^(99m)Tc-EC肾动态显像在儿童肾瘢痕诊断中的价值  

Value of ^(99m)Tc-EC dynamic renography in diagnosis of renal scars in children

作　　者：冯阳[1] 苏潇[2] 李佳宁[1] 

机构地区：[1]上海交通大学医学院附属新华医院核医学科,上海200092 [2]上海交通大学医学院附属第三人民医院放射科,上海201999

出　　处：《临床儿科杂志》2014年第3期232-234,共3页Journal of Clinical Pediatrics

摘　　要：目的探讨99mTc-EC肾动态显像在尿路感染患儿肾瘢痕诊断中的价值。方法回顾性分析同期行99mTc-EC肾动态显像和99mTc-DMSA肾静态显像的67例尿路感染患儿的显像资料,以99mTc-DMSA肾静态显像结果为金标准,分析比较99mTc-EC肾动态显像与尿路感染、肾积水与肾瘢痕的关系。结果99mTc-EC肾动态图起始2 min叠加图像诊断肾瘢痕的灵敏性是80.28%,特异性是88.89%,阳性似然比为7.23。采用99mTc-DMSA肾静态显像诊断肾瘢痕,发现与上尿路排泄通畅和排泄延缓的患儿相比,上尿路排泄梗阻患儿的肾瘢痕形成概率较高,差异有统计学意义(P<0.05);但积水程度不同患儿的肾瘢痕发生概率的差异无统计学意义(P>0.05)。结论对尿路感染患儿,99mTc-EC肾动态显像早期叠加图像诊断肾瘢痕形成的灵敏性和特异性均较高,99mTc-EC肾动态显像提供的上尿路排泄情况对肾瘢痕形成的诊断具有一定价值。Objective To evaluate the diagnostic value of ^99mTc-EC dynamic renography for renal scars in children with urinary tract infection. Methods The ^99mTc-EC and ^99mTc-DMSA renographic results of 67 children diagnosed with urinary tract infection were retrospectively studied. In comparison with ^99mTc-DMSA cortical images, the value of ^99mTc-EC dynamic renogra- phy for the diagnosis of urinary tract infection, hydronephrosis and renal scars was analyzed. Results The sensitivity and specificity of the initial 2 minutes summed images in the ^99mTc-EC images for the diagnosis of renal scars was 80.28% and 88.89% respectively, and the likelihood ratio was 7.23. Renal scars were more likely to be formed in patients with obstructed upper urinary tracts, as compared with patients with unobstructed upper urinary tracts and unsmooth upper urinary tracts （P〈0.05）. The incidence of renal scar formation was not significantly different among groups with hydronephrosis of varying degrees （P〉0.05）. Conclusions For children with urinary tract infection, the diagnostic sensitivity and specificity of the initial summed images of ^99mTc-EC dynamic renography are high. Furthermore, the excretion of upper urinary tract showed by ^99mTc-EC dynamic renography is valuable for the diagnosis of renal scars.

关 键 词：^99MTC-EC 放射性核素显像 尿路感染 肾脏瘢痕 儿童 

分 类 号：R726.9[医药卫生—儿科]