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⁹⁹Tc^m-mercapto acetyl triglycine in paediatric renal tract disease

F. E. Pickworth, MRCP G. C. Vivian, MRCP, FRCR ^* K. Franklin, FRCR and E. F. Brown, MRCP, FRCR ^*,

Department of Diagnostic Radiology, Freedom Fields Hospital, Plymouth ^* Department of Diagnostic Radiology, Royal Cornwall Hospital, Truro

The use of ⁹⁹Tc^m-mercapto acetyl triglycine (⁹⁹Tc^m-MAG3), a new hippuran substitute, has been reported widely in adults but not in children. Our experience of its use in 100 infants and children for renography and indirect micturating cystography (IMC) is reported. The average age was 5.6 years. 65 patients completed IMC studies and nine patients had ⁹⁹Tc^m-dimercaptosuccinic acid (⁹⁹Tc^m-DMSA) scans performed on the same day. The majority of patients were referred for the investigation of urinary tract infection. 32 kidneys were found to be scarred on ⁹⁹Tc^m-MAG3 scans, 17 kidneys and ureters refluxed on IMC and 14 kidneys were obstructed. The results of ⁹⁹Tc^m-MAG3 scans were compared with those of other urinary tract investigations including ultrasound, micturating cystography (MCUG), intravenous urography (IVU) and ⁹⁹Tc^m-DMSA scintigraphy. No kidney which was scarred had a normal ⁹⁹Tc^m-MAG3 scan. All significant degrees of dilatation or obstruction on IVU or ultrasound were also detected by ⁹⁹Tc^m-MAG3. ⁹⁹Tc^m-MAG3 gave more information than any other single imaging modality and we believe it represents an ideal initial screening test in the investigation of urinary tract infection in older toilet-trained children.

Key Words: ⁹⁹Tc^m-mercapto acetyl triglycine • Paediatric • Indirect radionuclide cystography

Currently at: Department of Diagnostic Radiology, Bristol Royal Infirmary, Marlborough Street, Bristol. Offprint requests should be directed to G. C. Vivian, Department of Nuclear Medicine, Derriford Hospital, Plymouth PL6 8DH.

Received for publication December 6, 1990. Revision received April 3, 1991. Accepted for publication September 19, 1991.