Mercaptoacetyltriglycine (MAG-3) Renogram
- Radionuclide scans performed with a diuretic are dynamic studies which allow for assessment of obstruction which, in this setting, is mostly due to pelviureteric junction (PUJ) obstruction.
- Mercaptoacetyltriglycine (MAG-3) or a diethylene triamine pentaacetic acid (DTPA) can both be used, however, MAG-3 is preferred due to its favourable renal excretion properties which allow for more accurate assessment of renal drainage. 15
- Renograms require careful interpretation as they can be affected by the level of hydration, the region of interest selected for analysis and failure of the immature kidney to respond to the diuretic. 15 Some institutions perform a “well-tempered renogram” with intravenous hydration and a urethral catheter in-situ to minimise the effect of these variables. However, this increases the invasiness of the procedure.
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Disadvantages of radionuclide scans include:
● Exposure to ionising radiation
● Can be difficult to interpret
● "Well-tempered renograms” are invasive
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