^99Tc^m—DTPA肾动态显像评价儿童重复肾功能  

^99 Tc^m.DTPA renography in evaluating the function of duplex kidneys in pediatric patients

作　　者：张丽霞[1] 王晓明 陈金燕[1] 苏君梅[3] 

机构地区：[1]浙江省中医院核医学科,浙江省杭州310006 [2]杭州市江干区凯旋卫生服务中心 [3]杭州师范大学基础医学部病理生理教研室

出　　处：《中华核医学与分子影像杂志》2013年第3期188-191,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨^99Tc^mDTPA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^99Tc^m-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�Objective To study the value ot ^99 Tc^m-DIFA dynamic renograpny m evatuaung me 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, Ⅱ 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 pa- tients and controls were divided into two subgroups according to their ages （ group ][ , 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. Re- suits 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 l] , 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 ＋ Ⅱ.15） ml/min （group Ⅱ ）, continuously up- ward type was （72.Ⅱ ±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

关 键 词：泌尿生殖系统畸形 肾 DTPA 肾功能试验 JL童 

分 类 号：R726[医药卫生—儿科]