主动脉夹层动脉瘤术前肾动态显像研究  

The study of the necessity of preoperative radionuclide dynamic renal imaging in the patients with dissecting aneurysm of aorta

作　　者：王蒨[1] 王金城[1] 归海旻[1] 

机构地区：[1]首都医科大学附属北京安贞医院核医学科,100029

出　　处：《中华核医学杂志》2002年第6期340-342,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨主动脉夹层动脉瘤患者术前行肾动态显像的必要性。方法　正常受检者2 5例 ;主动脉夹层动脉瘤患者 5 4例 ,其中DebackeyⅠ型 2 4例、DebackeyⅢ型 30例 ,据肾功能情况分为 3组。均行99Tcm 双半胱氨酸 (EC)肾动态显像 (坐位 )并计算肾功能参数 ,包括 :①高峰时间 (Tp) ;②半排时间 (T1 2 ) ;③ 2 0min清除率 [CR2 0min(% ) ]。结果　 2 5例正常人肾动态显像示 ,腹主动脉显影后 2s双肾显像 ,双肾位置、形态正常 ,大小一致 ,Tp 为 (2 .89± 0 .76 )min ,T1 2 为 (7.2 4± 1.6 4 )min,CR2 0min为 (6 9.87± 5 .4 5 ) %。主动脉夹层动脉瘤患者组 1双肾显像时间及各项肾脏功能指标在正常范围内 ;组 2双肾大小差异明显 ,异常 (缩小 )侧肾显影时间明显延迟 ,各项肾功能指标明显异常 ;组 3双肾血流灌注时间均明显延缓 ,各项肾功能指标明显异常 ,各值与对照组和组 1相比 ,差异均有显著性。结论　肾动态显像可早期反映主动脉夹层动脉瘤患者肾血管 (特别是单侧 )受累和肾功能异常情况。此与手术方式的选择及预后有密切关系。ObjectiveTo study the necessity of radionuclide dynamic renal imaging before the operation for the patients with dissecting aneurysm of aorta. MethodsTwenty-five normal subjects (male∶female=16∶9, average age 48.32±10.09) and 54 patients with dissecting aneurysm of aorta (male∶female=44∶10, average age 54.39±11.55) were included in this study. Twenty-four of them belonged to Debackey Ⅰ and 30 belonged to Debackey Ⅲ. They were divided into 3 groups according to the situation of renal function and all of the study groups underwent renal scintigraphy. During the study, time of peak(T p), half clearing time(T 1/2), clear rate of 20 min (CR 20 min) were measured. ResultsRenal scintigraphy of 25 normal subjects showed:①both kidneys appeared 2 min later than abdominal aorta developed; ②both kidneys were in the normal position, and with normal shape and size; ③T p:(2.89±0.76) min, T 1/2:(7.24±1.64) min, CR 20 min: (69.87±5.45)%. The scintigraphic results of the 54 patients with dissecting aneurysm of aorta showed: ①Group 1, both renal developing time and renal function of both kidneys were in the normal range; ②Group 2, the sizes of two kidneys were obviously different, renal developing time of the abnormal kidney was extended, and the renal function of two kidneys were different from each other; ③Group 3, the renal developing time and renal function of both kidneys were abnormal, and were significantly different from that in the control group and group 1. ConclusionsThe renal artery is easy to be involved leading to low perfusion and renal insufficiency in the case of dissecting aneurysm of aorta belonging to either Debackey Ⅰ or Ⅲ. Renal scintigraphy is more sensitive in renal perfusion and function estimation than other noninvasive examinations, and it could demonstrate early involvement of renal vessels and renal function, this situation is of close relationship with the selection of the operation program and the prediction of the prognosis for the patients. In general,

关 键 词：主动脉夹层动脉瘤 术前 肾动态显像 肾功能试验 放射性核素显像 

分 类 号：R817.4[医药卫生—影像医学与核医学]