Case Author(s): m quinn, md and k fischer, md , . Rating: #D2, #Q4

Diagnosis: polycystic kidney disease

Brief history:

45 yo male with increasing creatinine and decreased urine output


1 minute posterior images

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View second image(rs). posterior post void

Full history/Diagnosis is available below

Diagnosis: polycystic kidney disease

Full history:

45 year old male with polycystic kidney disease s/p recent cyst decortication. His urine output was decreasing, and the renogram was ordered to evaluate renal function.




The kidneys are enlarged bilaterally. Their architecture is distorted by numerous photopenic areas. The images also demonstrate an unusual focus of activity in the region of the upper pole of the right kidney. This collection appears to extend beyond the borders of the kidney.


The kidneys are enlarged and their architecture distorted due to the numerous cysts that characterize adult polycystic kidney disease. The function of these kidneys is relatively well maintained. The collection of radiopharmaceutical in the region of the upper pole of the right kidney was concerning for a leak into the perinephric space.


An injection of contrast into the indwelling catheter indeed revealed extravasation from the upper pole calyx of the right kidney. Normally, there is no connection between the cysts of polycystic kidney disease and the collecting system. However, in this case it was presumed that such a connection was present, possibly formed at the time of cyst decortication. A renal stent was placed in a retrograde fashion to decompress the system and allow healing of the site of leak.

View followup image(gu). anterior image from nephrostogram

ACR Codes and Keywords:

References and General Discussion of Renal Scintigraphy (Anatomic field:Genitourinary System, Category:Organ specific)

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Case number: rs016

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