passage?

What is the purpose of measuring the 20-minute maximal cortical ratio for 99mTc-MAG3?

What is the significance of the clearance of a particular substance per minute (mL/min) as the plasma passes through the kidneys?

What is the difference between the radionuclide methods of determining GFR and ERPF?

What is the normal range for the 20-minute maximal cortical ratio for 99mTc-MAG3?

What is the relationship between the clearance of insulin and the glomerular filtration rate (GFR)?

What is the relationship between the clearance of para-aminohippurate (PAH) and the effective renal plasma flow (ERPF)?

What is the normal glomerular filtration rate (GFR) in mL/min?

Why does DTPA tend to slightly underestimate the GFR?

Which radiopharmaceutical is predominantly cleared by the proximal tubules with minimal filtration?

Why is MAG3 considered to provide more satisfactory images than 99mTc-DTPA?

Which phase of the kidney scan involves evaluation of renal blood flow and function of native kidneys from the posterior projection?

In which patients is 99mTc-DTPA not considered an ideal agent for demonstrating intraparenchymal renal lesions?

What is the typical administered activity for adults for 99mTc-MAG3?

'Imaging renal perfusion is usually begun as the bolus is visualized in the proximal abdominal aorta' refers to which phase of a kidney scan?

'The spleen overlies the left kidney, giving a false impression of asymmetrically increased left renal perfusion' indicates what type of issue in imaging?

Which radiopharmaceutical can be used to measure effective renal plasma flow (ERPF)?

What phase of the renogram curve represents the period during minutes 1 through 5 with the peak of the curve?

Which phase of the renogram curve is characterized by the down slope of the curve and is produced by excretion of the radiopharmaceutical from the kidney and clearance from the collecting system?

What should be considered abnormal if the relative renal uptake ratio at 2 to 3 minutes is 40% or less in one kidney?

Which term refers to the time for half of the peak activity to be cleared from the kidney?

What is the normal percentage expected for differential cortical retention at 15 minutes after injection in each kidney?

What should be taken into account if cortical regions of interest are used and are not of equal size when measuring relative renal function between the two kidneys?

Which part of the renogram curve is helpful in deriving semiquantitative indices and inspecting for alterations in the normal configuration?

What is a significant effect of dehydration on renograms?

What part of the renogram curve closely correlates with ERPF values?

What is indicated by an abnormal renogram curve that shows delayed peak activity, delayed parenchymal clearance, and/or an elevation of the excretion slope?

What is the function of the renal perfusion phase in renal imaging studies?

Which radiopharmaceutical is commonly used in renal parenchymal function imaging?

At what time interval is the maximal parenchymal activity typically observed in imaging with 99mTc-MAG3?

What is the purpose of administering furosemide (Lasix) during renal imaging studies?

What do renograms provide a graphic representation of?

When is the information displayed on a renogram curve obtained using agents like 99mTc-MAG3?

How many phases are typically present in a normal computer-generated renogram curve using a tubular radiopharmaceutical?

Which region of interest might be used to assess the discreteness and adequacy of the injected bolus in a renogram?

At what point in time is maximal activity usually observed in both kidneys during normal renal blood flow imaging with technetium-99m diethylenetriamine pentaacetic acid (99mTc-DTPA)?

What is the main advantage of omitting the renal perfusion phase in renal imaging studies?

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