应用放射性核素方法测量肾小球滤过率及相关技术问题

Glomerular filtration rate determined by radionuclide method and pitfalls worth notice

应用放射性核素功能测定或肾动态显像获得肾小球滤过率(GFR)是临床常用的测量方法,核素显像的特点在于获得肾血流和尿路排泄系列影像的同时计算 GFR 及其他参数,方法实用简便,GFR 数值通常与临床判断或与其他计算 GFR 的方法相吻合。但核素显像测量 GFR 受多种因素的影响,包括测量放射性剂量的准确性、"弹丸"注射技术、患者的体形变异和肾脏位置差异、肾脏疾病严重程度和肾外因素干扰、计算机处理方法和操作技能因素等,因此计算 GFR 的精确度存在不确定性,临床要特别注重参考其他相关指标综合评估肾脏的功能状态。

Glomerular filtration rate （GFR） can be calculated either by radionuclide technology or by dynamic renal scintillation. The latter technique is simple and practical, and provides serial measurement of renal blood flow and excretion images in addition to estimate GFR and other renal parameters. GFR assessed with this method usually coincides with clinical diagnosis and correlates with GFR value determined by other methodology. GFR determined by radionuclide imaging may result in significant bias or be indeterminate due to many influencing factors such as inaccurate measurement of radioactivity, misconduct of ＂bolus＂ injection, irregular body shape and varied kidney locations, severities of renal conditions and extrarenal interference, soft-ware proceeding methods and technician＇s skills, etc. It is worth notice that, in clinic, renal parameters other than GFR should be taken into account for full evaluation of renal function status.