99Tcm-DMSA与99Tcm-DTPA显像评估急性泌尿道感染患儿相对肾功能的比较

Comparison of the relative renal function evaluated by 99Tcm-DMSA and 99Tcm-DTPA imaging in children with acute urinary tract infection

目的比较99Tcm-二巯基丁二酸(DMSA)肾静态显像和99Tcm-二乙撑三胺五乙酸(DTPA)肾动态显像测定的急性泌尿道感染(UTI)患儿的相对肾功能(RRF)。方法回顾性分析2017年1月至2019年6月间无锡市人民医院临床确诊的病程<6个月的急性UTI患儿69例[男29例,女40例;年龄(45±38)个月;病程<6个月]。所有患儿均行99Tcm-DMSA肾静态显像和99Tcm-DTPA肾动态显像。利用感兴趣区(ROI)技术勾画肾脏轮廓和肾周本底,分别计算双肾RRF。2种显像方法测得的RRF差异比较采用两独立样本t检验,一致性检验采用Bland-Altman分析,相关性采用Pearson相关分析。结果99Tcm-DMSA和99Tcm-DTPA显像测得的左肾RRF分别为(52.27±14.53)%和(52.22±14.14)%,右肾RRF分别为(47.73±14.53)%和(47.78±14.14)%,差异均无统计学意义(t=0.913和0.913,均P>0.05)。2种显像方法测得的左肾RRF和右肾RRF均存在明显正相关(r=0.959和0.959,均P<0.01)。Bland-Altman一致性检验结果示2种显像方法测得的左肾RRF差异平均值为0.1%,95%一致性界限(LoA)为-8.0%~8.1%;右肾RRF差异平均值为-0.1%,95%LoA为-8.1%~8.0%。结论99Tcm-DMSA肾静态显像和99Tcm-DTPA肾动态显像测定的急性UTI患儿RRF之间具有良好相关性,2种显像方法均可作为评估急性UTI患儿RRF的检测方法。

ObjectiveTo compare the relative renal function(RRF)evaluated by 99Tcm-dimercaptosuccinic acid(DMSA)and 99Tcm-diethylene triamine pentaacetic acid(DTPA)imaging in children with acute urinary tract infection(UTI).MethodsA total of 69 children(29 males,40 females,age:(45±38)months;duration of disease:<6 months)with acute UTI diagnosed clinically in Wuxi People′s Hospital from January 2017 to June 2019 were enrolled retrospectively.All children underwent 99Tcm-DMSA renal static imaging and 99Tcm-DTPA renal dynamic imaging,and the regions of interest(ROI)were drawn manually to calculate the RRF of the right and left kidneys.The consistency of RRF evaluated by the two imaging methods was analyzed by Bland-Altman analysis,the correlation was analyzed by Pearson correlation analysis,and the difference was compared by the independent-sample t test.ResultsThe values of RRF measured with 99Tcm-DMSA and 99Tcm-DTPA were(52.27±14.53)%and(52.22±14.14)%for the left kidney(t=0.913,P>0.05),those for the right kidney were(47.73±14.53)%and(47.78±14.14)%(t=0.913,P>0.05),respectively.A significant positive correlation was found between the RRF measured with the two imaging methods both for left and right kidneys(r values:0.959,0.959;both P<0.01).Bland-Altman analysis showed that the average difference of RRF measured with the two imaging methods for left kidney was 0.1%and the 95%limits of agreement(LoA)was from-8.0%to 8.1%,those for right kidney were-0.1%and from-8.1%to 8.0%.ConclusionsThere is a good correlation between RRF measured with 99Tcm-DMSA renal static imaging and that measured with 99Tcm-DTPA renal dynamic imaging in children with acute UTI.Both imaging methods can be used to evaluate the RRF in children with acute UTI.