Download This examination, commonly known as a `MAG3 renogram/scan

This examination, commonly known as a ‘MAG3 renogram/scan’, looks at the drainage of urine from
the kidneys into the bladder. It can also be used to check for a condition called ‘reflux’, where urine
flows up the ureters (tubes from the kidneys to the bladder) during micturition (passing urine).
During the test, a liquid (known as ‘radioactive tracer’) is injected into a blood vessel using a cannula
(fine, plastic tube) inserted into a vein in your child’s hand or foot. The liquid allows detailed images
(pictures) of the drainage of your child’s urine to be seen using a ‘gamma camera’ (a type of scanning
equipment). In some cases it is necessary to give a diuretic (a drug to make the kidneys work faster)
before the scan or during the scan depending on the child’s clinical history.
The MAG3 renogram can quickly and accurately give detailed information about the drainage of urine
from your child’s kidneys and show whether there is any reflux. .
There is a very small risk associated with this type of scan, as it requires the use of ionising radiation.
The amount of radiation is kept to the minimum needed for the test (0.7 milliseverts), which is
equivalent to 3 months natural background radiation. (i.e. Cosmic rays, etc.)
However, the benefits gained from having the test far outweigh any possible effects of the radiation
dose. The staff in the Clinical Physics Department will discuss these risk factors with you again
before starting the procedure and will be happy to answer any questions you may have.
A MAG3 scan will only have been requested by your child’s doctor if it is felt that this is the best way
to find out more information about their condition.
Other tests such as ultrasound, micturating cystograms and intravenous urograms can also give
information about the kidneys, but not in the same detail as this examination.
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Please follow all the instructions below and on your child’s appointment letter. Also please ring and
confirm the appointment as soon as possible on the number given on your appointment letter.
It is important that you confirm your current telephone number when you contact us. This is because
we may need to contact you at short notice before your appointment if there is a problem with the
radioactive tracer or the scanning equipment.
Please note:
 If we have still not received your child’s confirmation 2 days before their scan, we may offer your
child’s appointment to another patient.
 If you report for your child’s appointment without prior confirmation, we will offer you another date.
 If your child is unable to come for the appointment, but you do not let us know, we will discharge
them back to the care of your doctor. They will then need to re-refer your child if you still wish them
to have the test.
 Prepare your child for the test by keeping explanations simple and truthful. You can start to talk
about what is going to happen about a week before they come into hospital. Playing hospital
games, reading books about hospitals and watching children’s television programmes or videos
can be useful and fun. However, ER and Casualty may not be the best programmes to watch!
 Your child can eat normally before the test and should take all their medications as usual.
Encourage them to drink plenty of fluids before the test, but they must go to the toilet as normal.
 Your child can wear clothes during the scan, so please dress them in something loose and
comfortable. Avoid any metals if possible, i.e. belts etc.
 Expect to be at the hospital for most of the day. You are welcome to bring a selection of your
child’s favourite toys, as well as music or CDs to keep them entertained during the scan. You and
your child will be able to use the restaurant if you wish, otherwise please bring food and drink with
you. If you need to, also remember to bring sufficient nappies for the day.
Report to the radiology reception desk on the third floor, Queen Elizabeth Queen Mary building
where your attendance will be recorded and you will be directed to the nuclear medicine department
for the scan.
On arrival we will take your child’s weight to ascertain the amount of radioactive tracer and diuretic
we need to give to your child if it is necessary.
Either the radiographer or technologist will explain the procedure to you and then, after applying
some anaesthetic cream or spray to their hand or arm to numb the area, they will cannulate your
child’s vein (insert a plastic tube into the vein). If any special assistance is required with the
cannulation, the radiographer/ technologist will apply the anaesthetic cream (known as ‘EMLA’) on
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your child’s hands and feet to numb the area and you will be sent to the paediatric ward where a
specialist nurse or doctor will insert the cannula. The cream takes about 45 minutes to work and your
child can either play during this time or you may like to take them to the café. Once the area is numb,
the specialist nurse or doctor will insert the cannula into a vein, and will send you and your child back
to the nuclear medicine department.
While your child is lying on the imaging bed, the radioactive tracer is injected via the cannula. We will
take images (pictures) as the tracer passes through your child’s veins into their kidneys. The cannula
will remain in place until the end of the test
It takes approximately 40-60 minutes to take all the pictures needed for the test. During this time,
your child must lie still while the pictures are being taken and to help them do this, we may need to
wrap your child up in foam padding during this time.
In some cases, we will need to take delayed pictures up to two hours after the injection of the tracer
to check when the tracer clears from the kidneys. You and your child do not have to stay in the
department during this time, but it is important that you both return to the nuclear medicine
department at the time we tell you.
If we are also checking for reflux, we will ask your child to drink plenty of fluids during the test. Once
their bladder is full, we will ask your child to empty it whilst we take another set of pictures. If your
child is a girl, we will ask her to sit down on a bedpan to do this. If your child is a boy, we will ask him
to stand up and empty his bladder into a urine bottle. This procedure is often repeated to make sure
we capture any possible reflux.
You are encouraged to stay with your child throughout the test.
The MAG3 renogram requires the support of the experts in the specialist paediatric services which
are based at St Mary’s Hospital.
When all the necessary pictures have been taken, you are free to take your child home. The results
of the test will be sent to the consultant who referred your child for the scan.
No pain is associated with this test. However it may be necessary to keep your chid still with straps
similar to a car seat belt during the imaging, which may cause discomfort.
There are no delayed side effects to the test. However, if your child feels unwell later in the day,
please contact their GP or take them to your nearest Accident & Emergency (Casualty) Department.
If your child is in nappies, we advise you to wear gloves for nappy changes for the rest of the day as
a precaution. The nappies can then be disposed of as normal.
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Your test will be interpreted the same day. The results will be forwarded to the doctor who referred
your child for the test, and will be available at the time of your child’s next appointment.
Please contact us on 020 3312 6418 as soon as possible if you are unable to keep your child’s
appointment. We can then offer this date to another patient and agree a new appointment date and
time with you.
We aim to provide the best possible service and staff are happy to answer any questions you may
have. If you were pleased with your care and want to write to let us know we would appreciate your
time in doing so.
However, if your experience of our services does not meet your expectations and you would like to
speak to someone other than staff caring for you, please contact the patient advice and liaison
service (PALS) on 020 3313 0088 for Charing Cross, Hammersmith, and Queen Charlotte’s and
Chelsea Hospitals or 020 3312 7777 for St Mary’s and Western Eye Hospitals. You can also email
PALS at [email protected] or visit www.imperial.nhs.uk/pals. The PALS team will listen to your
concerns, suggestions or queries and are often able to solve problems on behalf of patients.
Please do not hesitate to contact us if you have any queries or concerns.
Imaging Department
St Mary’s Hospital
Praed Street, Paddington
London W2 1NY
Telephone: 020 3312 6418
Alternatively, you may wish to express your concerns in writing to:
Chief executives office
Imperial College Healthcare NHS Trust
Trust Headquarters, The Bays, South Wharf Road, London W2 1NY
This leaflet can be provided on request in large print, as a sound recording, in Braille, or in alternative
languages. Please contact the communications team on 020 3312 5592
Imaging
Published: January 2014
Review date: January 2017
Reference no: 2249Tv2
© Imperial College Healthcare NHS Trust
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