^(99)Tc^(m)-DMSA肾显像校正肾脏ROI及深度对先天性肾积水患儿患肾GFR测定的影响  

Effects of renal ROI and depth calibrated by ^(99)Tc^(m)-DMSA renal imaging on GFR measurement of the injured-kidney in infants with congenital hydronephrosis

作　　者：郭钶 赵德善[1] Guo Ke;Zhao Deshan(Nuclear Medicine Department,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院核医学科,太原030001

出　　处：《中华核医学与分子影像杂志》2024年第1期20-24,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨用^(99)Tc^(m)-二巯基丁二酸(DMSA)肾静态显像肾影校正肾动态显像中肾脏ROI及深度对先天性肾积水婴儿单肾肾小球滤过率(GFR)测定的影响。方法前瞻性纳入2022年1月至2022年11月山西医科大学第二医院核医学科的30例先天性肾积水患儿[男25例、女5例, 年龄3.0(1.0, 5.5)个月], 根据积水程度将60个肾脏分为3组:正常组(左肾7个、右肾12个), 轻度积水组(左肾10个、右肾12个), 中重度积水组(左肾13个、右肾6个)。患儿于3 d内分别接受^(99)Tc^(m)-二乙撑三胺五乙酸(DTPA)利尿肾动态和^(99)Tc^(m)-DMSA肾静态显像, 在显像结束后行双肾侧位采集。依据侧位图像和Tonnesen公式分别获得肾脏深度(单位:cm), 并进行比较。通过常规Gates法测得的单侧GFR(单位:ml·min^(-1)·1.73 m^(-2))用gGFR_(single)表示。将肾静态显像肾脏深度校正后单肾GFR(dGFR_(single))、静态显像ROI对动态显像ROI校正后得到的面积校正后单肾GFR(aGFR_(single))、深度和ROI均校正后单肾GRF(adGFR_(single))与gGFR_(single)进行对比。采用单因素方差分析、最小显著差异t检验及Dunnett-t检验比较数据差异。结果在不同程度积水组中, 肾动态显像、静态显像和Tonnesen公式所测肾脏深度有差异, 两两比较差异也有统计学意义(F值:38.07~59.63, t值:2.53~15.17, 均P<0.05)。正常组2种显像所得的肾脏深度差异无统计学意义(F值:34.89、54.30, 均P<0.05;t值:0.65、1.60, 均P>0.05)。各组aGFR_(single)均较gGFR_(single)小, 但数值相近, 其在正常肾差异无统计学意义(F值:3.02、5.51, 均P<0.05;t值:0.12、0.53, 均P>0.05), 而在异常肾(左肾:43.27±8.84与46.19±7.88, F=9.75, t=2.18, 均P<0.05;右肾:39.87±10.25与42.94±10.28, F=10.32, t=2.04, 均P<0.05)及轻度(48.58±10.94与51.08±11.44;F=10.34, t=2.04, 均P<0.05)、中重度(34.41±8.84与37.62±8.84;F=19.97, t=3.41, 均P<0.05)积水肾差异有统计学意义。正常、轻度和中重度积水组dGFR_(singleObjective To investigate the application value of ^(99)Tc^(m)-dimercaptosuccinic acid(DMSA)renal static imaging to correct renal ROI and renal depth in measurement of glomerular filtration rate(GFR)of the injured-kidney in infants with congenital hydronephrosis.Methods From January 2022 to November 2022,30 infants with congenital hydronephrosis(25 males,5 females,age 3.0(1.0,5.5)months)in Nuclear Medicine Department of the Second Hospital of Shanxi Medical University were prospectively included.Sixty kidneys were divided into 3 groups according to the degree of hydronephrosis:normal group(7 left kidneys and 12 right kidneys),mild hydronephrosis group(10 left kidneys and 12 right kidneys)and moderate to severe hydronephrosis group(13 left kidneys and 6 right kidneys).The patients received ^(99)Tc^(m)-diethylenetriamine penta-acetic acid(DTPA)diuretic renal dynamic imaging and ^(99)Tc^(m)-DMSA renal static imaging within 3 days,and bilateral renal lateral acquisition was performed at the end of the imaging.The depths(cm)of kidneys measured based on the lateral image and Tonnesen′s formula were compared.The single kidney GFR(ml·min^(-1)·1.73 m^(-2))measured after the renal ROI corrected,or renal depth corrected,or renal ROI-depth corrected by renal static imaging(aGFR_(single),dGFR_(single),adGFR_(single))was compared with that measured by Gates method(gGFR_(single)).The one-way analysis of variance,the least significant difference-t test and Dunnett-t test were used for data analysis.Results In different hydronephrosis groups,renal depths measured by dynamic imaging,static imaging and Tonnesen formulas were significantly different(F values:38.07-59.63,t values:2.53-15.17,all P<0.05).There were no significant differences in renal depth between the two kinds of imaging in the normal group(F values:34.89,54.30,both P<0.05;t values:0.65,1.60,both P>0.05).aGFR_(single) of all groups were smaller than gGFR_(single),but the values were similar,and were not significantly different in normal kidneys(F values:3.02,5.51,b

关 键 词：肾盂积水 肾小球滤过率 放射性核素显像 99m锝二巯基丁二酸 99M锝五乙酸盐 

分 类 号：R726.9[医药卫生—儿科] R816.92[医药卫生—临床医学]