^(99)Tc^m-MDP骨显像对肾功能判断价值分析  

Value of differential renal function with ^(99)Tc^m-MDP in clinical jugement

作　　者：李蕾[1,2] 沈召红[2] 张秀丽[3] 霍宗伟[2] 张鹏[2] 王晓慧[2] 杨国仁[2] 

机构地区：[1]济南大学.山东省医学科学院医学与生命科学学院,山东济南250022 [2]山东省肿瘤医院核医学科,山东济南250117 [3]山东省肿瘤医院内六科,山东济南250117

出　　处：《中华肿瘤防治杂志》2014年第11期862-865,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省自然科学基金(ZR2012HM011;ZR2009CL023)

摘　　要：目的:探讨99 Tc m-MDP骨显像对分肾功能的判断价值。方法:收集2011-12-01-2013-06-01山东省肿瘤医院1周内进行99 Tc m-MDP骨显像和99 Tc m-DTPA肾动态显像的65例肿瘤患者,共130个肾,按肾功能异常类型分为A、B、C、D和E 5组,每组肾个数分别为62、25、20、10和13。A^D组为肾实质不同程度受损组,E组为肾排泄受损组。在全身骨显像图像上利用感兴趣区(region of intevest,ROI)技术勾画得出每个肾的总放射性计数(K)、平均计数(aK),全身骨显像图总计数(W)及平均计数(aW)。组间比较采用单因素方差分析,K、aK、K/W及aK/aW与肾小球滤过率(glomerular filtration,GFR)的相关性采用Pearson直线相关分析。结果:A^D 4组间GFR、K、aK、K/W、aK/aW值差异均有统计学意义,P值均<0.05;K、aK、K/W和aK/aW值D组与A组比较差异均有统计学意义,P值均<0.05;aK/aW值A组与C组比较差异有统计学意义,P值<0.01;而K、aK、K/W值A组与B组、C组两两比较差异均无统计学意义,P均>0.05;4组GFR与K、aK、K/W、aK/aW存在正相关关系,P<0.001。E组13个肾中1个GFR<35mL/min,12个均>35mL/min,GFR为(42.04±9.84)mL/min,K、aK、K/W和aK/aW分别为42 195.31±23 210.54、32.67±15.49、0.030±0.0122和4.283±1.539,与A、B、C、D组相应值比较差异有统计学意义,P值均<0.01;E组GFR与aK/aW存在负相关,r=-0.533,P=0.030,与K、aK、K/W不相关,P值均>0.05。结论:99 Tc m-MDP通过分析其肾脏影像对分肾功能状态具有一定的判断价值,而作为定量指标,aK/aW值对肾实质中度及以上受损与肾排泄功能受损均有较好的参考价值。OBJECTIVE：To evaluate the usefulness of the bone tracer 99 Tcm-MDP for assessment of differential renal function. METHODS： Sixty-five cases with 130 kidneys conducted 99Tcm_MDP bone seintigraphy and 99Tcm-DTPA renal dynamic imaging during one week were retrospectively analyzed. According to renal dysfunction type, they were divided into five groups （A,B,C, D and E group） ,and A-D group as renal parenchyma damage group, E group as impaired renal excretion group. On the use of regions of interest （ROD on whole-body bone scintigraphy image, total radioactive counts（K） and the average count（aK）per kidney were measured, the same as total whole-body bone image radioactive counts （W） and the average count （aW）. RESULTS： The differences of K, aK, K/W and aK/aW among A-D group were significant（P〈 0.05）. The differences of K,aK,K/W and aK/aW values between Group A and D were statistically significant（P〈0.05）. For aK/aW value,the difference between Group A and C was significant（P〈0.05）. But for K, aK and K/W value, the differences of pairwise comparison among A group,B group and C group were not significant（P〉0.05）. The glomerular filtration rate（GFR） in A-I） group showed significant and positive correlation with K （ P 〈 0. 00] ）, aK （P 〈 0. 001 ）,K/W（P〈0. 001）,aK/aW（P〈0. 001）. For E group,the value of GFR was （42.04±9.84） mL/min,and one group was less than 35 mL/min,hut the rests were greater than 35 mL/min. The value of K（42 495.31±23 210.54） ,aK（32.67± 15.49）,K/W（0. 030±0. 0122） ,aK/aW（4. 283± 1. 539） in E group were significantly different with A--D group （P〈 0.01）. The GFR in E group showed significant negative correlation with aK/aW （r= -0. 533, P= 0. 030）, but it showed no correlation with K,aK, K/W, P〈0.05. CONCLUSIONS： 99 Tcm_MDP bone scintigraphy has the value for analyzing differential renal function when screening bone metastases in patients with malignant tumor, as the quantification, the val

关 键 词：99TcmMDP骨显像 分肾功能 放射性计数 99TcmDTPA肾动态显像 

分 类 号：R730.44[医药卫生—肿瘤]