Abstract
Study design
Retrospective cohort study.
Objective
To investigate the potential of technetium-99m-mercaptoacetyltriglycine (99mTc-MAG-3) renal scintigraphy for predicting maximal detrusor pressure in the early stages of spinal cord injury (SCI).
Setting
Tertiary rehabilitation facility.
Methods
Medical records of individuals with SCI admitted between January 2020 and April 2023 who underwent both 99mTc-MAG-3 renal scintigraphy and urodynamic study within 90 days of SCI onset were retrospectively reviewed. Pearson’s coefficient analysis was performed to determine the relationship between 99mTc-MAG-3 renal scintigraphy findings and urodynamic study findings. A multivariate linear regression analysis was performed to determine the best predictors of maximal detrusor pressure. A multivariate logistic regression analysis was performed to determine risk factors for high detrusor pressure.
Results
Ninety-four participants were enrolled in this study. Pearson’s correlation analysis showed that effective renal plasma flow (ERPF) and ERPF (% predicted) were significantly correlated with maximal detrusor pressure. The multivariate linear regression analysis demonstrated that ERPF (% predicted) was a significant predictor of maximal detrusor pressure. The multivariate logistic regression analysis showed that ERPF (% predicted) was significantly associated with high detrusor pressure. The receiver operating characteristic curve demonstrated that the predictive model had an area under the curve of 0.725, with an ERPF (% predicted) cut-off of 64.05%, sensitivity 1.000, and specificity 0.429.
Conclusions
These results suggest that 99mTc-MAG-3 renal scintigraphy may be useful for predicting high detrusor pressure in early SCI and may guide the timing of urodynamic studies in individuals with early SCI for appropriate management of neurogenic lower urinary tract dysfunction.
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Data availability
The authors will freely share the unfiltered raw data underlying the results of this study.
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Funding
This study is supported by a research grant of Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine.
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This paper was co-authored by SJL and JCS. JCS contributed as a corresponding author. SJL and JCS contributed equally to data analysis and interpretation. All authors participated in the writing and editing of the manuscript.
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The study was approved by the institutional review board of Severance Hospital, Yonsei University Health System, Seoul, Korea (4-2022-1490).
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Due to the retrospective nature of the study, the review board waived the need for informed consent.
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Lee, S.J., Shin, J.C. Maximal detrusor pressure can be predicted using technetium-99m-mertcaptoacetyltriglycine renal scintigraphy in the early stages of spinal cord injury. Spinal Cord (2024). https://doi.org/10.1038/s41393-024-00967-w
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DOI: https://doi.org/10.1038/s41393-024-00967-w