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Figure 16. Renovascular hypertension secondary to fibromuscular hyperplasia in a young woman. The baseline 99mTc-DPTA study (A) shows mild asymmetry in initial renal uptake with quantitation (not shown) attributing 40% of renal function to the right kidney. There is normal clearance of tracer from the renal parenchyma. Following captopril (B), initial uptake on the right decreases with quantitation now attributing 30% of function to the right kidney. Clearance from the right kidney is slowed with marked parenchymal retention. A renal angiogram (C, inverted to correspond to the scan) shows fibromuscular hyperplasia.

Figure 16. Renovascular hypertension secondary to fibromuscular hyperplasia in a young woman. The baseline 99mTc-DPTA study (A) shows mild asymmetry in initial renal uptake with quantitation (not shown) attributing 40% of renal function to the right kidney. There is normal clearance of tracer from the renal parenchyma. Following captopril (B), initial uptake on the right decreases with quantitation now attributing 30% of function to the right kidney. Clearance from the right kidney is slowed with marked parenchymal retention. A renal angiogram (C, inverted to correspond to the scan) shows fibromuscular hyperplasia.

Table 9.3 Change in tracer handling after angiotensin converting enzyme (ACE) inhibitor challenge for affected kidneys in renovascular hypertension

Uptake

Transit

99mTc-DTPA Decreased 99mTc-MAG3 No change

Prolonged Prolonged

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