Comparing the role of renal ultrasound vs MAG3 renal scans for evaluation of neurogenic bladder after spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2088504 · Published: January 1, 2023

Spinal Cord Injury Urology Medical Imaging

Simple Explanation

Following spinal cord injury, bladder issues are common, and careful monitoring of the upper urinary tracts is essential to prevent complications like renal failure. This study compares two imaging methods: renal ultrasound and MAG3 renal scans. Renal ultrasounds are good for seeing the structure of the kidneys, but MAG3 scans may be better at finding problems early by measuring how well the kidneys filter waste. The study found that MAG3 scans identified more cases of upper urinary tract stasis (a condition where urine isn't draining properly) than renal ultrasounds in people with spinal cord injuries.

Study Duration

Not specified

Participants

165 individuals with spinal cord injury

Evidence Level

Level 3: Retrospective chart review

Key Findings

1
MAG3 renal scan identified a significantly higher rate of upper tract stasis compared to renal ultrasound (P < 0.0001).
2
The odds ratio of improved identification using MAG3 renal scan was 16.5 (95% CI 3.96–68.76).
3
There was a strong relative correlation between test results (Yule’s Q = 0.90), though this was largely due to agreement when both tests were negative.

Research Summary

This retrospective study compared renal ultrasound and MAG3 renal scans in 165 individuals with spinal cord injury to identify upper urinary tract stasis. MAG3 renal scans identified significantly more cases of upper urinary tract stasis than renal ultrasounds, suggesting they may be more sensitive for detecting early physiologic changes. The authors suggest that MAG3 renal scans should be considered, especially in patients with urodynamic risk factors for upper tract damage, as an adjunct to renal ultrasound.

Practical Implications

Improved Detection of Early Renal Issues

MAG3 renal scans can detect early kidney problems in SCI patients, allowing for earlier intervention and potentially preventing long-term damage.

Adjunct to Renal Ultrasound

MAG3 renal scans should be considered as an adjunct to renal ultrasound, especially in individuals with risk factors for upper tract damage.

Guidance for Treatment

Renal scans can serve as an important adjunct both to identify and guide treatment for those who are potentially at high risk for upper tract stasis identified via urodynamics.

Study Limitations

1
The study is retrospective and represents a single time point, so it did not assess if those with renal stasis on MAG3 scan later developed anatomic changes visible on ultrasound.
2
Individuals were selected if they had both renal ultrasound and MAG3 renal scan performed.
3
Demographics, race/ethnicity, and comorbidities were not recorded, limiting potential subanalyses.

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