Abstract:

Objective To observe the characteristics of diuretic renography (DR) of children with neurogenic bladder (NB) and to evaluate the application value of DR in the diagnosis and follow-up of children with NB. Methods Thirteen children diagnosed as NB by clinical syndromes and urodynamic investigations underwent 15 DR examinations. Two cases were re-examined after treatment. Images and clinical data of these patients were analyzed. Images of two examinations of two followup cases were compared. Results According to the DR images, bladders of 10 cases were badly filled or even unvisualized and their ureters were wholly or partly dilatated. All patients had different degree of hydronephrosis and kidneys of 7 patients shrank (46.7%). Functions of renal cortex were severely damaged. The nephrograms indicated mechanical obstruction of upper urinary tract and some of which showed lower level. The blood perfusion rate (BPR) ratio of the atrophic kidney of patients with single atrophic kidney was significantly lower than that of the contralateral kidney (t=－11.19, P<0.05). For two follow-up cases, the functions of upper urinary tract of one case were significantly improved, while the other showed no change. Conclusion The DR imaging of children with NB showed that every part of upper urinary tract has characteristic changes, which can help the diagnosis. DR imaging can evaluate the damage level of renal functions and DR has certain application value for the evaluation of therapeutic effect and follow up.

Key words: neurogenic bladder, children, radionuclide imaging, ethylenedicysteine