中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2013年
3期
188-191
,共4页
张丽霞%王晓明%陈金燕%苏君梅
張麗霞%王曉明%陳金燕%囌君梅
장려하%왕효명%진금연%소군매
泌尿生殖系统畸形%肾%DTPA%肾功能试验%儿童
泌尿生殖繫統畸形%腎%DTPA%腎功能試驗%兒童
비뇨생식계통기형%신%DTPA%신공능시험%인동
Urogenital abnormalities%Kidney%DTPA%Kidney function tests%Child
目的 探讨99Tcm-DTPA肾动态显像在评价儿童重复肾功能中的应用价值.方法 选择经B超或MR尿路成像(MRU)示有重复肾的患儿25例,男9例,女16例,年龄2～ 72 (23.80±20.97)个月.选择同期且年龄匹配、B超或MRU结果正常、为探查泌尿系统感染病因行肾动态显像的婴幼儿20名作为对照组,其中男9名,女11名,年龄2 ～72(32.95±23.58)个月.2组均按照年龄分亚组:组Ⅰ,年龄0～24个月；组Ⅱ,年龄25～72个月.受检者99Tcm-DTPA肾动态显像经医院伦理委员会批准并经监护人知情同意.显像后勾画双肾ROI(包括重复肾)获得肾图,计算肾GFR及患肾上、下半肾摄取率.多组间均数两两比较采用Dunnett-t检验.结果25例患儿共26个重复肾(1例左、右双侧重复肾),其中左侧重复肾16个,右侧重复肾10个.26个重复肾中,肾图正常6个、持续上升型9个、高水平延长线型4个、抛物线型2个、低水平延长线型5个.患儿组组Ⅰ患肾19个,组Ⅱ患肾7个；对照组2组均为20个肾.患儿组中正常肾图者GFR为(78.81±15.97) ml/min(组Ⅰ)及(64.68±11.15) ml/min(组Ⅱ),持续上升型肾图者GFR为(72.11±22.76) ml/min(组Ⅰ)及(63.41±16.42) ml/min(组Ⅱ),高水平延长线型肾图者GFR为(68.74±16.17) ml/min(组Ⅰ),抛物线型肾图者GFR为(65.26±15.27) ml/min(组Ⅰ),以上各组GFR与对照组GFR[组Ⅰ:(79.35±13.31) ml/min;组Ⅱ:(76.46±9.69) ml/min]相比,差异均无统计学意义(均P＞0.05)；而5个肾图呈低水平延长线型患肾的GFR为(45.83±10.17) ml/min(组Ⅰ)及(45.53±10.42) ml/min(组Ⅱ),均低于对照组(均P ＜0.05).26个患肾中,23个可清晰分辨上、下半肾,占88.46％.相对于整个患肾而言,3个重复肾摄取率＞30％,5个重复肾摄取率为10％ ～30％,15个重复肾摄取率＜10％.结论 99Tcm-DTPA肾动态显像可定量评价重复肾功能,对临床重复肾患儿治疗方式的选择有一定的参考价值.
目的 探討99Tcm-DTPA腎動態顯像在評價兒童重複腎功能中的應用價值.方法 選擇經B超或MR尿路成像(MRU)示有重複腎的患兒25例,男9例,女16例,年齡2～ 72 (23.80±20.97)箇月.選擇同期且年齡匹配、B超或MRU結果正常、為探查泌尿繫統感染病因行腎動態顯像的嬰幼兒20名作為對照組,其中男9名,女11名,年齡2 ～72(32.95±23.58)箇月.2組均按照年齡分亞組:組Ⅰ,年齡0～24箇月；組Ⅱ,年齡25～72箇月.受檢者99Tcm-DTPA腎動態顯像經醫院倫理委員會批準併經鑑護人知情同意.顯像後勾畫雙腎ROI(包括重複腎)穫得腎圖,計算腎GFR及患腎上、下半腎攝取率.多組間均數兩兩比較採用Dunnett-t檢驗.結果25例患兒共26箇重複腎(1例左、右雙側重複腎),其中左側重複腎16箇,右側重複腎10箇.26箇重複腎中,腎圖正常6箇、持續上升型9箇、高水平延長線型4箇、拋物線型2箇、低水平延長線型5箇.患兒組組Ⅰ患腎19箇,組Ⅱ患腎7箇；對照組2組均為20箇腎.患兒組中正常腎圖者GFR為(78.81±15.97) ml/min(組Ⅰ)及(64.68±11.15) ml/min(組Ⅱ),持續上升型腎圖者GFR為(72.11±22.76) ml/min(組Ⅰ)及(63.41±16.42) ml/min(組Ⅱ),高水平延長線型腎圖者GFR為(68.74±16.17) ml/min(組Ⅰ),拋物線型腎圖者GFR為(65.26±15.27) ml/min(組Ⅰ),以上各組GFR與對照組GFR[組Ⅰ:(79.35±13.31) ml/min;組Ⅱ:(76.46±9.69) ml/min]相比,差異均無統計學意義(均P＞0.05)；而5箇腎圖呈低水平延長線型患腎的GFR為(45.83±10.17) ml/min(組Ⅰ)及(45.53±10.42) ml/min(組Ⅱ),均低于對照組(均P ＜0.05).26箇患腎中,23箇可清晰分辨上、下半腎,佔88.46％.相對于整箇患腎而言,3箇重複腎攝取率＞30％,5箇重複腎攝取率為10％ ～30％,15箇重複腎攝取率＜10％.結論 99Tcm-DTPA腎動態顯像可定量評價重複腎功能,對臨床重複腎患兒治療方式的選擇有一定的參攷價值.
목적 탐토99Tcm-DTPA신동태현상재평개인동중복신공능중적응용개치.방법 선택경B초혹MR뇨로성상(MRU)시유중복신적환인25례,남9례,녀16례,년령2～ 72 (23.80±20.97)개월.선택동기차년령필배、B초혹MRU결과정상、위탐사비뇨계통감염병인행신동태현상적영유인20명작위대조조,기중남9명,녀11명,년령2 ～72(32.95±23.58)개월.2조균안조년령분아조:조Ⅰ,년령0～24개월；조Ⅱ,년령25～72개월.수검자99Tcm-DTPA신동태현상경의원윤리위원회비준병경감호인지정동의.현상후구화쌍신ROI(포괄중복신)획득신도,계산신GFR급환신상、하반신섭취솔.다조간균수량량비교채용Dunnett-t검험.결과25례환인공26개중복신(1례좌、우쌍측중복신),기중좌측중복신16개,우측중복신10개.26개중복신중,신도정상6개、지속상승형9개、고수평연장선형4개、포물선형2개、저수평연장선형5개.환인조조Ⅰ환신19개,조Ⅱ환신7개；대조조2조균위20개신.환인조중정상신도자GFR위(78.81±15.97) ml/min(조Ⅰ)급(64.68±11.15) ml/min(조Ⅱ),지속상승형신도자GFR위(72.11±22.76) ml/min(조Ⅰ)급(63.41±16.42) ml/min(조Ⅱ),고수평연장선형신도자GFR위(68.74±16.17) ml/min(조Ⅰ),포물선형신도자GFR위(65.26±15.27) ml/min(조Ⅰ),이상각조GFR여대조조GFR[조Ⅰ:(79.35±13.31) ml/min;조Ⅱ:(76.46±9.69) ml/min]상비,차이균무통계학의의(균P＞0.05)；이5개신도정저수평연장선형환신적GFR위(45.83±10.17) ml/min(조Ⅰ)급(45.53±10.42) ml/min(조Ⅱ),균저우대조조(균P ＜0.05).26개환신중,23개가청석분변상、하반신,점88.46％.상대우정개환신이언,3개중복신섭취솔＞30％,5개중복신섭취솔위10％ ～30％,15개중복신섭취솔＜10％.결론 99Tcm-DTPA신동태현상가정량평개중복신공능,대림상중복신환인치료방식적선택유일정적삼고개치.
Objective To study the value of 99Tcm-DTPA dynamic renography in evaluating the function of duplex kidneys in pediatric patients.Methods Twenty-five pediatric patients with duplex kidneys diagnosed by ultrasound or MR urography (MRU) were included (9 males,16 females; mean age:(23.80 ± 20.97) months,range:2-72 months).Twenty patients (9 males,11 females; mean age:(32.95 ± 23.58) months,range:2-72 months) with urinary tract infection but without duplex kidneys confirmed by ultrasound or MRU were chosen as control group during the same period of this study.All patients and controls were divided into two subgroups according to their ages (group Ⅰ,0-24 months; group Ⅱ,25-72 months).The research was approved by the ethics committee,and all patients' parents (or guardians) signed informed consents.The time-activity curve was generated on the dynamic imaging data automatically with GFR calculated.The uptake rates of the upper and lower moieties were measured by drawing the corresponding ROIs in the duplex kidney.Dunnett-t test was used for statistical analysis.Results There were 25 patients with 26 duplex kidneys (1 case bilateral),16 on the left and 10 on the right.The time-activity curve of 6 cases was normal,9 with continuously upward type,4 with high level plateau type,2 with parabolic type and 5 with low level plateau type.There were 19 abnormal kidneys in group Ⅰ and 7 in group Ⅱ,and 20 kidneys in each control subgroup.The GFR of patients with normal renography was (78.81 ± 15.97) ml/min (group Ⅰ) and (64.68 ± 11.15) ml/min (group Ⅱ),continuously upward type was (72.11 ±22.76) ml/min (group Ⅰ) and (63.41 ± 16.42) ml/min (group Ⅱ),high level plateau and parabolic types were (68.74 ± 16.17) ml/min and (65.26 ± 15.27) ml/min in group Ⅰ,respectively.There was no statistically significant difference between the GFR of different renography type groups and that of the controls (group Ⅰ:(79.35 ±13.31) ml/min,group Ⅱ (76.46 ±9.69) ml/min;all P ＞0.05).The GFR of patients with low level plateau type was (45.83 ± 10.17) ml/min (group Ⅰ) and (45.53 ± 10.42) ml/min (group Ⅱ).There was statistically significant difference between the GFR of two subgroups of low level plateau type and that of control group,respectively (both P ＜ 0.05).Among the 26 abnormal kidneys,23 could be separated into upper and lower moieties.Among the 23 duplex kidneys,15 cases had uptake rate less than 10％ of that of the whole kidney,5 cases ranging from 10％ to 30％,and 3 cases greater than 30％.Conclusions Quantitative evaluation of duplex kidney functions can be performed with 99Tcm-DTPA renography.It may provide important information for the management of pediatric patients with duplex kidneys.
