A DMSA scan is a radionuclide scan that uses

dimercaptosuccinic acid Succimer, sold under the brand name Chemet among others, is a medication used to treat lead, mercury, and arsenic poisoning. When radiolabeled with technetium-99m, it is used in a number of types of diagnostic testing. A full course is 19 days ...

(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 medical ra ...

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), # 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 especially young hypertensive and in cases of suspected

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

. # It is sometimes used as a test for the diagnosis of

acute pyelonephritis Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. Symptoms most often include fever and flank tenderness. Other symptoms may include nausea, burning with urination, and frequent urination. Complications may ...

. 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