Is Ureter Visualization Possible on Tc-99m DMSA Scintigraphy with Vesicoureteral Reflux Patients?

Aim: Ureter or pelvicalyceal system is not be vizualized with 99mTechnetium- dimercaptosuccinic acid (99mTc-DMSA) which is accumulated by renal cortex normally. In this study the cases whose ureters are visible were reviewed with 99mTc-DMSA scintigraphy. Material and Method: 18 patients (5 females, 13 males) with median age 3.5 years (min 2 months-max 18 years) were included in this study. Twenty ureters and/or pelvis of 18 patients were visible in 99mTc-DMSA scintigraphy. In two patients%u2019s both ureters were visible. Vesicoureteral reflux (VUR) grade, 99mTc-DMSA uptake, renal size, status of pelvicalyceal system, urea, creatinine levels were evaluated in all patients. Results: Three of the visible ureters were actually due to pelvicaliectasis. These pelvicaliectasic patients were excluded from the study. In the evaluation of the remaining 17 ureters of patients, congenital megaureter was present in three patients. Grade 3 VUR was detected in three patients, grade 4 was in three patients. VUR is seen as grade five in eight kidneys of seven patients because one of these patients has bilateral vizualized ureter. Discussion: In patients with congenital megaureter and VUR, ureters can be visible with 99mTc-DMSA scintigraphy and further imaging modalities are recommended for these patients