肾动态显像在肾占位性病变中的临床应用价值  

Clinical Application Value of Renal Dynamic Imaging in Renal SpaceOccupying Lesions

作　　者：王莹[1] 邓长林[2] 杨鹏飞[1] 李艳梅[1] 李娟[1] Wang Ying;Deng Chang-lin;Yang Peng-fei;Li Yan-mei;Li Juan(Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan Ningxia 750004,China;Department of Neurology, the First People’s Hospital of Yinchuan, Yinchuan Ningxia 750001, China)

机构地区：[1]宁夏医科大学总医院核医学科,宁夏银川750004 [2]银川市第一人民医院神经内科,宁夏银川750001

出　　处：《中国医疗设备》2017年第5期94-97,101,共5页China Medical Devices

摘　　要：目的评价肾动态显像在肾占位性病变诊疗方面的应用价值。方法 169例肾脏占位病例术前均行锝-二乙三胺五乙酸(^(99m)Tc-DTPA)肾动态显像,观察并总结肾动态显像中肾占位性病变的血流灌注特征。术后成功随访的96例恶性肿瘤患者,观察肾功能与健肾肾小球滤过率(Glomerular Filtration Rate,GFR)之间的关系。结果 169例肾脏占位的病例中,恶性肿瘤148例,良性肿块21例。148例恶性肿瘤患者中,117例血流相上表现为阳性;84.7%的透明细胞癌、20%的乳头状肾细胞癌有早期血供;恶性肿瘤组以2分和3分为主,而良性肿块组以0分和1分为主,两组血流灌注评分有显著差异(χ~2=27.957,P<0.01)。直径3~10 cm的病灶血流灌注阳性率明显高于直径<3 cm或>10 cm的病灶(χ~2=19.182,P<0.01)。术前健肾GFR≥30 m L/min时,术后肾功能生化指标基本可维持在正常水平。术前健肾GFR<30 m L/min时,术后多数会出现肾功能异常。结论肾动态显像虽然在肾占位性病变的定性诊断方面不及B超、多层螺旋CT尿路成像(CTU),但有助于疾病的预后评估。Objective To explore the application value of renal dynamic imaging in diagnosis and treatment of renal space-occupying lesions.Methods A total of169patients with renal space-occupying preoperative underwent99mTc-DTPA renal dynamic imaging,to observe and summarize the blood supply of renal space-occupying lesions in renal dynamic imaging.The relationship between renal function and Glomerular Filtration Rate(GFR)was observed in96patients with malignant tumors who were postoperative followed up successfully.Results In the169cases of kidney placeholder,there are148cases with malignant tumor and21cases with benign lesion.Of148patients with malignant tumor,117cases of blood flow on the phase performance is positive;84.7%of clear cell carcinoma and20%of papillary renal cell carcinoma had early blood supply;2and3scores is the common grades in malignant tumor group,and benign tumor group is given priority to with0and1,the difference of blood perfusion score was statistically significant(χ2=27.957,P<0.01).The lesions in diameter of3～10cm were significantly higher than the lesions in diameter less than3cm or more than10cm in early blood supply(χ2=19.182,P<0.01).When the contralateral kidney GFR was≥30mL/min before surgery,renal function could maintain the normal level after surgery.And when the contralateral kidney GFR was<30mL/min,abnormal renal function mostly appeared.Conclusion Although renal dynamic imaging has less value in qualitative diagnosing compared with type-B ultrasonic and Computed Tomography Urography(CTU),but contribute to disease prognosis evaluation.

关 键 词：肾动态显像 肾占位性病变 99MTC-DTPA 肾小球滤过率 SPECT 

分 类 号：R737.11[医药卫生—肿瘤] R730.44[医药卫生—临床医学]