FULL PATIENT HISTORY:10 year old boy hit in the left flank while playing baseball followed by pain in the left flank and vomiting. CT scan showed grade 4 left renal laceration with no contrast extravasation on delayed images from ureter or bladder. He was managed conservatively, followed up with USG and a renal scan was obtained after 3 months to evaluate renal function. 

DISCUSSION:Renal cortical imaging is performed by using Tc99m-DMSA or glucoheptonate and a pinhole or high-resolution collimator or SPECT (Single photon emission computed tomography). A pinhole or high-resolution collimator provides very high resolution images. SPECT improves image contrast because it focuses on a thin slice of an organ and minimizes overlying and underlying activity that may obscure the area of interest.

Indications for renal cortical imaging include evaluation of mass lesions, functioning pseudotumors such as cortical columns of Bertin, edema and scarring secondary to pyelonephritis (acute or chronic) especially in children. Follow up of a renal laceration is an uncommon indication of renal cortical scintigraphy; renal functional imaging by using Tc99m-MAG3 or Tc99m-DTPA is preferred.