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. 2023 Sep;46(5):825-829.
doi: 10.1080/10790268.2022.2088504. Epub 2022 Jul 5.

Comparing the role of renal ultrasound vs MAG3 renal scans for evaluation of neurogenic bladder after spinal cord injury

Ryan Solinsky  1   2   3 , Susan V Garstang  4   5 , Todd A Linsenmeyer  6   7   8
Affiliations

Comparing the role of renal ultrasound vs MAG3 renal scans for evaluation of neurogenic bladder after spinal cord injury

Ryan Solinsky et al. J Spinal Cord Med. 2023 Sep.

Abstract

Objective: Compare ability of renal ultrasound and Tc-99m mercaptoacetyltriglycine (MAG3) renal scan to identify upper urinary tract stasis.

Design: Retrospective chart review.

Setting: Outpatient Neuro-urology clinic serving a large SCI population.

Participants: One hundred and sixty-five individuals with spinal cord injury, presenting for annual evaluation.

Interventions: Renal ultrasound, MAG3 renal scan.

Outcome measures: Radiologic evidence of upper urinary tract stasis as reviewed by independent radiologist. For renal ultrasounds, this included: mild hydronephrosis, dilation of collecting systems, pelviectasis, or caliectasis. For MAG3 renal scans, this included evidence of slow drainage of radioisotope, dilation of collecting systems, or reverse peristalsis.

Results: Forty-five individuals with spinal cord injury demonstrated upper tract stasis, with 12 identified by renal ultrasound and 43 identified by MAG3 renal scan. There was a strong relative correlation between test results (Yule's Q = 0.90), though MAG3 renal scan identified a significantly higher rate of upper tract stasis within the same patients (P < 0.0001). The odds ratio of improved identification using MAG3 renal scan was 16.5 (95% CI 3.96-68.76).

Conclusions: While renal ultrasound is more effective at evaluating renal anatomy, MAG3 renal scan identifies significantly more upper urinary tract stasis than renal ultrasound and should be considered for SCI individuals with risk factors of upper tract injury.

Keywords: Neurogenic bladder; Renal insufficiency; Spinal cord injury.

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Figures

Figure 1
Figure 1
Venn diagram demonstrating incidence of upper tract stasis identification (n = 45) with both renal ultrasound and MAG3 renal scan. Notably, MAG3 renal scan identified 33 individuals (73%) with upper tract stasis that would have been missed by renal ultrasound alone.
See this image and copyright information in PMC

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