Patient Name: Doe, John

Patient Name: Doe, John

ID Number: 123456

Date of birth: 4-2-63

Height: 71 in

Sex: Male

Referring physician: Dr. Jones

Date of the exam: 4-1-12

Radiopharmaceutical: 11.1 mCi 99mTc MAG 3 IV

Weight: 196 lb

Renal Scan

Indications/History: 49-year-old male referred with a history of left ureteropelvic junction obstruction; status post recent stenting.

Previous Study: CT scan of the abdomen and pelvis performed at XX Radiology Associates 1-9-12.

Findings: Immediately following the intravenous administration of 11.1 mCi of Tc99m MAG3, a posterior renal flow study was performed. Subsequent dynamic imaging through 30 minutes was performed, and a post-void film was obtained.

Split Renal Function:

Left: 29.5%

Right 70.5%

20-Minute Cortical Clearance:

Left: Could not be calculated

Right: 33.9%

T 1/2 Max (normal range x minutes):

Left: 30.5 minutes

Right 7 minutes

The study demonstrates asymmetry in the size of the kidneys, left kidney smaller than the right. There is prompt, though decreased left renal perfusion, probably due to the smaller size of the kidney. There is normal intrarenal transit time on the right with the collecting system visualizing at 3 minutes. There is prolonged intrarenal transit time on the left with the collecting system seen between 6 and 7 minutes. Neither renal pelvis is well visualized. The right ureter is faintly seen and is not dilated. The left ureter is not visualized. There is mild retention of radio-pharmaceutical in the right collecting system at 30 minutes. There is progressive intensification of the radio-pharmaceutical in the left collecting system throughout the course of the study. The findings on the left are suggestive of obstruction, although the level of obstruction is uncertain since the left renal pelvis and ureter were not visualized. The findings on the right could be due renal parenchymal disease or dehydration since there is no evidence of right hydronephrosis or obstruction on the CT scan of the abdomen from 1-9-17.

Impression:

1. Discrepancy in the size of the kidneys, left smaller than right.
2. Prompt but decreased left renal perfusion, probably related to the size of the kidney.
3. Non visualization of the left renal pelvis and ureter with progressive intensification of activity within the left collecting system as above. The findings are most compatible with an obstruction on the left, although the level of obstruction is uncertain based on this examination.
4. Prolonged excretion on the right, which could be due to renal parenchymal disease or dehydration. No scintigraphic evidence of obstruction on the right.

Electronically signed by Maria Costello, M.D. on 4/2/17 at 10:30 AM