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作 者:陈维安[1] 李纬明[1] 李春亿[1] 张祥松[1] 梁宏[1] 胡平[1]
机构地区:[1]中山大学附属第一医院核医学科,广州510080
出 处:《临床泌尿外科杂志》2009年第2期91-93,共3页Journal of Clinical Urology
摘 要:目的:探讨^(99)Tc^m-DTPA肾动态显像在肾移植术后监测中的图像特征和临床价值。方法:28例肾移植患者进行^(99)Tc^m-DTPA肾动态显像,同时测定移植肾的肾小球滤过率(GFR)和膀胱放射性计数与肾脏放射性计数比值(B/K值),定性和定量分析肾移植术后的影像特征。结果:12例肾移植术后肾血流灌注及功能良好,GFR值为(51.5±6.3)ml/min,B/K均>3.6例急性排斥反应肾血流灌注受损程度重于功能相,GFR值为(33.4±5.7)ml/min,B/K均<1.7例慢性排斥反应肾血流灌注和功能相均同时受损,GFR值为(27.5±2.1)ml/min,B/K均<1.1例超急性排斥反应表现为放射性空白区。2例肾小管坏死肾血流灌注损伤轻于功能相。所有影像表现与临床或病理结果相吻合。结论:^(99)Tc^m-DTPA肾动态显像可快速且定量评价移植肾的血流和功能,早期初步鉴别排斥反应的类别且具有无创、简单、重复性强的特点。Objective:To describe the characteristics of the transplanted kidney dynamic imaging and to evalu ate the clinical value of ^99Tc^m-DTPA renal dynamic imaging on allografted kidney monitoring. Methods: 28 patients who underwent allogeneic kidney transplantation were examined with ^99Tc^m- DTPA dynamic imaging. Glomerular filtration rate (GFR) and bladder to kidney radioactive counting (B/K) ratio of the transplanted kidney were ac quired. The characteristics of transplanted kidney dynamic imaging were analyzed quantitatively and qualitatively. Results:The perfusion and function of 12 patients with allografted kidney were normal, GFR was (51.5 ± 6.3 )ml/ min, B/K ratio was )〉3. The function was superior to perfusion in 6 cases with acute rejection. GFR was (33.4 ± 5.7) ml/min, B/K ratio was〈1. The perfusion and function of 7 chronic rejection cases were impaired symmetri cally. Where GFR was (27.5±2. 1) ml/min, all B/K ratio was 〈1. There is 1 case with ultra- acute rejection showed no radioactivity. The perfusion was superior to function in 2 cases with necrosis of renal tubules. All imaging materials consistant with clinical symptoms or pathology. Conclusions: The blood flow and function of transplanted kidney can be evaluated quantitatively and rapidly by ^99Tc^m-DTPA renal dynamic imaging. ^99Tc^m-DTPA dynamic imaging can identify rejection early, noninvasive, simply and repeated.
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