Yang Jigang,Wang Wei.Value of nuclear medicine renal imaging in the assessment of renal function in pediatric hydronephrosis[J].Journal of Clinical Pediatric Surgery,2021,20(04):307-311.[doi:10.12260/lcxewkzz.2021.04.002]
核医学肾脏显像对儿童肾积水患者分肾功能的评估价值
- Title:
- Value of nuclear medicine renal imaging in the assessment of renal function in pediatric hydronephrosis
- Keywords:
- Kidney/RI; Hydronephrosis/DI; Kidney Function Tests; Child
- 分类号:
- R726.9;R692.2
- 摘要:
- 核医学肾脏显像包括肾动态显像和肾静态显像。利尿肾动态显像如应用于儿童肾积水患者，在评估分肾功能的同时，可协助判断尿路梗阻的性质。由于婴儿肾脏肾小球发育不成熟，建议行肾动态显像时，<2岁患者使用肾小管分泌型显像剂99mTc-双半胱氨酸（99mTc-EC），>2岁者使用肾小球滤过型显像剂99mTc-喷替酸（99mTc-DTPA）。分析肾动态显像的分肾功能及肾图曲线时，需注意各种因素的影响。基于双血浆法的肾小球滤过率（glomerular filtration，GFR）评估肾功能较准确，但因有创、操作复杂而难于普遍应用于临床；基于肾动态显像法评估GFR的影响因素多，需综合判读。肾静态显像主要用于评估肾盂肾炎及肾脏瘢痕的病变范围及严重程度，也可用于评估分肾功能。近年来SPECT/CT在核医学领域广泛应用，如进行99mTc-DMSA SPECT/CT断层显像，可更准确地评估肾积水患者双肾功能。本文对核医学肾脏显像在儿童肾积水患者分肾功能评估中的价值进行评述。
- Abstract:
- In nuclear medicine, renal scan includes renal dynamic and static imaging.Diuretic renal dynamic imaging is recommended for pediatric hydronephrosis.It evaluates the nature of hydronephrosis while assessing differential renal function.Different radiotracers are utilized for renal dynamic scan of pediatric hydronephrosis.According to age, 99mTc-EC is recommended for children aged under 2 years and 99mTc-DTPA for those aged over 2 years.When analyzing renal function and renogram curve, clinicians should pay attention to various influencing factors.Glomerular filtration rate(GFR) based upon double plasma method is accurate.However, wider clinical applications are difficult.Based upon renal dynamic imaging, many influencing factors for GFR require comprehensive analyses.Renal static imaging is employed for evaluating the extent and severity of pyelonephritis and renal scar.Also renal function may be evaluated.There are fewer influencing factors of renal static imaging.With recent widespread applications of single photon emission computed tomography/computed tomography(SPECT/CT) in nuclear medicine, 99mTc-DMSA SPECT/CT tomography can more accurately assess the kidney function of pediatric hydronephrosis.This review discussed the uses of nuclear medicine renal imaging in evaluating renal function in pediatric hydronephrosis.
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备注/Memo
收稿日期:2021-01-18。
基金项目:国家自然科学基金（编号：81971642）
作者简介:杨吉刚,Email:yangjigang@ccmu.edu.cn