A DMSA scan is a

radionuclide A radionuclide (radioactive nuclide, radioisotope or radioactive isotope) is a nuclide that has excess numbers of either neutrons or protons, giving it excess nuclear energy, and making it unstable. This excess energy can be used in one of three ...

scan that uses

dimercaptosuccinic acid Succimer, sold under the brand name Chemet among others, is a medication tool used to treat lead poisoning, lead, mercury poisoning, mercury, and arsenic poisoning. When it's radioactive tracer, radiolabeled with technetium-99m, it's used in ...

(DMSA) in assessing renal morphology, structure and function. Radioactive

technetium-99m Technetium-99m (99mTc) is a metastable nuclear isomer of technetium-99 (itself an isotope of technetium), symbolized as 99mTc, that is used in tens of millions of medical diagnostic procedures annually, making it the most commonly used Radiophar ...

is combined with DMSA and injected into a patient, followed by imaging with a gamma camera after 2-3 hours. A DMSA scan is usually static imaging, while other radiotracers like DTPA and MAG3 are usually used for dynamic imaging to assess renal excretion. The major clinical indications for this investigation are # Detection and/or evaluation of a renal scar, especially in patients having vesicoureteric reflux (VUR) # Small or absent kidney (

renal agenesis Renal agenesis is a medical condition in which one (unilateral) or both (bilateral) fetal kidneys fail to develop. Unilateral and bilateral renal agenesis in humans, mice and zebra fish has been linked to mutations in the gene GREB1L. It has also ...

), # Ectopic kidneys (sometimes cannot be visualized by ultrasonography of abdomen due to intestinal gas) # Evaluation of an occult duplex system, # Characterization of certain renal masses, # Evaluation of systemic

hypertension Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...

especially young hypertensive and in cases of suspected

vasculitis Vasculitis is a group of disorders that destroy blood vessels by inflammation. Both artery, arteries and veins are affected. Lymphangitis (inflammation of lymphatic vessels) is sometimes considered a type of vasculitis. Vasculitis is primarily c ...

. # It is sometimes used as a test for the diagnosis of acute pyelonephritis. However, the sensitivity of DMSA scan for acute pyelonephritis may be as low as 46%. Procedure: Patient is injected with 2-5 mCi of Technetium-99m DMSA intravenously and static imaging is done using Gamma camera after 2-3 hours. Imaging time is approximately 5 - 10 minutes depending on the views taken. Usually, posterior and oblique views are a must for better interpretation of the scan. Patient is asked to maintain good hydration before and after the radiotracer injection by drinking water or intravenous fluid administration, if patient cannot drink water for any reason. Usually fasting is not required for scanning purpose and patients can have light breakfast in the morning of the scan day. The technetium-99m DMSA binds to the proximal convoluted tubules in kidney so the excretion pattern of the kidneys cannot be assessed by this for which renal dynamic scans using radiotracers like DTPA, MAG3 are used.

References

{{Medical imaging, state=collapsed Nephrology Radiography 2D nuclear medical imaging

See also

References