SPECT肾动态显像在小儿先天性肾盂积水中的临床应用

The clinical application of SPECT renal dynamic imaging in children with hydronephrosis

目的 :探讨SPECT肾动态显像在诊断小儿先天性肾盂积水的价值。方法 :回顾性分析肾盂积水患儿 30例 ,采用99mTc DTPA肾动态显像方法 ,部分患儿静脉注射速尿 ,其中 12例作手术前后比较。定量指标有 :高峰摄取率 (PUR) ,肾血流灌注率 (BPR) ,半排时间 (T1/2 )结果 :BPR随肾盂积水程度加重而明显下降 ,重度积水为 16 .8%± 6 .8% ,中度积水为35 .1%± 6 .9% ,轻度积水为 4 0 .6 %± 9.2 %。PUR在重度积水时为 2 1.6 %± 12 .9%。 12例患儿手术后其中 10例BPR明显升高 ,术后T1/2 明显改善。结论 :SPECT可准确反映肾盂积水和肾功能受损程度 ,两者呈正相关 。

Objective:To evaluate the clinical value of 99m Tc DTPA renal dynamic imaging for diagnosis of child hydronephrosis.Methods:30 children with hydronephrosis were examined by 99m Tc DTPA renal dynamic imaging combined with intravenous injection of furosemide,twelve of them had surgical treatment and underwent the dynamic imaging pre and post operation. Some was given furosemide with injection of imaging agent.Quantitatively analysed renal blood perfusion rate(BPR),peak uptake(PUR) and half washout time after furosmide injection(T 1/2 ).Results:The more the hydronephrosis deteriorated, the lower the BPR was; severe cases:16.8%±6.8%,moderate cases:35.1%±6.9%,mild cases:40.6%±9.2%.the lower the PUR was:21.6%±12.95,ten of twelve children had obvious hoisted after operation in BPR.Conclusion:BPR can be used as an index of good correlation for the existence of hydronephrosis and the damage intensity of renal function. SPECT renal dynamic imaging is helpful for the judgement of urinary obstruction.