84歳男.腹部超音波検査と腹部単純CT検査にて早期に腎腫瘤の存在を確認していたにも拘わらず, 中等度の腎機能障害を認めたこと, 虚血性心疾患に対する抗凝固剤の内服により強血尿が続いたことの2点により, 造影剤を使用する検査ならびに尿管鏡検査が行えず, 質的診断に至る迄に時間を要した.最終的にはMAG3腎シンチグラフィ検査とMRI検査にて, 腫瘍が腎盂腫瘍ではなく腎癌であるとの結論に至ったAn 84-year-old man presented at our hospital with complaints of severe gross hematuria and lower right abdominal pain. A right renal mass was detected by ultrasound sonography and plain computerized tomography (CT) scan, but an exact diagnosis was not obtained. Because the patient presented with moderate renal dysfunction and severe gross hematuria, we were unable to perform imaging studies using contrast material or ureteroscopic instruments. Finally, mercaptoacetylglycyl-glycylglycine (MAG3) scintigraphy and magnetic resonance imaging (MRI) demonstrated renal cell carcinoma, and we performed transarterial embolization (TAE) therapy using ethanol and gel foam. Based on their efficacy and noninvasiveness, we conclude that MAG3 scintigraphy and MRI are the optimal modalities for imaging in patients with renal dysfunction
