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TH
CONGRESS OF THE ESPU
S17-17 (P without presentation)
PREDICTIVE VALUE OF CORTICAL TRANSIT TIME
ON MAG3 FOR THE NEED OF SURGERY IN ANTENATALLY
DETECTED UNILATERAL HYDRONEPHROSIS DUE
TO URETEROPELVIC JUNCTION STENOSIS
Jun Nyung LEE, Jae-Wook CHUNG, Yun-Sok HA and Sung Kwang CHUNG
Kyungpook National University School of Medicine, Urology, Daegu, REPUBLIC OF KOREA
PURPOSE
In antenatal hydronephrosis (ANH) due to ureteropelvic junction (UPJ) stenosis, the main challenge
is to predict which patients have significant obstruction and require surgical intervention. Some
studies showed that cortical transit time (CTT) could successfully predict functional deterioration in
children with UPJ stenosis. We assessed the impact of initial CTT on Technetium-99m mercaptoa-
cetyltriglycerine (MAG3) diuretic renogram for the need for surgery in children with unilateral ANH
due to UPJ stenosis.
MATERIAL AND METHODS
We retrospectively reviewed the medical records of 33 patients with unilateral ANH due to UPJ
stenosis who managed at our institution between 2006 and 2014. Delayed CTT was defined by
absence of activity in the subcortical structures within 3 minutes of tracer injection on MAG3 reno-
gram. This study analyzed and compared the initial level of society of fetal urology (SFU) grade,
anteroposterior diameter (APD), spilt renal function, drainage pattern on diuretic renogram, and
CTT with the need for surgery.
RESULTS
Of the 33 children, 16 were classified as the delayed CTT group and 17 were placed in the normal
CTT group. During follow-up period (31.8 months), the surgery was needed in 75.0% (12/16) of
delayed CTT group and in 5.9% (1/17) of normal CTT group. Multivariate analysis showed that
delayed CTT on initial MAG3 scan and APD on initial ultrasonography were independent predictive
factors of the need for surgery.
CONCLUSIONS
CTT on initial MAG3 scan is useful predictor of the need for surgery in children with antenatally
detected unilateral hydronephrosis due to UPJ stenosis.